Mometasone furoate is a potent synthetic corticosteroid available in multiple topical formulations, each targeting different anatomical sites: nasal spray (50 micrograms per actuation) for allergic rhinitis, skin cream and ointment (0.1%) for dermatological conditions, and inhaler for asthma. Its anti-inflammatory and immunosuppressive properties make it effective across all of these applications.

Mometasone is notable within the corticosteroid class for its favourable benefit-to-risk profile: it has high topical potency and anti-inflammatory efficacy alongside very low systemic bioavailability. Following nasal or inhaled administration, less than 1% is absorbed systemically — substantially lower than many comparable corticosteroids — meaning it delivers powerful local anti-inflammatory effects with minimal impact on the hypothalamic-pituitary-adrenal (HPA) axis or other systemic corticosteroid effects at standard doses.

The nasal spray (Nasonex) is one of the most widely prescribed treatments for seasonal and perennial allergic rhinitis and is the only topical nasal corticosteroid licensed in the UK for the treatment of nasal polyps. The skin formulations are classified as potent topical corticosteroids, appropriate for moderate-to-severe inflammatory skin conditions that have not responded to milder steroids.

Prescription mometasone formulations are prescription-only medications in the UK. A licensed clinician must assess your condition before prescribing.

Mometasone is indicated for:

Mometasone furoate exerts its therapeutic effects by binding with high affinity to intracellular glucocorticoid receptors, which are present in virtually all cell types. The drug-receptor complex translocates to the cell nucleus, where it modulates the transcription of numerous genes involved in the inflammatory cascade.

The principal anti-inflammatory effects include: suppression of the production of pro-inflammatory cytokines (including interleukins IL-1, IL-3, IL-4, IL-5, IL-6, and GM-CSF), inhibition of histamine release from mast cells, reduction of prostaglandin and leukotriene synthesis (via upregulation of lipocortin/annexin-1, which inhibits phospholipase A2), and decreased recruitment and activation of eosinophils, neutrophils, and lymphocytes at sites of inflammation.

In the nasal mucosa, this reduces mucosal oedema, vascular permeability, and inflammatory cell infiltration — directly addressing the pathophysiology of allergic rhinitis and nasal polyposis. On the skin, the anti-inflammatory and antiproliferative effects reduce erythema, pruritus, scaling, and epidermal thickening associated with inflammatory dermatoses.

The high lipophilicity of mometasone furoate promotes exceptional tissue penetration and retention, with rapid first-pass hepatic inactivation contributing to its very low systemic bioavailability via topical routes.

The correct dose depends on the type and severity of infection, age, weight, and kidney function. Always follow your clinician's instructions. The table below is for general reference only.

For the nasal spray — blow the nose gently before use. Shake the bottle well. Tilt the head slightly forward, insert the nozzle into the nostril while aiming away from the nasal septum, and spray while breathing in gently through the nose. Breathe out through the mouth.

For the skin cream or ointment — apply a thin layer to the affected area only. Do not apply to normal skin, and avoid application to the face, groin, or axillae unless specifically directed — these are areas where skin is thinner and absorption is highest.

Do not cover treated skin with occlusive dressings (cling film, tight bandages) unless directed — this dramatically increases systemic absorption and local side effects.

For the inhaler — use correct technique as for any preventer inhaler; rinse mouth and gargle with water after each use to prevent oral candidiasis.

Use the nasal spray consistently every day — do not use intermittently as needed; unlike decongestants, it must be used regularly for full effect.

Systemic side effects are rare at recommended doses due to very low systemic bioavailability. Local side effects are the main concern.

Mometasone may interact with other medications, including strong CYP3A4 inhibitors. Always inform your clinician about all medications you are taking.

Getting advice no longer means sitting in a waiting room. Through The GP Service, you can consult with a licensed clinician in minutes — from home, on your lunch break, or wherever works for you. If treatment is clinically appropriate, your clinician can issue a prescription during the consultation. A consultation does not guarantee a prescription.