1. Clinical Overview
Mometasone furoate 0.1% w/w is a potent, synthetic, topical corticosteroid of the glucocorticoid class. It exerts anti-inflammatory, anti-pruritic, and vasoconstrictive actions. It is a medium-potency steroid (Class 3-4) and is a mainstay in the treatment of various steroid-responsive dermatoses in the Indian clinical setting due to its favorable efficacy-to-safety ratio and once-daily dosing.
| Onset | Duration | Bioavailability |
|---|---|---|
| Clinical improvement in pruritus and erythema is typically observed within 3-5 days of starting therapy. | The anti-inflammatory effect persists for 24 hours, allowing for once-daily application. | Topical bioavailability is low, estimated at <1% for intact skin. It increases significantly with application to inflamed skin, occlusive dressings, or on thin skin areas (e.g., face, groin). |
2. Mechanism of Action
Mometasone furoate acts by diffusing across cell membranes and binding with high affinity to cytoplasmic glucocorticoid receptors. The activated receptor complex translocates to the cell nucleus, where it modulates gene transcription. It induces the synthesis of anti-inflammatory proteins (lipocortin-1) and inhibits the synthesis of pro-inflammatory mediators.
3. Indications & Uses
- Corticosteroid-responsive dermatoses (e.g., Atopic Dermatitis, Contact Dermatitis)
- Psoriasis (plaque-type)
- Seborrheic Dermatitis
- Lichen Planus
4. Dosage & Administration
Adult Dosage: Apply a thin film to the affected area once daily. The total duration should not exceed 4 weeks for most conditions without medical supervision.
Administration: 1. Wash and dry hands and affected area. 2. Apply a thin film and rub gently until it disappears. 3. Do not bandage or cover the area unless directed by a physician (occlusion increases absorption). 4. Avoid contact with eyes, mouth, nose, and mucous membranes. 5. Wash hands after application unless hands are the treatment area.
5. Side Effects
Common side effects may include:
- Local burning or stinging sensation
- Skin dryness
- Itching at application site
- Folliculitis
6. Drug Interactions
| Drug | Effect | Severity |
|---|---|---|
| Other Topical Corticosteroids | Additive risk of local and systemic adverse effects. | Major |
| Topical Immunosuppressants (e.g., Tacrolimus, Pimecrolimus) | May be used in sequential therapy but concurrent use on same area may increase infection risk. | Moderate |
| CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Clarithromycin) | May theoretically increase systemic levels of mometasone if significantly absorbed, increasing adverse effect risk. | Moderate |
7. Patient Counselling
- DO use exactly as prescribed by your doctor.
- DO apply a thin layer only.
- DO wash hands before and after application (unless hands are treated).
- DON'T use on the face, groin, or armpits unless directed.
- DON'T cover or bandage the area (occlude) unless told to do so.
- DON'T use for longer than the prescribed duration.
- DON'T use on broken, infected, or ulcerated skin.
8. Toxicology & Storage
Overdose: Topical overdose can lead to: 1) Local: Severe skin atrophy, striae, ulceration, hypersensitivity. 2) Systemic: Symptoms of hypercorticism (Cushing's syndrome) - moon face, central obesity, hypertension, hyperglycemia, HPA axis suppression leading to adrenal insufficiency.
Storage: Store at room temperature (15-30°C). Protect from light and moisture. Do not freeze. Keep the tube tightly closed. Keep out of reach and sight of children.