Who should not use mometasone furoate? A guide to contraindications and warnings

October 9, 2025 •

4 min read

Mometasone furoate is a powerful corticosteroid used to treat conditions like allergies and skin inflammation, but certain health issues, allergies, and patient groups mean some individuals should not use mometasone furoate. Understanding these contraindications and warnings is crucial for safe medication use and avoiding potentially serious complications.

Quick Summary

This guide covers key warnings for mometasone furoate, detailing who should avoid its use due to allergies, active infections, recent surgery, or specific health conditions. It also discusses age restrictions and use during pregnancy or breastfeeding.

Key Points

Known Allergy: Anyone with a history of allergic reactions to mometasone furoate or other corticosteroids should not use this medication.
Untreated Infections: Avoid use with active, untreated infections, including fungal, bacterial, viral (such as herpes), chickenpox, or measles, as it can suppress the immune system.
Recent Surgery or Trauma: Do not use nasal spray after recent nasal surgery or injury, or if there are sores inside the nose, until healing is complete.
Specific Medical Conditions: Patients with certain eye problems (glaucoma, cataracts), endocrine disorders (Cushing's syndrome, adrenal insufficiency), diabetes, or liver disease should use with caution and under medical supervision.
Children: Age restrictions vary by formulation. Mometasone can affect growth in children, so long-term use is closely monitored.
Pregnancy and Breastfeeding: Consultation with a healthcare provider is necessary, and caution is advised.
Improper Application: Avoid topical use on the face, groin, underarms, broken skin, or in the diaper area unless specifically instructed by a doctor.

Mometasone furoate is a highly effective corticosteroid available in various formulations, including nasal spray and topical creams or ointments. While it offers significant relief for many people, it is not suitable for everyone. Using it when contraindicated can lead to serious side effects or worsen existing medical conditions. This guide breaks down the key patient groups and medical situations where mometasone furoate should be avoided.

Absolute Contraindications and Allergic Reactions

The most fundamental reason to avoid mometasone furoate is a known allergy or hypersensitivity to the drug itself or any of its inactive ingredients. Allergic reactions can be severe and may include wheezing, hives, rash, itching, or swelling of the face, lips, and tongue. In severe cases, anaphylaxis may occur, which is a life-threatening emergency. If you have a history of such a reaction to corticosteroids, you should not use this medication. Always inform your doctor or pharmacist about any known allergies before starting a new medication.

Patients with Active Infections

Mometasone is an immunosuppressant, meaning it can weaken the body's immune response. For this reason, it is generally contraindicated for use by individuals with active, untreated infections, as it could worsen the condition or allow the infection to spread.

Specific infections to be aware of include:

Herpes simplex: Specifically, ocular herpes simplex (an infection of the eye) requires extreme caution.
Tuberculosis: Both active and inactive (quiescent) infections of the respiratory tract should be discussed with a doctor.
Fungal or viral infections: Untreated systemic infections fall under this category. Topical formulations should not be used on skin infections like acne, rosacea, or shingles.
Chickenpox and measles: Unexposed individuals should avoid contact with infected people while using mometasone, as contracting these illnesses can be more severe. Prophylactic treatment may be needed after exposure.

Surgical and Injury-Related Restrictions

For nasal formulations of mometasone, patients with recent nasal surgery, trauma, or unhealed ulcers in the nose should not use the spray. The medication's immunosuppressive and anti-inflammatory properties can inhibit or delay wound healing, and direct application to a wound can cause further damage. It is essential to wait for complete healing before starting or resuming treatment.

Individuals with Eye Conditions

Both nasal and topical corticosteroids have been associated with ophthalmic issues. Individuals with a history of or pre-existing glaucoma or cataracts should exercise caution. Regular eye exams may be recommended for long-term users. Report any vision changes, such as blurred vision, halos around lights, or eye pain, to a healthcare provider immediately.

Endocrine System Conditions

Long-term or high-dose use of mometasone can affect the hypothalamic-pituitary-adrenal (HPA) axis, leading to adrenal suppression and potential issues like Cushing's syndrome. Patients with pre-existing adrenal gland disorders, diabetes, or hyperglycemia should be monitored closely. Symptoms of adrenal suppression include fatigue, muscle weakness, and weight loss. Children are particularly susceptible to these systemic effects due to their larger skin surface-to-body mass ratio.

Age-Specific and Pregnancy Restrictions

Children: Age limits are in place for safety. Topical cream and ointment are generally not recommended for children under 2 years of age. Topical lotion is not recommended for children under 12. Nasal spray for allergic rhinitis is typically approved for children as young as 2 or 3, but the dosage and duration are crucial. Long-term use in children can cause growth suppression.
Pregnancy and Breastfeeding: While studies suggest low risk, pregnant or breastfeeding individuals should consult their doctor before using mometasone. For topical use, it's advised to use the smallest amount possible for a short duration and avoid application on the breasts while breastfeeding.

Comparison of Risks for Nasal vs. Topical Mometasone


Condition / Factor	Nasal Mometasone (e.g., Nasonex)	Topical Mometasone (e.g., Elocon)
Known Allergy	Contraindicated due to risk of severe systemic allergic reaction.	Contraindicated due to risk of severe systemic allergic reaction.
Active Infections	Avoid with nasal sores, untreated fungal, bacterial, or viral infections.	Avoid on infected skin, including acne, rosacea, shingles, or untreated bacterial infections.
Recent Trauma	Avoid with recent nasal surgery, trauma, or ulcers until healed.	Avoid on broken skin, cuts, or unhealed wounds.
Children's Age Limit	Varies by indication: 2+ for allergic rhinitis, 12+ for polyps.	2+ for creams/ointments, 12+ for lotions. Not for diaper dermatitis.
HPA Axis Suppression	Risk exists, especially with higher doses or prolonged use.	Risk is higher with use over large areas, occlusive dressings, or prolonged use.
Eye Conditions	Potential for glaucoma and cataracts; requires caution and monitoring.	Potential for glaucoma and cataracts, avoid contact with eyes.
Site of Application	Nasal use only; do not spray into eyes or mouth.	Avoid on face, groin, underarms, or diaper area unless directed.

Conclusion

While mometasone furoate provides effective relief for many, its use is not universal. Patients with a history of allergic reactions, active infections, or recent surgery should refrain from using it. Special caution is warranted for individuals with certain medical conditions, including glaucoma, cataracts, diabetes, or endocrine disorders. Age restrictions apply, particularly for children, and pregnant or breastfeeding individuals should consult their healthcare provider. Always provide your doctor with a full medical history and disclose all other medications, supplements, and vitamins to ensure the safe and appropriate use of mometasone furoate. Discontinue use and contact a doctor if symptoms worsen or if any new side effects arise. MedlinePlus: Mometasone Nasal Spray offers further details and patient information.

Frequently Asked Questions

No, you should not use topical mometasone on broken skin or infected areas unless your doctor specifically directs you to. Its immunosuppressive properties can worsen the infection. Topical use is also not recommended for conditions like acne or rosacea.

Mometasone nasal spray should not be used by individuals with known allergies to the product, untreated nasal infections, recent nasal trauma or surgery, or certain eye conditions like glaucoma and cataracts. It is also not recommended for children under 2 years of age for allergic rhinitis.

Yes, age restrictions vary by the formulation. For topical cream/ointment, it is generally not for use in children under 2 years old. For nasal spray, it is not recommended for children under 2 for allergic rhinitis.

Pregnant or breastfeeding individuals should consult a healthcare provider before use. For topical use, it's recommended to use the lowest dose for the shortest period, and avoid application on the breasts while breastfeeding.

Mometasone should be used with caution in patients with diabetes, as it can affect blood sugar levels. Your doctor will monitor you closely if use is necessary.

Yes, mometasone can interact with other drugs, particularly strong CYP3A4 inhibitors like ritonavir and ketoconazole, which can increase systemic exposure. Always inform your doctor about all medications and supplements you take.

Using topical mometasone on an infant's diaper area is not recommended because diapers act as an occlusive dressing, increasing the absorption of the medicine and raising the risk of systemic side effects.