Do not use Nasonex if:⁷

• the patient is allergic (hypersensitive) to mometasone furoate or any other ingredients of this medicine
• the patient has an untreated infection in their nose. Use of Nasonex during an untreated infection in your nose, such as herpes, can worsen the infection. The patient should be advised to wait until the infection is resolved before starting to use the nasal spray
• the patient has recently had an operation on their nose or has injured their nose. The patient should be advised to wait until their nose has healed

The safety and efficacy of Nasonex nasal spray in children under 3 years of age have not been established.¹

PRECAUTIONS¹
Immunosuppression: Use with caution, if at all, in patients with active or quiescent pulmonary tuberculosis, or untreated fungal, bacterial or systemic viral infections. Warn patients who are potentially immunosuppressed of the risk of exposure to certain infections (eg chickenpox, measles) and to seek medical advice. Local nasal effects: Monitor for changes in the nasal mucosa with prolonged use. Treat appropriately or discontinue Nasonex treatment if localised fungal infection of the nose or pharynx develops. Nasonex contains benzalkonium chloride which may cause nasal irritation. Consider discontinuing treatment if persistent nasopharyngeal irritation occurs. Do not use in patients with nasal septum perforation. Systemic effects of corticosteroids: Systemic effects of nasal corticosteroids may occur, particularly at high doses prescribed for long periods. These may include Cushing’s syndrome, Cushingoid features, adrenal suppression, growth retardation in children and adolescents, and more rarely, a range of psychological or behavioural effects including psychomotor hyperactivity, sleep disorders, anxiety, depression or aggression (particularly in children). Visual disturbance has also been reported. Consider referral to an ophthalmologist if blurred vision or other visual disturbances occur to evaluate possible causes, which may include cataract, glaucoma or central serous chorioretinopathy. Patients transferred from long-term administration of systemically active corticosteroids may exhibit signs and symptoms of adrenal insufficiency or symptoms of withdrawal and systemic corticosteroid administration may need to be resumed. Such transfer may also unmask pre-existing allergic conditions. If there is evidence of use of higher than recommended doses that could result in clinically significant adrenal suppression, consider additional systemic corticosteroid cover during periods of stress or elective surgery. Nasal polyps: Safety and efficacy has not been studied for the treatment of unilateral polyps, polyps associated with cystic fibrosis, or polyps that completely obstruct the nasal cavities. Effects on growth in paediatric population: Regularly monitor the height of children receiving prolonged treatment with nasal corticosteroids. If growth is slowed, therapy should be reviewed with the aim of identifying the lowest effective dose and consider referral to a paediatric specialist. Non-nasal symptoms: Concomitant use of additional therapy may provide additional relief of other symptoms, particularly ocular symptoms. Drug interactions: Co-treatment with CYP3A inhibitors, including cobicistat-containing products, is expected to increase the risk of systemic side effects. The combination should be avoided, unless the benefit outweighs the risk.

For full safety information, please see the Summary of product characteristics¹

Adverse effects of Nasonex commonly reported in clinical trials in adult and adolescent patients include headache, epistaxis, pharyngitis, upper respiratory tract infection,^† nasal burning, nasal irritation, nasal ulceration and throat irritation.^1‡

Refer to Summary of Product Characteristics for complete information on adverse effects

†Recorded at uncommon frequency for twice-daily dosing for nasal polyposis.
‡Recorded for twice-daily dosing for nasal polyposis.