Drug Guide
Mometasone Furoate; Olopatadine Hydrochloride
Classification
Therapeutic: Allergic Rhinitis, Seasonal and Perennial
Pharmacological: Antihistamine and Corticosteroid Combination
FDA Approved Indications
- Treatment of symptoms of seasonal allergic rhinitis (hay fever) and perennial allergic rhinitis in adults and children aged 12 years and older
Mechanism of Action
Mometasone Furoate is a corticosteroid that reduces inflammation by inhibiting multiple types of inflammatory mediators. Olopatadine Hydrochloride is a selective H1-antihistamine that blocks histamine at H1-receptor sites, preventing allergic responses.
Dosage and Administration
Adult: Two sprays per nostril twice daily as recommended, dose may be adjusted based on severity.
Pediatric: Not approved for children under 12 years. For those aged 12 and older, follow adult dosing.
Geriatric: No specific adjustment needed, but assess individual response.
Renal Impairment: No specific adjustment required.
Hepatic Impairment: No specific adjustment required.
Pharmacokinetics
Absorption: Rapid when administered intranasally.
Distribution: Mometasone Furoate has extensive tissue distribution; olopatadine binds to tissue and plasma proteins.
Metabolism: Primarily hepatic via CYP3A4 (mometasone); olopatadine undergoes first-pass metabolism in the liver.
Excretion: Fecal and urinary routes; metabolites excreted, parent drugs minimally.
Half Life: Mometasone: ~6 hours; Olopatadine: ~12 hours.
Contraindications
- Hypersensitivity to mometasone, olopatadine, or any component of the formulation.
Precautions
- Use with caution in patients with nasal infections, untreated local nasal infections, or recent nasal surgery or injury.
- Monitor for signs of nasal bleeding or crusting.
Adverse Reactions - Common
- Nasal irritation or burning (Common)
- Bad taste or smell (Common)
- Headache (Less Common)
Adverse Reactions - Serious
- Nasal septum perforation (Rare)
- Oral or pharyngeal candidiasis (Uncommon)
Drug-Drug Interactions
- Potential increased systemic corticosteroid effects when used with other corticosteroids.
- No significant interactions reported with antihistamines.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Assess nasal and respiratory symptoms, nasal mucosa condition, and for any adverse reactions.
Diagnoses:
- Ineffective breathing pattern related to nasal congestion
- Risk for infection related to nasal corticosteroid use.
Implementation: Administer as prescribed, educate on proper spray technique, and monitor for side effects.
Evaluation: Assess symptom relief and side effects, adjust dose if necessary.
Patient/Family Teaching
- Use medication regularly, even if asymptomatic.
- Instructions on correct nasal spray technique.
- Report new or worsening symptoms like nasal bleeding, irritation.
- Avoid blowing nose immediately after administration.
Special Considerations
Black Box Warnings:
- None specifically for Ryaltris
Genetic Factors: No known significant genetic considerations.
Lab Test Interference: May affect cortisol levels due to corticosteroid component.
Overdose Management
Signs/Symptoms: Nasal irritation, headache, or systemic corticosteroid effects in case of excessive use.
Treatment: Discontinue medication; symptomatic treatment as needed.
Storage and Handling
Storage: Store at room temperature away from moisture and heat.
Stability: Stable under recommended storage conditions.