mometasone (implant)

Therapeutic Classification: corticosteroids, allergy, cold and cough remedies

Pharmacologic Classification: corticosteroids

Indications ⬆ ⬇

REMS

Propel

To maintain patency following ethmoid sinus surgery.

Sinuva

Chronic rhinosinusitis with nasal polyps in patients who have had ethmoid sinus surgery.

Action ⬆ ⬇

Stabilizes and separates nasal mucosal tissues, prevents obstruction caused by adhesions and decreases edema.

Therapeutic effects:

Decreased need for postoperative interventions such as lysis of adhesions and/or the need for corticosteroids.
Reduction in nasal obstruction/congestion and quantity of nasal polyps.

Pharmacokinetics ⬆ ⬇

Absorption: Action is local.

Distribution: Unknown.

Metabolism/Excretion: Primarily metabolized in the liver via the CYP3A4 isoenzyme.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
Implant	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to mometasone or any of the copolymers present in implant;
Nasal ulcers or trauma.

Use Cautiously in:

OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

EENT: epistaxis, nasal perforation

Neuro: headache

Resp: sinusitis, bronchitis

Misc: foreign body reaction, TOXIC SHOCK SYNDROME

Interactions ⬆ ⬇

Drug-drug:

Strong CYP3A4 inhibitors, including ketoconazole may ↑ levels and risk of toxicity.

Route/Dosage ⬆ ⬇

Sinus implant
(Adults ): One implant (1350 mcg) placed endoscopically.

Availability ⬆ ⬇

Implant (Sinuva): 1350 mcg in a bioabsorbable copolymer sinus implant

Assessment ⬆ ⬇

Monitor degree of nasal stuffiness, amount and color of nasal discharge, and frequency of sneezing.

Implementation ⬆ ⬇

Implant must be placed under endoscopic visualization.
- Routine debridement may be performed as part of the usual postoperative care.
- Implant may be removed at discretion of health care professional by use of suction, forceps, or other surgical instruments.

Patient/Family Teaching ⬆ ⬇

Explain purpose, procedure for placement of implant, and postoperative care.
Frequent use of saline sprays, rinses, or irrigations is recommended postoperatively.
Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes ⬆ ⬇

Maintenance of patency, prevention of obstruction by adhesions, and reduced edema following ethmoid sinus surgery.

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Pronunciation ⬇

Classifications ⬆ ⬇