AVOCOM 0.05% AQUA NASAL SP 120/SPRAYS

Indications

Approved Uses

Treatment of nasal symptoms of seasonal and perennial allergic rhinitis, Treatment of nasal congestion associated with seasonal allergic rhinitis, Prophylaxis of seasonal allergic rhinitis, Treatment of nasal polyps.

Off-Label Uses

Chronic rhinosinusitis (with or without nasal polyps as adjunct), non-allergic rhinitis; adenoid hypertrophy has also been used in pediatrics.

Dosage & Administration

Dosing by Condition

Seasonal/Perennial Allergic Rhinitis (Adults & adolescents ≥12 years): 2 sprays in each nostril once daily (total 200 mcg/day); may reduce to 1 spray in each nostril once daily for maintenance (100 mcg/day).
Seasonal/Perennial Allergic Rhinitis (Children 2-11 years): 1 spray in each nostril once daily (total 100 mcg/day).
Nasal Polyps (Adults ≥18 years): 2 sprays in each nostril twice daily (total 400 mcg/day); may reduce to 2 sprays in each nostril once daily once controlled.
Prophylaxis of seasonal allergic rhinitis (Adults ≥18 years): 2 sprays in each nostril once daily starting 2-4 weeks before expected pollen exposure.

Initial Dose

For Allergic Rhinitis (Adults & Children ≥12 years): 2 sprays in each nostril once daily (total dose 200 mcg).

Maintenance Dose

For Allergic Rhinitis: Once symptoms are controlled, dose may be reduced to 1 spray in each nostril once daily (total dose 100 mcg).

Maximum Dose

For Allergic Rhinitis: 4 sprays in each nostril once daily (total dose 400 mcg). For Nasal Polyps: 2 sprays in each nostril twice daily (total dose 400 mcg).

Children's Dosage

Children 2-11 years: 1 spray per nostril once daily (100 mcg/day) for allergic rhinitis. Not approved for nasal polyps in patients under 18 years.

Dose Adjustment Notes

No routine dose adjustment is required in renal or hepatic impairment due to low systemic bioavailability; titrate to the lowest effective dose for maintenance, and in children do not exceed the labeled pediatric maximum (typically 1 spray per nostril once daily).

How to Take

Blow the nose gently; shake well before each use (suspension). Prime the pump before first use (typically 10 sprays until a fine mist) and re-prime if not used for ≥1 week (typically 2 sprays). With head slightly forward, insert nozzle into one nostril aiming away from the nasal septum, close the other nostril, and spray while breathing in gently; repeat for the other nostril as prescribed. Wipe/clean the nozzle after use and replace the cap; avoid spraying into eyes.

How to Prepare

Shake well. Prime the pump before first use until a fine mist appears (commonly ~10 actuations); if not used for about 1 week or longer, re-prime with a few sprays (commonly 2) before dosing.

Side Effects

Common Side Effects

Epistaxis, headache, nasal irritation/burning/stinging, sneezing, pharyngitis/sore throat; upper respiratory tract infection can occur.

Side Effect Frequency

Very common: headache, epistaxis. Common: pharyngitis/upper respiratory symptoms, nasal irritation/burning/stinging, sneezing, nasal dryness. Uncommon/rare: nasal ulceration and (rare) nasal septal perforation; hypersensitivity reactions. Frequency not known/rare: blurred vision, increased intraocular pressure, glaucoma, cataract.

Safety & Warnings

Contraindications

Contraindication: hypersensitivity to mometasone furoate or any excipients; Do not use in the presence of untreated localized infection involving the nasal mucosa; avoid use after recent nasal surgery/trauma until healing is complete.

Warnings & Precautions

Use caution with active/quiescent TB and untreated fungal/bacterial/viral infections; monitor for epistaxis/irritation and rare septal perforation; monitor growth in children with long-term use; monitor for glaucoma/cataracts with prolonged use; avoid use until healing after nasal surgery/trauma; counsel immunosuppressed patients about exposure to infections (e.g., varicella/measles); consider adrenal insufficiency risk when switching from systemic steroids; avoid eye contact.

Age Restriction

Allergic rhinitis: approved for ≥2 years; Nasal polyps: approved for adults ≥18 years (not indicated <18).

Driving Warning

Safe

Drug Interactions

Drug Interactions

Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir/cobicistat) may increase systemic corticosteroid exposure; additive systemic effects possible with other corticosteroids (systemic/inhaled/high-dose topical).

Interaction Severity

Clinically significant interaction with strong CYP3A4 inhibitors (e.g., ritonavir/cobicistat, ketoconazole): increased systemic corticosteroid exposure-avoid or use with caution and monitor for systemic steroid effects.

Food Interaction

No restriction

Alcohol Interaction

Safe

Special Populations

Pregnancy

Caution

Breastfeeding

Caution

Children

Children 2-11 years: 1 spray per nostril once daily (100 mcg/day) for allergic rhinitis. Not approved for nasal polyps in patients under 18 years.

Elderly

Standard adult dosing.

Kidney Impairment

No adjustment needed

Liver Impairment

No specific dose adjustment recommended; use with caution in severe hepatic impairment.

Storage & Patient Advice

Preparation Instructions

Shake well. Prime the pump before first use until a fine mist appears (commonly ~10 actuations); if not used for about 1 week or longer, re-prime with a few sprays (commonly 2) before dosing.

Missed Dose

Use the missed dose as soon as remembered the same day; if it is close to the next scheduled dose, skip the missed dose and resume the regular schedule-do not double doses.

Stopping the Medicine

Do not stop abruptly if used regularly for a prolonged period or at higher-than-recommended doses; taper/discontinue under prescriber guidance to minimize risk of symptom rebound and potential adrenal suppression. If used short-term at usual intranasal doses, stopping is generally acceptable but symptoms may recur-follow the prescriber’s plan.

Overdose

Acute overdose is unlikely to cause toxicity; chronic excessive use may cause systemic corticosteroid effects (e.g., hypercorticism/adrenal suppression)-manage with clinical observation and reduction to recommended dosing/supportive care.

Patient Counseling

Use AVOCOM (mometasone furoate) intranasally exactly as prescribed and regularly (daily) for best control; it is not for immediate relief and full benefit may take ~1-2 weeks. Shake well before each use. Prime before first use until a fine mist appears and re-prime if not used for several days (per product leaflet). Aim the nozzle slightly outward (away from the nasal septum), avoid spraying into eyes, and do not exceed the prescribed sprays. Seek medical advice for persistent/recurrent nosebleeds, nasal sores/ulceration, white patches (possible candidiasis), or any vision changes (blurred vision, glaucoma/cataract symptoms). Store below 30°C. Prescription-only; do not share. Children should be supervised during administration.

Monitoring Requirements

Periodically inspect nasal mucosa/septum for irritation, ulceration, candidiasis, or epistaxis; monitor growth in children with long-term use; consider ocular monitoring (glaucoma/cataracts) and HPA-axis/systemic steroid effects if prolonged high-dose use or with strong CYP3A4 inhibitors.

Pharmacology

Mechanism of Action

Binds glucocorticoid receptors to downregulate inflammatory gene transcription and inhibit release of pro-inflammatory mediators (e.g., cytokines, eicosanoids) and inflammatory cell recruitment, reducing nasal mucosal inflammation.

Onset of Action

Some symptom improvement may occur within ~12 hours, but maximal benefit typically requires several days and up to 1-2 weeks of regular daily use.

Duration of Effect

Approximately 24 hours (supports once-daily dosing for allergic rhinitis when controlled).

Bioavailability

<1% systemic bioavailability after intranasal administration (very low/usually not measurable).

Metabolism

Extensive hepatic metabolism, primarily via CYP3A4, to inactive metabolites (marked first-pass effect).

Excretion

Excreted mainly as metabolites in feces via biliary elimination, with a small fraction in urine (e.g., ~74% feces and ~8% urine reported after systemic dosing).

Protein Binding

98-99%.

Product Information

Available Dosage Forms

Nasal spray, suspension (aqueous nasal spray).

Composition per Dose

Each spray (100 mg): Mometasone furoate monohydrate equivalent to mometasone furoate 50 mcg (0.05%)

Generic Availability

Yes

OTC Alternatives

No direct OTC equivalent to prescription mometasone nasal spray; OTC options for symptom relief include saline nasal sprays/irrigation, and OTC availability of other intranasal steroids (e.g., fluticasone, budesonide) is region- and country-specific and should be verified locally.

Symptom Target

Allergy, Congestion, Runny Nose

Sedating

No

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 16-07-2026