Olopatadine / mometasone

Class
Antihistamines / glucocorticoids
Subclass
Second-generation H1-antihistamine / glucocorticoid combination
Substance name
Olopatadine / mometasone
Brand names
Ryaltris®
Contains
Mometasone
Olopatadine
Common formulations
Nasal spray
Dosage and administration
Adults patients
Symptomatic relief of allergic rhinitis • Seasonal
•
2 spray(s) per nostril IN BID (665/25 mcg per spray)
Indications for use
Labeled indications
Adults
•
Symptomatic relief of allergic rhinitis (seasonal)
Safety risks
Contraindications
Hypersensitivity to olopatadine/mometasone or its components
Warnings and precautions
Glaucoma, cataract
•
Maintain a high level of suspicion, as mometasone has been associated with an increased risk of glaucoma, increased intraocular pressure, and cataracts.
Growth delay
•
Use caution in pediatric patients.
Hypothalamic-pituitary-adrenal axis suppression, Cushing's syndrome
•
Use caution in patients receiving high doses or susceptible patients receiving regular doses.
Immunosuppression
•
Use caution in patients with active or latent tuberculous, systemic fungal, bacterial, viral, or parasitic infections, or ocular herpes simplex.
Increased serum mometasone levels
•
Use caution in patients taking strong CYP3A4 inhibitors, such as ritonavir, cobicistat-containing products, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, and telithromycin.
Nasopharyngeal candidiasis
•
Maintain a high level of suspicion, as mometasone has been associated with an increased risk of nasopharyngeal candidiasis.
Nosebleed, nasal ulcers, nasal septum perforation, delayed wound healing
•
Maintain a high level of suspicion, as olopatadine/mometasone has been associated with an increased risk of local nasal effects.
Somnolence
•
Use extreme caution in patients performing activities requiring mental alertness, such as driving or operating machinery.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
No guidance available.
Renal replacement therapy
Any modality
•
No guidance available.
Hepatic impairment
Any severity
•
Use with caution. Monitor for increased mometasone exposure.
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals.
Breastfeeding
Use only if benefits outweigh potential risks.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Common 1-10%
•
Dysgeusia, nosebleed, nasal discomfort
Uncommon < 1%
•
Somnolence
Unknown frequency
•
Anaphylaxis, oropharyngeal candidiasis, glaucoma, cataract, immunosuppression, adrenal suppression, Cushing's syndrome, asthma, bronchitis, dysmenorrhea, musculoskeletal pain, pharyngitis, arthralgia, chest pain, conjunctivitis, diarrhea, dyspepsia, ear pain, myalgia, nausea, flu-like symptoms, rhinitis, bitter taste, throat pain, cough, postnasal drip, ↑ serum CK, dry mouth, fatigue, throat irritation, skin rash, fever, cough, headache, nasal irritation, angioedema, change in taste, change in smell, blurred vision, nasal septum perforation, wheezing, growth delay, sinusitis, urinary tract infections, upper respiratory tract infections, viral infections
Interactions
Drug(s)
Check Interactions
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