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Corticosteroids - topical (skin), nose, and eyes - Management
Basis for recommendation

  • CKS found no studies on the effects of intranasal corticosteroids on pregnancy and breastfeeding.
  • The manufacturer of Nasonex® (mometasone furoate) recommends that, as with other nasal corticosteroids, it should not be used in pregnancy or lactation unless the potential benefit to the woman justifies any potential risk to the woman and the fetus or infant [ABPI Medicines Compendium, 2008a].
    • There are no adequate or well-controlled studies in pregnant women. Following intranasal administration of the maximal recommended clinical dose, the plasma concentration of mometasone is not measurable; thus fetal exposure is expected to be negligible and the potential for reproductive toxicity very low [ABPI Medicines Compendium, 2008a].
  • The manufacturer of Flixonase® (fluticasone propionate) recommends that the possible benefits of the drug is weighed against the possible hazards before using it in pregnancy or breastfeeding [ABPI Medicines Compendium, 2010a].
    • Administration of corticosteroids to pregnant animals can cause abnormalities of fetal development (including cleft palate and intra-uterine growth retardation). However, these effects occurred after very high systemic exposure. In contrast, direct intranasal application ensures minimal systemic exposure.
    • There may be a very small risk of such effects in the human fetus [ABPI Medicines Compendium, 2010a].

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