Are mometasone and dexamethasone equally potent steroids?/nBackground: The questioner wishes to kno

Fråga: Are mometasone and dexamethasone equally potent steroids?

Background: The questioner wishes to know if there is any difference in potency between Elocon (mometasone) solution for skin and Decadron (dexamethasone) eye and ear drops if the drugs are administered in the ear.

Sammanfattning: According to pharmacological handbooks, mometasone is more potent than dexamethasone if it is given solved in the same vehicle and administered in the same way.

Svar: The potency of a corticosteroid is dependent on the vehicle it is solved in and the way of administration. In order to compare the potency of mometasone and dexamethasone, the substances have to be solved in the same vehicle and administered in the same way.

In Goodman and Gilman (1) topical glucocorticoids have been grouped into seven classes in order of decreasing potency. The potency is measured using a vasoconstrict assay, in which an agent is applied to skin under occlusion and the area of skin blanching is assessed, and a psoriasis bioassay, in which the effect of the steroid on psoriatic lesions is quantified.

According to this system mometasone cream 0.1 per cent (Elocon) belongs to class six and dexamethasone cream 0.1 per cent (Decadron) belongs to class seven.

AMA Drug Evaluations (2) has a similar system with seven groups in order of decreasing potency. The potency is determined in the same way as in Goodman and Gilman but here mometasone cream is 0.1 per cent (Elocon, Schering) classified as group four and dexamethasone is 0.1 per cent (Decadron phosphate, Merck) classified as group seven.

A thorough literature search including Medline, Drugline and common pharmacological handbooks gave no studies where mometasone and dexamethasone were compared.

Elocon solution for skin (mometasone) and Decadron ear drops (dexamethasone) are solved in similar (but not identical) vehicles and are planned to be administered in the same way. A comparison should therefore be possible in the same way as with creams. Elocon is probably more potent than Decadron. 1 Goodman and Gilman, The pharmacological basis of therapeutics. 1996; 9th ed: 2 Americal Medical Association, Drug evaluations. Annual 1995