Does local treatment of the nipples twice daily with Elucon (mometason) impose any risk to the nurs

Fråga: Does local treatment of the nipples twice daily with Elucon (mometason) impose any risk to the nursed infant?

Sammanfattning: The properties of mometason and the small area of exposure despite a possible impaired barrier function suggest that the risk of exposure for the lactating child by the breast-milk is small.

The possibility of an exposure per os is relevant, but due to rapid degradation of the substance by supposed first passage metabolism, the oral absorption may also be small.

Svar: Mometason is a group III local steroid classified as "IV a" which means "Information about any passage to breast milk is missing". The systemic absorption of mometason is estimated to be less than 1.0 per cent (1).

No specific information about mometason and breast-feeding was found in Drugline, Medline or in the literature.

According to a previous question the risk of absorption and systemic effects may be possible when fluorsubstituted local steroids are used on more than 25 per cent of the body surface (2).

No question about per os exposure by a lactating child when the mother is using local steroids on the nipples and the areolae, has been raised in Drugline before.

The area of exposure is very small and even if the barrier function may be impaired, the amount absorbed by the mother may be small, hence the exposure for the child by the breast-milk may also be small.

When the child is suckling, an intake per os of the agent may be possible. According to the manufacturer mometason is rapidly degradated after oral intake probably by first passage metabolism (3).

To reduce the risk of the oral exposition for the child it is suggested to first minimize the exposure of the agent and wait as long as possible to the next lactation after application. It may be appropriate to choose a less potent corticosteroid or to avoid treatment with the steroids and instead try an other treatment of the eczema.