Cymbalta
Asmanex Twisthaler
Mometasone Furoate
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Asmanex Twisthaler 200mcg
Mometasone Furoate
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Asmanex Twisthaler 400mcg
Mometasone Furoate
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Asmanex Twisthaler (Mometasone Furoate)

What is Asmanex Twisthaler?

Mometasone Furoate belongs to a class of medications called corticosteroids. It is used by asthmatics aged 4 and over to prevent asthma symptoms however will not provide relief from an asthma attack. Instead, Asmanex Twisthaler can help to prevent asthma attacks from happening. It is more effective if it is used regularly by asthma sufferers.

How does it work?

Asmanex Twisthaler is a steroid that stops the body from releasing substances that lead to inflammation. It helps to control asthma symptoms, and asthma attacks and stop the lungs’ airways from swelling up.

Ingredients

100 µg/ inhalation

Each metered inhalation contains 100 µg of mometasone furoate. The nonmedicinal ingredients include lactose anhydrous.

200 µg/ inhalation

Each metered inhalation contains 200 µg of mometasone furoate. The nonmedicinal ingredients include lactose anhydrous.

400 µg/ inhalation

Each metered inhalation contains 400 µg of mometasone furoate. The nonmedicinal ingredients include lactose anhydrous.

Dosage

For children between the ages of 4 to 11, the typical recommended dose is 100 µg to be inhaled orally, once daily each evening.

For adults and children over the age of 12, the typical recommended dose is 200 µg to 400 inhaled orally, once daily each evening.

Patients who have been using high doses of inhaled steroids may respond more positively to 200 µg inhaled twice daily. 800 µg is the maximum dose each day.

Depending on how well Asmanex Twisthaler is working for the patient, their doctor may either increase or decrease the dose. Once the patient’s breathing has improved, the dose should be kept as low as possible to keep the patient’s asthma under control. If a patient’s asthma symptoms become worse while using mometasone furoate, their doctor may increase their dose or instruct them to use it more often.

Patients should follow the instructions to use the inhaler correctly. If they have any concerns, they should ask their doctor or pharmacist. Patients may not be able to sense the powder entering their mouth or their lungs as it will be difficult to detect such a small amount of powder in each dose.

If the patient’s doctor advises them to stop taking Asmanex Twisthaler, they should not suddenly stop using it. Instead, they should gradually taper off to avoid exacerbating the symptoms.

To help avoid developing a yeast infection (thrush) in the mouth, patients should rinse their mouth and gargle after each inhalation.

Asmanex Twisthaler will not help to relieve the effects of an asthma attack that is already in progress. Mometasone furoate is meant to help to prevent asthma symptoms. Patients should not use Asmanex Twisthaler when experiencing an asthma attack. Instead, patients should use their “reliever” medication, such as salbutamol or terbutaline. It will be necessary to use these fast-action medications with mometasone furoate.

Overdose

A severe overdose of mometasone furoate could lead to symptoms of hypercorticism.

If the patient or anyone else has overdosed on mometasone furoate, a doctor should be contacted. If someone has collapsed or is no longer breathing after using the medication, emergency services should be contacted.

Side Effects

If patients are concerned about side effects after taking this medication, they should discuss the possible risks and potential benefits with their doctor. Many of these side effects may disappear over time or can be managed. A pharmacist should be able to make recommendations for managing these side effects. However, the patient should contact their doctor if the side effects become severe or significantly uncomfortable.

Not everyone who takes this medication will experience side effects. However, at least 1% of people taking this medication have experienced the side effects listed below.

  • burning or painful sensation on the tongue
  • constipation
  • decreased appetite
  • diarrhea
  • dizziness
  • dry mouth or throat
  • ear pain
  • fatigue
  • headache
  • hoarseness or loss of voice
  • increased saliva production
  • increased sweating
  • muscle and joint pain or stiffness
  • nasal congestion
  • nausea
  • sore throat or mouth
  • red or itchy eyes
  • stomach ache
  • thirst
  • upset stomach
  • vomiting

More serious side effects

These serious side effects are rare but can cause severe issues if they are not addressed. If a patient experiences any of these, they should see their doctor as soon as possible.

  • cough
  • fever
  • irregular menstrual bleeding
  • migraine
  • osteoporosis or bone fractures
  • pins and needles or numb arms or legs, sinus pain and congestion, worsening breathing problems (Churg-Strauss Syndrome)
  • signs of depression, such as:
    • poor concentration
    • changes in weight
    • changes in sleep
    • decreased interest in activities
    • thoughts of suicide
  • signs of clotting problems, such as:
    • unusual nosebleeds
    • bruising
    • blood in urine
    • coughing blood
    • bleeding gums
    • cuts that don’t stop bleeding
  • signs of liver problems, such as:
    • nausea
    • vomiting
    • diarrhea
    • loss of appetite
    • weight loss
    • yellowing skin or eyes
    • dark urine
    • pale stools
  • signs of respiratory tract infection, such as:
    • fever or chills
    • shortness of breath
    • prolonged dizziness
    • headache
    • weight loss
    • tightness in chest
    • difficulty breathing
    • wheezing
  • skin issues, such as:
    • rash
    • hives
    • chafing
    • itching
    • bruising
  • slowed growth in children and adolescents
  • symptoms of adrenal insufficiency, such as:
    • tiredness
    • headache
    • nausea
    • vomiting
    • muscle or joint pain
  • symptoms of glaucoma or cataracts, such as:
    • blurred vision
    • seeing circles of bright colors around lights
    • red eyes
    • increased pressure in your eyes
    • eye pain or discomfort
  • wheezing or difficulty breathing right after inhaling the medication
  • white fungal infection patches in the mouth or throat
  • worsening asthma

Side effects requiring urgent medical attention

Patients experiencing any of the following side effects should discontinue treatment and immediately seek the attention of a medical professional.

  • chest pain
  • increased heart rate
  • severe allergic reaction, such as:
    • hives
    • difficulty breathing
    • swelling of the face
    • mouth or tongue
  • worsening asthma or sudden asthma attacks with symptoms such as:
    • cough
    • difficulty breathing
    • wheezing

It is possible to experience side effects other than those listed above. Patients should discuss with their doctor any symptoms that worry them.

Warnings & Precautions

Before taking any medication, patients should always check the ingredients for anything they may be allergic to. They should not take this medication if they are allergic to it or any of its ingredients.

The patient’s medical conditions or allergies may impact whether or not their doctor may recommend this medication.

Patients should not take this medication if they:

  • are allergic to mometasone or any of its ingredients
  • are allergic to milk or lactose
  • are experiencing an asthma attack
  • have active or inactive lung tuberculosis
  • have an untreated fungal, bacterial, or viral lung infection
  • have herpes simplex infection of the eye
  • have status asthmaticus (severe, unresponsive asthma)

Drug interactions

This medication may interact with any of the following drugs. If a patient is taking any of the medications below, they should let their doctor know or seek guidance from their pharmacist.

  • aldesleukin
  • “azole” antifungals, such as:
    • itraconazole
    • ketoconazole
    • voriconazole
  • ceritinib
  • clarithromycin
  • cobicistat
  • desmopressin
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs), such as:
    • efavirenz
    • etravirine
    • nevirapine
  • HIV protease inhibitors, such as:
    • atazanavir
    • indinavir
    • ritonavir
    • saquinavir
  • idelalisib
  • mifepristone

Frequently Asked Questions

Asmanex Twisthaler should be used to control asthma symptoms. It should not be used to relieve an asthma attack that is already in progress. It is a preventative medication that is most effective when used regularly.

Do not share your prescribed Asmanex Twisthaler with others. Even if they have the same symptoms as you, it can be harmful to others who have not been prescribed this medication.

This medication is almost tasteless. Only a small amount of powder will enter your mouth, so it is highly unlikely that you will notice it.

Take Asmanex Twisthaler exactly as prescribed by your doctor. If you miss a dose, seek guidance from your physician. You should not take two doses of Asmanex Twisthaler to make up for any doses missed. Instead, skip the missed dose and take your next one as usual.

Asmanex Twisthaler should be stored at room temperature (68°F-77°F) in its sealed foil pouch until it is going to be used. 59°F-86°F is fine for excursions. It should also be stored safely and kept away from children.

Before using Asmanex Twisthaler, you should shake the inhaler vigorously and remove the mouthpiece’s cap. Avoid spraying any of the medication in the eyes.

Asmanex Twisthaler and any remaining mometasone furoate contained within should be discarded after 2 months of being removed from its foil pouch.

Consult with your doctor before you stop taking Asmanex Twisthaler. If you both agree that you should stop using it, you should slowly taper off to avoid making the symptoms worse.

An interaction does not necessarily mean you need to stop taking Asmanex Twisthaler or a medication you’re already taking. You should speak with your doctor for assistance in managing your medications.

In some cases, patients can develop thrush, a yeast infection. That’s why patients are advised to you rinse their mouth thoroughly and gargle several times after each inhalation.

Other medications may interact with Asmanex Twisthaler. You should inform your doctor of all prescription, over-the-counter and herbal supplements you are currently taking.  Inform your doctor if you are a smoker, use street drugs or consume caffeine products.

It is not known whether Asmanex Twisthaler may affect an unborn baby. However, uncontrolled asthma during pregnancy can lead to complications, such as:

  • Low birth weight
  • Premature birth
  • Eclampsia (dangerously high blood pressure)

You should discuss the possible risks of using this medication while pregnant or breastfeeding with your doctor.

Before prescribing Asmanex Twisthaler, your doctor should know if you are allergic to mometasone or milk proteins. However, you should also let them know if you have ever had any of the following:

  • liver disease
  • herpes infection of the eyes
  • glaucoma, cataracts, or other vision problems
  • low bone mineral density, osteoporosis
  • any illness or infection, including tuberculosis

You should avoid getting too close to people who are sick or have infections. If you come into contact with anyone with chicken pox or measles, you should see your doctor for preventative measures. For people using steroid medication, such as mometasone furoate, chicken pox and measles can be very serious and even life-threatening.

Osteoporosis (bone loss) can be a side effect of long-term steroid use. The risk is even greater if:

  • you are a smoker
  • you do not exercise
  • you do not get enough vitamin D
  • you do not get enough calcium
  • there are cases of osteoporosis in your family history

If you are concerned about using Asmanex Twisthaler because of the risk of developing osteoporosis, you should discuss it with your doctor.

Asmanex Twisthaler will begin working within 24 hours of taking your first dose. However, you may not begin to notice a significant change for roughly 1 to 2 weeks.