Asmanex HFA, Asmanex Twisthaler
Asmanex, also known by its generic name, mometasone furoate, is a steroid inhaler used for maintenance treatment of asthma in adults and children. Asmanex HFA is approved for people ages 5 years and older, and is inhaled through the mouth twice daily. Asmanex Twisthaler is for people ages 4 years and older, and is inhaled once to twice daily. Some common side effects include headache, runny nose, and sore throat.
What is Asmanex (mometasone)?
What is Asmanex (mometasone) used for?
- Maintenance treatment of asthma
How Asmanex (mometasone) works
Asmanex (mometasone) is an inhaled corticosteroid. It lessens inflammation and swelling in the lungs, which helps you breathe better.
Drug facts
Side effects of Asmanex (mometasone)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Asmanex Twisthaler
- Headache (up to 22%)
- Allergy symptoms (e.g., sneezing, itchy nose, watery or itchy eyes; up to 15%)
- Sore throat (up to 13%)
- Sinus infection (up to 6%)
- Muscle pain (up to 8%)
- Oral thrush (up to 6%)
Asmanex HFA Inhaler
- Cold-like symptoms (up to 8%)
- Headache (up to 5%)
Less Common Side Effects
- Indigestion
- Back pain
- Nausea
- Headache
Asmanex (mometasone) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: hives, swelling of your face or tongue, difficulty breathing
- Sudden narrowing of your airways: difficulty breathing, wheezing, chest pain or tightness, cough
The following Asmanex (mometasone) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
White patches inside the nose or mouth
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Difficulty with moving
discouragement
feeling sad or empty
headache
increased abdominal or stomach pain and cramping during menstrual periods
irritability
joint pain
lack of appetite
loss of interest or pleasure
muscle pain or stiffness
nasal burning and irritation
stomach discomfort following meals
stuffy or runny nose
tiredness
trouble concentrating
trouble sleeping
unexplained runny nose or sneezing
Less common
Accidental injury
bladder pain
bloated
bloody mucus or unexplained nosebleeds
bloody or cloudy urine
difficult, burning, or painful urination
excess air or gas in stomach or intestines
frequent urge to urinate
full feeling
general feeling of discomfort or illness
lower back or side pain
menstrual changes
passing gas
post-procedure pain
shivering
sweating
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Asmanex (mometasone)
Pros
- Works well to prevent and lower asthma symptoms
- Available as two different (HFA inhaler and Twisthaler)
- Twisthaler typically used once per day (in most cases)
- Works directly in the lungs, so it has fewer side effects compared to oral steroids
Cons
- Must use every day for it to work well
- Can't use to treat active asthma attacks
- Can take over 2 weeks before your symptoms improve
- Can't use the Twisthaler if you're allergic to milk proteins since it contains lactose
Pharmacist tips for Asmanex (mometasone)
- Use a rescue inhaler, such as albuterol (Ventolin), if you have sudden trouble breathing during an asthma attack. Asmanex (mometasone) won't treat an asthma attack as it's happening.
- Make sure to rinse your mouth with water and spit after each time you use Asmanex (mometasone). This helps prevent fungal infections in your mouth and throat (thrush).
- Call your prescriber if your breathing or peak flow meter results worsen. Also contact your care team know if you need to use your rescue inhaler more often than usual. These could be signs that you need some treatment changes to help manage your asthma better.
- Clean the mouthpiece of the Asmanex (mometasone) inhaler using clean, dry tissues at least once a week. Don't use water to clean any part of the inhaler.
- Use the dose counter to track how many doses of Asmanex (mometasone) you have left so you know when to get a refill. When the display window shows you only have 20 inhalations left, you should get a refill. When the display window reads "00" or "0" (depending on the type of inhaler you have), throw your inhaler away, even if the canister isn't completely empty.
More tips for the Asmanex Twisthaler:
- Make sure you know how to use your Twisthaler so it can work as best as possible to control your asthma. Carefully read the Asmanex Twisthaler instructions on how to use your inhaler. Ask your care team if you have any questions.
- Breathe out fully before placing your mouth over the mouthpiece in a horizontal (on its side) position. With your lips firmly closed around the Asmanex (mometasone) mouthpiece, take a fast and deep breath. Try to hold your breath for up to 10 seconds or for as long as you comfortably can. This allows time for the medication to reach deep into your lungs.
- Throw away the Twisthaler 45 days after opening from the foil pouch or when the dose counter reads "00", whichever comes first.
More tips for the Asmanex HFA inhaler:
- Make sure you know how to use your HFA inhaler so it can work as best as possible to control your asthma. Carefully read the Asmanex HFA instructions on how to use your inhaler. Ask your prescriber or pharmacist if you have any questions.
- If you're using a new inhaler for the first time or if you haven't used it in more than 5 days, you'll need to prime your inhaler. To prime the inhaler, hold it upright and away from your face, and spray 4 times. Shake the inhaler well between each test spray.
- Before each time you use the HFA inhaler, shake it well for 5 seconds. This mixes the medication in the canister so you receive the right dose every time.
- With your lips firmly closed around the Asmanex (mometasone) mouthpiece, take a slow and deep breath while pushing the button on the top of the canister to deliver the medication. Try to hold your breath for as long as you comfortably can (up to 10 seconds). This allows time for the medication to reach deep into your lungs.
- If you need to inhale more than one puff of Asmanex (mometasone), wait at least 30 seconds between inhalations.
Common questions about Asmanex (mometasone)
It depends on the product you have. The Asmanex Twisthaler 220 mcg inhaler can have either 30, 60, or 120 inhalations (puffs), depending on the specific size your pharmacy dispenses to you. The Asmanex Twisthaler 110 mcg inhaler has 30 inhalations. Finally, all strengths of the Asmanex HFA inhaler contain 120 inhalations. Both the Asmanex HFA and Twisthaler contain a dose counter that'll help you keep track of how many inhalations are left. Use this counter to help you determine when it's time to ask your pharmacy or prescriber for a refill.
No, fluticasone (Flovent) and Asmanex (mometasone) aren't the same, but they're similar. Both medications are inhaled corticosteroids (or steroids) used for asthma treatment. Both come as a dry powder inhaler (Flovent Diskus and Asmanex Twisthaler), but the inhalers look different and the technique to deliver the dose slightly differs between brands. Both medications also come as HFA (aerosolized) inhalers too. Talk to your pulmonologist if you have specific questions about both of these inhalers.
No. Asmanex (mometasone) isn't a rescue inhaler and isn't able to treat an asthma attack. It's only FDA-approved as a maintenance treatment for asthma. Short-acting inhalers, like albuterol (Ventolin), are rescue inhalers that open your airways quickly. Make sure to have your albuterol or other rescue inhaler with you at all times, even if you're taking Asmanex (mometasone).
Yes. Your pulmonologist will likely prescribe you albuterol (Ventolin) as a rescue inhaler when you're taking Asmanex (mometasone). This is because Asmanex (mometasone) is a long-acting medication that works over time to lessen inflammation and swelling in your lungs and open your airways. But it won't help if you have sudden trouble breathing during an asthma attack. A rescue inhaler, such as albuterol (Ventolin), works quickly and can relieve sudden symptoms. Ask your healthcare team if you have more questions about Asmanex (mometasone) and rescue inhalers.
Anxiety wasn't a reported side effect from people taking Asmanex (mometasone). Oral steroids can cause anxiety, but Asmanex (mometasone) typically stays in the lungs, so it's unlikely to make you anxious. Talk to your primary care provider or psychiatrist if you're noticing symptoms of anxiety after using this inhaler.
No, people who took Asmanex (mometasone) in clinical studies didn't report insomnia (trouble sleeping) as a side effect. While oral steroids can potentially cause insomnia, it's unlikely for Asmanex (mometasone) to do so since it's inhaled directly into your lungs.
Both the Asmanex (mometasone) HFA and Twisthaler contain the same active ingredient, mometasone furoate. They work just as well as each other to treat asthma. A major difference is the actual inhaler that delivers the medication and how you should use each device. The HFA inhaler works by using a propellant to push the aerosolized medication out of the inhaler and into your lungs. As you push down on the canister for a dose, you'll need to take a slow, long, deep breath to allow the medication to reach your lungs. In contrast, the Twisthaler is a dry powder inhaler. The medication reaches your lungs using the force of your inhalation. That's why you need to breathe in quickly and deeply when you're using the Twisthaler. Additionally, while the HFA inhaler is typically given twice per day, the Twisthaler is given once per day (in most cases). Ask your prescriber which type of Asmanex (mometasone) inhaler is right for you.
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Risks and warnings for Asmanex (mometasone)
Asmanex (mometasone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not for use in asthma attack or for worsened breathing
Don't use Asmanex (mometasone) if you're experiencing an asthma attack because this medication won't provide immediate relief. Use a rescue inhaler, such as albuterol (Ventolin HFA), if you're having trouble breathing.
If you're using your rescue inhaler more often than usual, let your pulmonologist know because this could be a sign that your condition is getting worse. Don't use more doses Asmanex (mometasone) than recommended because this won't improve your breathing. Rather, this can raise your risk for serious side effects, such as heart problems, tremors, and dizziness.
Fungal infection in the mouth (thrush)
- Risk factors: Not rinsing and spitting after using Asmanex (mometasone) | Weakened immune system from medical conditions or medications
Asmanex (mometasone), like all inhaled steroids, can cause a fungal infection in your mouth and throat called thrush. To lower your risk for thrush, rinse your mouth with water and spit after each inhalation of Asmanex (mometasone). If you develop thrush, your pulmonologist might prescribe you a medication to treat this infection and ask you to stop using Asmanex (mometasone) temporarily. Let your pulmonologist know if you notice symptoms of thrush, such as white patches in your mouth, cotton-like feeling in your mouth, pain while eating or swallowing, or loss of taste.
Narrowing of your airways (bronchospasm)
Inhaled medications, including Asmanex (mometasone), can sometimes cause a muscle spasm in your lungs. This can lead to difficulty breathing, wheezing, cough, and chest discomfort. If you have a hard time breathing after inhaling Asmanex (mometasone), use your rescue inhaler and get medical attention right away.
Higher risk of infections
Like all corticosteroid-containing medications, Asmanex (mometasone) can weaken your immune system and raise your risk for infections, including upper respiratory infections and pneumonia. Your risk for infections is higher if you're also taking other medications that also weaken your immune system. If you're currently being treated for a serious infection, such as tuberculosis, let your pulmonologist know. They might need to consider a different medication for your condition until you get better. Let your pulmonologist or primary care provider know right away if you have symptoms of infections, such as fever, chills, or body aches.
Changes in stress hormone levels
- Risk factors: Using Asmanex (mometasone) for a long time | Using too much Asmanex (mometasone)
Use Asmanex (mometasone) only as directed. Don't use more than the maximum number of inhalations each day. Doing so can cause more steroid to be absorbed into the body and raise your risk for symptoms of too much stress hormones, such as higher blood sugar or blood pressure.
On the other hand, if you're transitioning to Asmanex (mometasone) from oral steroids, you might experience symptoms of low steroid hormone, such as stomach pain, loss of appetite, and nausea. When you transition to Asmanex (mometasone), your pulmonologist will work with you to lower your dose of oral steroids slowly over time to prevent these side effects.
Delayed growth in children
Children who use inhaled steroids, like Asmanex (mometasone), might experience a delay in growth. To lower the risk of growth problems, your child's pulmonologist will only prescribe the lowest dose needed to help their condition. Your child's care team will check your child's growth regularly while your child is using this medication. If you're concerned about how Asmanex (mometasone) might affect your child's growth, discuss with your child's pulmonologist to see if this medication is right for them.
Weakening bones
- Risk factors: Older age | Bed rest for a long time | Family members who have osteoporosis | Females who've gone through menopause | Using tobacco
People who use inhaled steroids, like Asmanex (mometasone), have reported lower bone mineral density (BMD) over time. It's unclear whether this leads to higher risk of bone fractures. But you're more likely to experience a fracture if you're an older adult, have family members who have osteoporosis, or are taking other medications that raise the risk of fractures.
Eye and vision problems
- Risk factors: History of glaucoma or cataracts
Although rare, people using inhaled steroids over a long period of time have reported having higher pressure in the eyes, glaucoma, and cataracts. Talk to your optometrist before using Asmanex (mometasone) if you have glaucoma or cataracts because they might ask you to come in more often for eye exams. Also speak with them if you notice any changes to your vision while using the medication.
Severe allergic reactions
Severe allergic reactions to Asmanex (mometasone) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). Let your healthcare professional know of any allergies before starting Asmanex (mometasone), especially if you have an allergy to milk proteins. Since Asmanex Twisthaler contains lactose, you'll need to use the HFA inhaler of Asmanex (mometasone) or a different medication instead to avoid getting an allergic reaction. Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using Asmanex (mometasone).
Asmanex (mometasone) dosage
Inhaler| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 60 doses of 220mcg | 1 inhaler | $122.22 | $122.22 |
| 120 doses of 220mcg | 1 inhaler | $171.23 | $171.23 |
| 30 doses of 110mcg | 1 inhaler | $98.52 | $98.52 |
| 30 doses of 220mcg | 1 inhaler | $105.56 | $105.56 |
| 14 doses of 220mcg | 1 inhaler | $46.55 | $46.55 |
Typical dosage for Asmanex (mometasone)
Your prescriber will decide on a starting dose based on which other asthma medications you were previously taking before starting Asmanex (mometasone). After starting Asmanex (mometasone), your prescriber will adjust your dose based on how well the medication is controlling your asthma symptoms and if you're having side effects.
Asmanex Twisthaler Asmanex Twisthaler is available in two strengths: 110 mcg and 220 mcg of mometasone per inhalation.
- Ages 12 years and older and previously taking inhaled asthma medications: The typical starting dose is 220 mcg inhaled through the mouth once every evening. The maximum daily dose is 440 mcg.
- Ages 12 years and older and previously taking oral corticosteroids: The typical starting dose is 440 mcg inhaled through the mouth twice per day. The maximum daily dose is 880 mcg.
- Ages 4 to under 12 years: The typical dose is 110 mcg inhaled through the mouth once every evening.
Asmanex HFA Asmanex HFA is available in three strengths: 50 mcg, 100 mcg, and 200 mcg of mometasone per inhalation.
- Ages 12 years and older: The typical dose is 2 inhalations through the mouth twice per day using the Asmanex HFA 100 mcg or 200 mcg strength.
- Ages 5 to under 12 years: The typical dose is 2 inhalations through the mouth twice per day using the Asmanex HFA 50 mcg strength.
Interactions between Asmanex (mometasone) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Bemiparin
- Lutetium Lu 177 Dotatate
- Macimorelin
- Nadroparin
- Ritonavir
- Sargramostim
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Auranofin
- Ketoconazole
How much does Asmanex (mometasone) cost?
$46.55
Asmanex (mometasone) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Asmanex (mometasone) will not be safe for you to take.
- Treatment of sudden asthma attack
- Allergy to milk proteins - for Asmanex Twisthaler only
What are alternatives to Asmanex (mometasone)?
