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.
Maintenance treatment of asthma
Asmanex (mometasone) is an inhaled corticosteroid. It lessens inflammation and swelling in the lungs, which helps you breathe better.
Source: DailyMed
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.
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
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 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).
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.
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.
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.
Treatment of sudden asthma attack
Allergy to milk proteins - for Asmanex Twisthaler only
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American Lung Association. (2024). How to Use a Metered-Dose Inhaler without a Valved Holding Chamber.
American Lung Association. (2024). How to Use a Twisthaler Asthma Inhaler.
American Lung Association. (2023). Measuring your peak flow rate.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison’s Disease.
Organon Global Inc. (2021). Patient information ASMANEX HFA 50 mcg, ASMANEX HFA 100 mcg, ASMANEX HFA 200 mcg.
Organon LLC. (2024). ASMANEX HFA- mometasone furoate aerosol. DailyMed.
Organon LLC. (2022). ASMANEX- mometasone furoate inhalant. DailyMed.
Usmani, O. S. (2017). Choosing the right inhaler for your asthma or COPD patient. Therapeutics and Clinical Risk Management.
You and Your Hormones. (2020). Cushing’s disease.
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