Asmanex Twisthaler (Mometasone)
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Fact Table
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| Formula | C27H30Cl2O6 |
| License | FDA approved (inhalation corticosteroid for asthma) |
| Bioavailability | <1% systemic (very low oral & pulmonary absorption) |
| Legal status | Prescription only (Rx) |
| Chemical Name | (6a,11ß,16a)-9,21-Dichloro-11-hydroxy-16-methyl-3,20-dioxopregna-1,4-dien-17-yl 2-furoate |
| Elimination half-life | ~5.8 hours |
| Dosage (Strength) | 110 mcg and 220 mcg inhalation powder (Twisthaler) |
| Pregnancy | Category C – Use only if potential benefit justifies risk |
| Brands | Asmanex Twisthaler; also Asmanex HFA (different formulation) |
| Protein binding | 98–99% |
| PubChem CID | 441336 |
| MedlinePlus | a602024 |
| ChEBI | 6435 |
| ATC code | R03BA07 |
| DrugBank | DB00764 |
| KEGG | D00460 |
| Routes of administration | Inhalation (dry powder inhaler) |
Asmanex Twisthaler (mometasone furoate) is a corticosteroid inhaler used for the maintenance treatment of asthma in adults and children 4 years and older. Mometasone furoate works by reducing inflammation in the airways, which helps prevent asthma symptoms when it’s taken daily. This medication isn't a rescue inhaler and won't treat sudden asthma attacks that have already started.
Directions
Asmanex Twisthaler is typically used by mouth once daily in the evening or twice daily (morning and evening), depending on what a doctor or healthcare provider prescribes. Adults who previously used bronchodilators alone typically start with 220 mcg once daily, with a maximum dose of 440 mcg per day. Adults who previously used inhaled corticosteroids may need 220 mcg twice daily, with a maximum of 880 mcg per day. Children ages 4 to 11 usually take 110 mcg once daily in the evening, regardless of previous therapy.
Ingredients
The active ingredient in this drug is mometasone.
Cautions
- Before using this medication, you may want to consult a healthcare provider about the following:
- Any existing health conditions
- Any allergies
- A list of all medications currently being taken
- Asmanex can sometimes cause a yeast infection in the mouth or throat. To lower the risk, rinse your mouth with water and spit it out after each dose.
- This medication is not meant for sudden asthma attacks. You should always keep a quick-acting rescue inhaler, like albuterol, on hand.
- Allergic reactions, including rash, swelling, and rare cases of anaphylaxis, have been reported. Asmanex contains trace milk proteins, so people with a severe milk allergy should not use it.
- Because Asmanex is a corticosteroid, it can weaken your immune system. This means illnesses like chickenpox or measles can be more severe if you're exposed and not immune.
- People switching from oral steroids to Asmanex need close monitoring. The body can take months to adjust, and some may develop adrenal insufficiency, a condition where the body cannot handle stress well.
- Using higher doses for long periods may cause steroid-related side effects such as adrenal suppression, slower bone growth in children, or reduced bone density in adults. Children should have their growth monitored, and those with osteoporosis risk factors may need extra follow-up.
- Rare eye problems like glaucoma or cataracts have been seen in some users. Tell your doctor if you notice vision changes, eye pain, or halos around lights. In rare cases, Asmanex may also trigger a paradoxical bronchospasm, a sudden worsening of wheezing right after using the inhaler.
- Asmanex may interact with strong CYP3A4 inhibitors, such as ketoconazole or certain HIV and antibiotic medications. These drugs can increase steroid levels in the body.
Contraindications
Avoid taking or using this medication if any of the following apply:
- Primary treatment of status asthmaticus or acute asthma episodes requiring intensive intervention
- Known hypersensitivity to mometasone furoate or any ingredients in the formulation
- Allergic reactions to any component of Asmanex Twisthaler
Side Effects
Common side effects of Asmanex Twisthaler include:
- Headache
- Sore throat
- Sinus or upper-respiratory infections
- Upset stomach
- Muscle, bone, or back pain
- Nasal allergy symptoms
These effects are usually mild and improve over time. Some people may also develop thrush, a yeast infection in the mouth or throat, which appears as redness or white patches; rinsing and spitting after each dose helps lower this risk. Any persistent throat irritation, coughing, or worsening asthma symptoms should be discussed with a healthcare provider.
More serious side effects can occur, especially with long-term or high-dose use. Asmanex can weaken the immune system, lower adrenal function, increase the risk of infections, or trigger sudden wheezing right after inhalation. Long-term use may also reduce bone density, slow growth in children, or cause eye problems such as cataracts or glaucoma.
Seek medical attention right away for allergic reactions, severe fatigue, dizziness, facial swelling, or signs of infection such as fever, chills, persistent nausea, or worsening breathing.
Frequently Asked Questions about Asmanex Twisthaler (Mometasone)
What is Asmanex Twisthaler used for?
Asmanex Twisthaler contains mometasone, an inhaled corticosteroid used to prevent and control asthma symptoms such as wheezing, chest tightness, and shortness of breath. It is not meant for quick relief during an asthma attack.
How does Asmanex Twisthaler work?
Mometasone reduces inflammation in the airways, helping to decrease asthma symptoms and prevent flare-ups. It works over time and needs to be used regularly, even when symptoms are not present.
How should Asmanex Twisthaler be used?
Use Asmanex exactly as prescribed, usually once or twice daily. Inhale the medication through the mouth using the Twisthaler device. Rinse your mouth with water after each use to reduce the risk of oral thrush.
What are the common side effects of Asmanex Twisthaler?
Common side effects include headache, sore throat, hoarseness, and fungal infections in the mouth (oral thrush). Using a spacer and rinsing your mouth can help minimize some of these effects.
Can Asmanex Twisthaler be used for acute asthma attacks?
No, Asmanex Twisthaler is not a rescue inhaler. It does not provide immediate relief during an asthma attack. A fast-acting bronchodilator such as albuterol should be used for sudden breathing difficulties.
Is Asmanex Twisthaler safe for children?
Asmanex Twisthaler is approved for use in children 4 years and older. The dose depends on the child’s age and asthma severity, and it should always be used under pediatric supervision.
How long does it take for Asmanex Twisthaler to work?
It may take 1 to 2 weeks of daily use to notice significant improvement in asthma symptoms, although some benefit may be seen within 24 hours. Continued daily use is important for full effect.
What should I do if I miss a dose?
If you miss a dose, use it as soon as you remember. If it's almost time for the next dose, skip the missed one. Do not double up to make up for a missed dose.
Are there any serious risks or warnings with Asmanex Twisthaler?
Long-term use may increase the risk of weakened immune response, decreased bone density, eye problems (like glaucoma or cataracts), and slowed growth in children. Regular monitoring by a healthcare provider is important.
How should Asmanex Twisthaler be stored and disposed of?
Store the Twisthaler at room temperature in a dry place, away from moisture and heat. The device should be discarded 45 days after opening or when the dose counter reads “00,” even if medication remains.
