mometasone inhaled (Rx)

Brand and Other Names:Asmanex Twisthaler, Asmanex HFA
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for inhalation (Asmanex Twisthaler)

  • 110mcg/actuation
  • 220mcg/actuation

metered dose inhaler (Asmanex HFA)

  • 100mcg/actuation
  • 200mcg/actuation
more...

Asthma

Indicated for maintenance treatment of asthma as prophylactic therapy

Asmanex Twisthaler

  • Received bronchodilators alone or inhaled corticosteroids: 220 mcg PO inhaled once daily in evening; may increase to 220 mcg q12hr if needed
  • Received PO corticosteroids: 440 mcg PO inhaled q12hr; not to exceed 880 mcg/day

Asmanex HFA

  • 2 inhalations PO q12hr (ie, 200-400 mcg q12hr); starting dose based on prior asthma therapy
  • -Received inhaled medium-dose corticosteroids: 200 mcg inhaled PO q12hr (as 2 actuations of 100 mcg/actuation)
  • -Received inhaled high-dose corticosteroids: 400 mcg inhaled PO q12hr (as 2 actuations of 200 mcg/actuation)
  • -Received oral corticosteroids: 400 mcg inhaled PO q12hr (as 2 actuations of 200 mcg/actuation)

Dosage Forms & Strengths

powder for inhalation (Asmanex Twisthaler)

  • 110mcg/actuation
  • 220mcg/actuation

metered dose inhaler (Asmanex HFA)

  • 100mcg/actuation
  • 200mcg/actuation
more...

Asthma

Indicated for maintenance treatment of asthma as prophylactic therapy

Asmanex Twisthaler

  • <4 years: Safety and efficacy not established
  • 4-11 years: 110 mcg PO inhaled once daily in evening; not to exceed 110 mcg/day
  • ≥12 years (received bronchodilators alone or inhaled corticosteroids): 220 mcg PO inhaled once daily in evening; may increase to 220 mcg q12hr if needed
  • ≥12 years (received PO corticosteroids): 440 mcg PO inhaled q12hr; not to exceed 880 mcg/day

Asmanex HFA

  • <12 years: Safety and efficacy not established
  • ≥12 years: 2 inhalations PO q12hr (ie, 200-400 mcg q12hr); starting dose based on prior asthma therapy
  • -Received inhaled medium-dose corticosteroids: 200 mcg inhaled PO q12hr (as 2 actuations of 100 mcg/actuation)
  • -Received inhaled high-dose corticosteroids: 400 mcg inhaled PO q12hr (as 2 actuations of 200 mcg/actuation)
  • -Received oral corticosteroids: 400 mcg inhaled PO q12hr (as 2 actuations of 200 mcg/actuation)
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Interactions

Interaction Checker

and mometasone inhaled

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Headache (26%)

            Viral infection (14%)

            Pharyngitis (12%)

            Epistaxis (11%)

            1-10%

            Cough (7%)

            Upper respiratory tract infection (6%)

            Dysmenorrhea (5%)

            Frequency Not Defined

            Loss of taste

            Muscle soreness

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            Warnings

            Contraindications

            Hypersensitivity

            Immunosuppressed patients

            Tuberculosis

            Status asthmaticus or other acute asthma episode necessitating intensive measures

            Known hypersensitivity to milk proteins or any other ingredients

            Cautions

            Respiratory tract tuberculosis, untreated fungal or bacterial infections, viral or parasitic infections, ocular herpes simplex

            Nasal septum perforation, epistaxis, wheezing

            Cataracts, glaucoma, increased intraocular pressure

            Risk of more serious or fatal course of chickenpox and measles in susceptible individuals; avoid use in unvaccinated or immunologically unexposed children or adults

            Deaths from adrenal insufficiency have occurred after abrupt withdrawal of oral steroids; taper withdrawal gradually

            May retard growth in children

            Immunocompromised patients

            Infections of nose and pharynx, including Candida albicans

            Excessive use may suppress hypothalamic-pituitary-adrenal function

            During periods of stress or severe status asthmaticus, patient may require supplementary systemic corticosteroids immediately; carry warning card to that effect

            Long-term administration reduces bone mineral density

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            Pregnancy & Lactation

            Pregnancy: There are no randomized clinical studies in pregnant women; there are clinical considerations with use in pregnant women In women with poorly or moderately controlled asthma, there is increased risk of several perinatal adverse outcomes such as preeclampsia in the mother and prematurity, low birth weight, and small for gestational age in the neonate; pregnant women with asthma should be closely monitored and medication adjusted as necessary to maintain optimal asthma control

            Lactation: There are no available data on the presence of mometasone in human milk, the effects on the breastfed child, or the effects on milk production; other inhaled corticosteroids, similar to mometasone furoate, are present in human milk; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed infant from drug or from underlying maternal condition

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Corticosteroid with potent anti-inflammatory properties; exerts effects on various cells, including mast cells and eosinophils; also exerts effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines)

            Absorption

            Minimally absorbed

            Onset: 1-3 days

            Bioavailability: <0.1%

            Distribution

            Protein bound: 98-99%

            Metabolism

            Metabolized in liver by CYP3A4

            Elimination

            Half-life: 5.8 hr

            Excretion: Urine, bile

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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