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Asmanex Twisthaler (Generic Mometasone Oral Inhalation)

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Why is this medication prescribed?

The usage of mometasone oral inhalation helps to reduce asthma-related coughing, wheezing, chest tightness, and difficulty breathing. The oral inhalation of mometasone (Asmanex® HFA) is prescribed for both adults and children over the age of 12 years old. The oral inhalation powder of mometasone (Asmanex® Twisthaler) is prescribed for usage in both adults and children older than 4 years old. It belongs to a group of drugs called corticosteroids. Mometasone facilitates breathing by reducing inflammation and edoema in the airways.

How should this medicine be used?

Both a powder for oral inhalation and an aerosol for oral inhalation with an inhaler are available for mometasone inhalation. Most people inhale mometasone oral inhalation twice day. It is typical to inhale mometasone powder for oral inhalation once day in the evening or twice daily. Utilize mometasone inhalation every day at roughly the same time(s). Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Mometasone inhalation should only be used as prescribed. Do not take it in larger or less amounts, or more frequently than advised by your doctor.

As part of your mometasone inhalation therapy, discuss with your doctor how you should use any additional oral or inhaled asthma drugs. Your doctor might want to gradually reduce the dosage of any oral steroids you were taking, such as dexamethasone, methylprednisolone (Medrol), or prednisone (Rayos), starting at least a week after you start using mometasone inhalation.

Inhaling mometasone can help avoid asthma attacks, but it cannot stop one that has already begun. Mometasone inhalation should not be used when having an asthma episode. To use during asthma attacks, your doctor will prescribe a short-acting inhaler.

You’ll likely begin receiving mometasone inhalation at a typical dose prescribed by your doctor. If your symptoms are under control, your doctor may reduce the dosage or progressively raise it if they have not subsided after two weeks.

Inhaling mometasone manages asthma but does not cure it. Before you experience the full benefits of the drug, it could take 1 to 2 weeks or longer. Even if you feel good, continue to use mometasone inhalation. Without consulting your physician, do not stop taking mometasone inhalation.

If your asthma gets worse while you’re receiving therapy, tell your doctor. If you experience an asthma attack that does not end after using your fast-acting asthma medicine or if you require more fast-acting medication than normal, call your doctor right away.

Read the printed directions that are included with your mometasone oral inhaler before using it for the first time. Check to see if you can identify every component of the inhaler by carefully studying the diagrams. To learn how to use it, ask your physician, pharmacist, or respiratory therapist. While he or she observes, practise using the inhaler.

You can determine how many doses of medication are still in your mometasone inhaler by looking at the dose counter on the base of the device. From top to bottom, read the numbers on the dosing counter. Every time you lift the cap to load a dose of medication, the dose counter’s number drops. If the dose counter’s numbers remain unchanged after you load a dose, do not use the inhaler. If your inhaler isn’t functioning properly, call your pharmacist.

Take the following actions to use the aerosol inhaler:

  1. Take off the mouthpiece’s cap.
  2. Release 4 test sprays into the air, away from your face, to prime the inhaler if you’re using it for the first time or if it has been more than 5 days since your last use. Avoid spraying the drug in your face or eyes. Before each inhalation, shake the inhaler.
  3. Use your mouth to exhale.
  4. Hold the inhaler with the mouthpiece on the bottom, facing you. Put your index finger on the centre of the dose indicator at the top of the canister and your thumb under the mouthpiece. Close your lips around the mouthpiece after placing it in your mouth.
  5. Take a long, steady breath in through your mouth. At the same time, firmly press down with your index finger on the centre of the dose indicator located at the top of the canister. Immediately after the spray is released, take off your index finger.
  6. Close your mouth after removing the inhaler from your mouth and taking a thorough breath.
  7. For around 30 seconds, try to hold your breath before slowly exhaling.
  8. Repeat steps 3 through 7 if your doctor has instructed you to inhale more than one puff per session.
    Put the mouthpiece’s cap back on.
  9. Spit out the water after rinsing your mouth with it. Don’t ingest the water.
  10. Once a week, clean the aerosol inhaler. Make use of a dry, clean tissue or cloth to clean your inhaler. No portion of your inhaler should be washed or submerged in water.

Follow these steps to use the inhaler with the powder:

  1. Remove the fresh inhaler from the foil packet before using it for the first time. In the space provided on the cap label, note the day you first used the inhaler.
  2. With the colourful base on the bottom, hold the inhaler upright. Remove the white cap by turning it counterclockwise. It is crucial to screw the cap rather than the base of the inhaler with your hand since doing so puts the appropriate quantity of medication into the inhaler. The dose counter on the base will start counting down by one as soon as the lid is lifted off to indicate how many doses are left after this use.
  3. Exhale completely.
  4. Hold the inhaler with the mouthpiece towards you and on its side. Make sure you are not blocking the inhaler’s ventilation ports on the sides. Put the inhaler’s mouthpiece in your mouth and firmly seal your lips around it.
  5. Take a quick, deep breath in. Your prescription will be given to you as a very fine powder, so you might not be able to taste, smell, or feel it as you breathe it in.
  6. Inhale normally for 10 seconds or as long as you can comfortably hold your breath before taking the inhaler out of your mouth. Never exhale into the inhaler.
  7. Dry off the mouthpiece. Reinstall the inhaler’s cap so that the indented arrow aligns with the dose counter. Turn clockwise while gently pressing down until you hear a click.
  8. Spit out the water after rinsing your mouth. Don’t ingest the water.

Cleanse your inhaler lightly with a dry cloth if necessary. Avoid cleaning the inhaler. Keep the inhaler away from liquids like water.

For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before using mometasone oral inhalation,

  • If you have an allergy to mometasone, any other medications, or any of the substances in mometasone inhalation powder or aerosol inhaler, let your doctor and pharmacist know right away. Tell your doctor if you have a lactose or a milk protein allergy if you plan to use the inhalation powder. Request a list of the components from your pharmacist.
  • Inform your physician and pharmacist of all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are now using or have previously used. Incorporate any of the following: HIV protease inhibitors such as atazanavir (Reyataz, in Evotaz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Viekira Pak, among others), and saquinavir (Invirase); antifungals such as itraconazole (Onmel, Sporanox) and ketoconazo; Nefazodone, oral steroids including dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos), as well as telithromycin, are seizure medicines (Ketek). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Tell your doctor about all of the medicines you are taking, including any not on this list, since many other drugs may also interact with mometasone oral inhalation.
  • Use of mometasone during an asthma episode is not advised. To use during asthma attacks, your doctor will prescribe a short-acting inhaler. If an asthma attack persists despite the use of a fast-acting asthma medicine or if you need to use more fast-acting medication than normal, contact your doctor right away.
  • Inform your doctor if you or anyone in your family has ever experienced osteoporosis (a condition in which the bones become brittle and prone to breaking), cataracts (clouding of the lens of the eye), glaucoma (an eye disease), high eye pressure, or liver disease. TB is a type of lung infection that affects the lungs. Tell your doctor if you are bedridden or unable to move around, have a herpes eye infection (a type of virus that forms a sore on the eyelid or eye surface), or have any other untreated infections anywhere on your body.
  • If you are breastfeeding a child or intend to become pregnant, let your doctor know. Call your doctor if you become pregnant while using mometasone inhalation.
  • Please inform your doctor or dentist that you are using mometasone inhalation if you are having surgery, including dental surgery.
  • Your other health issues, such as asthma, arthritis, or eczema (a skin problem), could get worse if your oral steroid dosage is cut back. If this occurs or if you encounter any of the following symptoms at this time, let your doctor know right away: Extreme fatigue, muscle weakness or pain, sudden pain in the stomach, lower body, or legs, appetite loss, weight loss, upset stomach, vomiting, diarrhoea, dizziness, fainting, depression, irritability, and skin darkening are all symptoms that might occur. During this time, your body can be less able to handle stressors like surgery, illness, severe asthma attacks, or injuries. If you become ill, call your doctor right away, and make sure that any medical professionals who care for you are aware that you recently switched from an oral steroid to mometasone inhalation. Keep a card with you or wear a medical identification bracelet to alert emergency responders to the possibility that you will require steroid treatment.
  • If you have never had chickenpox or measles and you have not received a vaccination against these diseases, let your doctor know. Avoid sick people, especially those who have the measles or chickenpox. Call your doctor right once if you are exposed to one of these infections or if you start to exhibit signs of one of these infections. To keep yourself safe from certain infections, you might need therapy.
  • You should be aware that mometasone inhalation might occasionally induce wheezing and breathing difficulties right away. Use your fast-acting (rescue) asthma medicine as soon as possible and call your doctor if this occurs. Mometasone inhalation shouldn’t be used again unless your doctor advises you to.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

Ignore the missed dose and carry on with my normal dosing routine. To make up for a missing dose, do not take a second dose.

What side effects can this medication cause?

Side effects from inhaling mometasone are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Headache
  • Runny or stuffed nose
  • Sinuses, throat, and nose swelling
  • Back, joint, muscle, or bone pain
  • Flu-like signs
  • Irritated or bleeding nose
  • Throat is dry
  • White spots that hurt in the mouth or throat
  • Difficult menstrual cycles

Some adverse effects can be very harmful. Get emergency medical attention if you develop any of the following symptoms or those listed in the SPECIAL PRECAUTIONS section.

  • Hives
  • Rash
  • Itching
  • Eye, face, tongue, throat, arm, hand, foot, ankle, or lower leg swelling
  • Hoarseness
  • Breathing or swallowing challenges
  • Throat constriction
  • Vision alters

Children’s growth may be inhibited by mometasone inhalation. While using mometasone inhalation, your child’s doctor will closely check your child’s growth. The dangers of administering this drug to your child should be discussed with your doctor.

Long-term mometasone users run the risk of developing cataracts or glaucoma. The dangers of using mometasone and how frequently you should have your eyes checked while receiving therapy should be discussed with your doctor.

By reducing bone mineral density (bone strength and thickness), mometasone inhalation may raise your chance of developing osteoporosis. Discuss the dangers of using mometasone inhalation with your doctor.

Other negative effects of mometasone inhalation are possible. If you experience any strange issues while taking this drug, call your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Store your mometasone inhaler at room temperature, away from intense heat, and away from moisture (not in the bathroom). Keep the inhaler away from heat sources and open flames when storing it. Keep the inhaler out of the sun and the cold. Avoid puncturing the aerosol container and burning it when discarding it. 45 days after you open the container, throw away your mometasone oral inhalation powder inhaler together with any other expired or no longer required medications.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at for additional information.

What other information should I know?

Keep all of your doctor’s appointments.

Do not share your medication with anybody else. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Asmanex® HFA
  • Asmanex® Twisthaler
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