Mometasone (Inhalation)

Mometasone is an ongoing treatment that is used to control the symptoms of asthma and to maintain control of asthma.

Overview

Mometasone is an inhaled treatment that is used to prevent the symptoms of asthma and improve breathing in patients over the age of four. The medication is inhaled daily to decrease the frequency and severity of asthma attacks.

In patients over the age of 12 Mometasone is also used as a maintenance treatment to prevent and control asthma.

Mometasone is a corticosteroid medication that works to prevent the release of certain substances by the cells of the lungs. In doing so the symptoms of asthma can be prevented and breathing can be improved in the patient.

Mometasone is a prescribed medication that can be inhaled as a powder or aerosol powder. The medication is prescribed as Asmanex HFA or Asmanex Twist.

Condition treated

  • Asthma

Type Of Medicine

  • Corticosteroid

Side Effects

In addition to the required effects of Mometasone, other unwanted side effects can also occur from use. While not all of these side effects may occur, in some cases where they do you may need to seek medical attention.

If the following side effects are experienced from the use of Mometasone you should contact your doctor immediately:

Occurring more commonly:

  • Dryness or soreness of the throat
  • Cough
  • Congestion
  • Cold or flu-like symptoms
  • Body aches or pain

Occurring less commonly:

  • Nausea
  • Lower back or side pain
  • Loss of appetite
  • Fever or chills
  • Diarrhea
  • Abdominal or stomach pain

Occurring only rarely:

  • White patches appearing on the nose or mouth

Certain other side effects can also occur that would not normally require that you seek any medical attention. These side effects are usually more mild and will often abate over time as the body becomes used to the treatment. Your doctor or nurse may also be able to advise you how to alleviate these symptoms. If the following side effects do become bothersome or are ongoing, however, then you should inform your doctor and seek advice:

Occurring more commonly:

  • Upset stomach
  • Unexplained runny nose or sneezing
  • Trouble sleeping
  • Trouble concentrating
  • Tiredness
  • Stuffy or runny nose
  • Stomach discomfort following meals
  • Nasal burning and irritation
  • Muscle pain or stiffness
  • Muscle or joint pain
  • Loss of interest or pleasure
  • Lack of appetite
  • Irritability
  • Increase in abdominal or stomach pains and/or cramping during menstruation
  • Headaches
  • Feeling sad or empty
  • Discouragement
  • Difficulty with moving

Occurring less commonly:

  • Vomiting
  • Unusual tiredness or weakness
  • Sweating
  • Shivering
  • Post-procedure pain
  • Passing gas
  • Menstrual changes
  • Lower back or side pain
  • General feeling of discomfort or illness
  • Full feeling
  • Frequent urge to urinate
  • Excess air or gas in stomach or intestines
  • Difficult, burning, or painful urination
  • Chest congestion
  • Bloody or cloudy urine
  • Bloody mucus or unexplained nosebleeds
  • Bloated
  • Bladder pain
  • Accidental injury

In some patients, Mometasone could also cause other side effects to occur that have not been listed herein. If other side effects do occur then you should seek advice from your doctor. If you are worried about your immediate health, however, then you should always contact the emergency services for treatment.

Dosage

This medication is a preventative treatment to stop asthma attacks from occurring. It is not, however, a treatment that can be used to relieve an asthma attack that has already begun. To relieve an asthma attack that has started you will need to use an alternative medication as prescribed by your doctor. You should discuss this with your doctor if you have not been prescribed another medication and should always ensure you know how to correctly take all medications that you are prescribed.

Mometasone must be inhaled with a special inhaler. This will come with special instructions for use. It is vital that you follow these instructions correctly and have fully understood how to use the inhaler correctly. If you have any questions then you should ask your doctor and you should also regularly show your doctor how you are using it at checkups to ensure it is being used correctly.

This medication must only be used as you have been directed to use it by your doctor. You should not ever use more of it nor use it more frequently than you have been ordered to. You should not ever stop use without discussing this with your doctor as these changes may increase side effects or cause symptoms and asthma attacks to occur.

This medication must be used regularly and at evenly spaced intervals in order for it to be effective at preventing asthma attacks. Your doctor will inform you of when you should take the medication and you should take it exactly as ordered by your doctor.

Use the following directions to take Mometasone using the Twisthaler:

  • Remove your new inhaler from the pouch it is provided in.
  • Make a note of the date of opening on the top of the inhaler using permanent ink to do so. This inhaler should not be used after 45 days of opening the original pouch.
  • The Twisthaler will have a counter on the side that will show you how many doses are remaining in the inhaler. You will need to get a replacement before the inhaler reaches'00'. At this point the Twisthaler will lock itself and it will not be operable. If the counter is working incorrectly then you must not use the twisthaler and should return it to your pharmacist or doctor for a replacement.
  • You should hold the inhaler in the upright position when removing the cap. This ensures that the correct dose is given each time. To open the Twisthaler you should turn the cap in anticlockwise direction. As you do this the counter on the side of the inhaler should count down by one dose each time. At this point the marker on the inhaler should be pointing towards the dose counter.
  • In order to inhale the medication you should then breathe out fully to empty the lungs of air as completely as you are able to. Immediately insert the mouthpiece into your mouth and then seal around the mouthpiece with your lips and mouth, ensuring that your tongue dose not block the mouthpiece at all.
  • Breathe in through the mouth and not the nose. Breathe through the inhaler until a deep breath has been taken and the lungs are full.
  • Hold your breath for 10 seconds after removing the inhaler and then expel the air from your lungs slowly.
  • Do not ever expel air back into the inhaler.
  • Wipe the mouthpiece of this inhaler and then replace the cap, ensuring that it is on the right way. Twist it in a clockwise direction and you should be able to hear an audible click when the Twist haler is fully closed.
  • Rinse your mouth and gargle after each use. Failing to do so can increase your chances of developing an infection or irritation from use. You should not swallow the water that you have rinsed your mouth with.

Use the following directions to take Mometasone using the Asmanex HFA inhaler:

  • This prescription is available in two different strengths. Your doctor will prescribe a particular strength and you should always ensure that this is the correct strength when you are issued with your prescription.
  • Each of the inhalers will contain around 124 doses of Mometasone. You will need to keep track of your use so that you can arrange to collect a new inhaler from the pharmacist before you run out of the medication. Each inhaler will also have a counter window that will tell you how many doses remain in the inhaler. This will help you to keep track of when you will need to get a new inhaler to continue your treatment.
  • Remove the cap from the inhaler before beginning use of this treatment.
  • If the inhaler has not been used for a few days and when first using it you will need to prime the inhaler. To do this you should point the inhaler away from you and spray 4 sprays into the air. Shake the inhaler well before each spray.
  • Shake inhaler again before use.
  • Before inhalation you must breathe out fully to empty the lungs of all air.
  • Once your lungs are empty you should seal your lips around the mouthpiece and ensure your tongue is not blocking the mouthpiece.
  • Press down on the top of the medication and then breathe in as deeply as you can through the mouth and inhaler.
  • Once you have taken a deep breath you should remove the mouthpiece and hold your breath for 10 seconds before breathing out slowly. Do not ever breath out into the inhaler.
  • Do not wash the inhaler. Instead you should wipe it with a dry wipe once per week.
  • Always replace the cap of the inhaler after use.
  • Rinse your mouth out and gargle after use. Doing so will help you to avoid infection and irritation of the throat. Do not swallow the water after rinsing your mouth.
  • You should not use any other canisters in this inhaler and should not remove the canister from the inhaler at all.

The dose of this medication that you are given will vary depending on a range of factors. The medication comes in different doses that can be used at different frequencies and your use will be specific to you. The dose will depend on factors such as age, reason for use and on any other medications that you are taking or any other medical conditions you have. The information included herein relates only to the average doses given and should not be used to make any adjustments to your dose. Mometasone should only ever be taken as you have been directed to by your doctor.

When treating a patient with the aerosol powder form of Mometasone:

  • In patients who have been given inhaled corticosteroids and bronchodilators:

O Those aged over 12 will begin with 220mcg of treatment taken once daily in the evening. This is usually one inhalation dose. The dose may be increased but would not normally be in excess of 440mcg taken daily.

O Those aged between 4 and 11 will begin with 110mcg of treatment taken once daily in the evening. This will usually be one inhalation dose of a lower dosage inhaler.

O Below the age of 4 use is not recommended and should be carried out only if directed to by a doctor. You should discuss this with the doctor before use.

  • In patients who have been given oral corticosteroids:

O Those aged over 12 should take 440mcg of treatment once daily in the evening. This is usually two inhaled doses of the medication. The dose may be increased but should not normally exceed 880mcg per day.

O Those aged between 4 and 11 will usually be treated with one dose of 110mcg taken once daily in the evening.

O Below the age of 4 this medication should only be used as directed by a doctor.

When treating a patient with the powder form of Mometasone:

  • In patients who have received inhaled corticosteroids:

O Those aged over 12 will normally be treated with two inhaled doses taken twice daily in the morning and the evening. The dose should not normally exceed 400 or 800mcg per day.

O Below the age of 12 the use of this medication with inhaled corticosteroids should only be used as directed by the prescribing doctor.

  • In patients who have received oral corticosteroids:

O Those over the age of 12 can be treated with 400mcg per day. This should be taken as a divided dose in the morning and evening. This dose may be increased but should not normally exceed 800mcg.

O Children below the age of 12 should only be treated as directed by the prescribing doctor.

If a dose of this medication is missed then you should skip it and return to your normal dosing schedule. You should not take a double dose of this medication and should not use it any more frequently than it has been prescribed.

Interactions

Certain medications should ever be used in conjunction with one another. In some cases medications can interact with one another in the body and cause severe medical problems to occur. In other cases medication interactions may increase the side effects experienced and prevent other medications from working properly. To ensure you are able to avoid all medication interactions you should always inform your doctor of all other medications that you are taking. Doing so will enable them to make adjustments to prescriptions as required and some medications may need to be stopped. For the use of Mometasone it is especially important that you inform your doctor if you are taking any of the following treatments:

The use of the following treatments would not normally be recommended in conjunction with Mometasone. In some cases you may need to be treated with both but your doctor may need to change the frequency of use or the dose given of one or both treatments:

  • Pixantrone
  • Nadroparin
  • Bemiparin

Using Mometasone in conjunction with the following medication can increase the risk or severity of certain side effects. Using both medications in conjunction with one another can still be the best treatment for you but your doctor may need to make changes to the dose of one or other treatment:

  • Ketoconazole

Interactions with other medications that have not been listed can also occur when taking Mometasone. Ensure your doctor is aware of all medications you are taking before use including any prescribed medications or over the counter treatments.

Other medical problems from which you are suffering can also impact on the use of Mometasone. This is because medications intended for the treatment of other conditions can make certain medical problems worsen. The side effects of use may also be increased in some cases. You should inform your doctor of all medical problems from which you are suffering. This is especially important in the following cases.

These conditions may be worsened through the use of Mometasone:

  • Cataracts
  • Glaucoma

The body may be less able to fight the following infections when you are using Mometasone:

  • Chicken pox
  • Herpes simplex
  • Infections
  • Measles
  • Tuberculosis

In patients with the following conditions Mometasone may further weaken the bones and increase the risk of breakages:

  • Prolonged immobilization
  • Osteoporosis

Patients with the following allergy should not be treated with Mometasone:

  • Milk protein allergy

The effects and side effects of use may be increased in patients with the following condition. This is because of a decreased ability to remove the medication from the body:

  • Liver disease

Warnings

Before beginning the use of any medication, it is very important that you weigh the benefits of using the treatment in relation to the potential risks of use. You should make the decision to take Mometasone only having ensured that all of the following has been considered by you and your doctor:

Allergies: You must inform your doctor of all allergies from which you suffer. This is especially important if you have an allergy to milk protein or have ever reacted badly to any other medications in the past. These allergies may prohibit your use of Mometasone. You must also inform your doctor of any other allergies to dyes, preservatives, foods or animals from which you suffer.

Pediatric: This medication has been approved for use down to certain ages in different forms as follows. The safety and efficiency of use below these ages has not, however, been established

  • Inhaled Mometasone has been established for safe use in children aged 4 or older, but not below this age.
  • Inhaled powder Mometasone has been established for safe use in children aged 12 and older, but not below this age.

You should discuss pediatric use with the doctor before beginning the treatment and should ensure that you understand all of the risks of using the medication.

Geriatric: There are no known limitations to use in the elderly. Elderly patients are, however, more likely to be suffering from other medical problems that may limit the use of this treatment. Conditions such as glaucoma or liver disease may prevent this medication from being suitable for use in the elderly so caution should be exercised to a greater extent.

Pregnancy: There is a risk to the use of Mometasone during pregnancy. You must inform your doctor if you are pregnant before you begin use. If you think you may become pregnant during use then you should also inform your doctor and you must tell your doctor right away if you think that you are pregnant.

Breastfeeding: There are no studies to determine the risk to infants when using this medication and breastfeeding. You should consider the benefits of continuing to do so in relation to the risks of doing so. Consider this with your doctor before you begin treatment.

When using this medication for a prolonged period it will be necessary to have regular check-ups with the prescribing doctor. They will need to assess the effectiveness of the treatment and check for any unwanted side effects that may be occurring. Your dose may be adjusted at these check-ups depending on condition.

Fungal infections can occur in the mouth and throat from the use of this treatment. You should inform your doctor if thrush occurs. The symptoms of thrush can include white patches in the mouth or throat or pain that is experienced when swallowing.

This medication is not for the treatment of asthma attacks and should not be used for this. Your doctor will prescribe you with another medication for treating asthma attacks in most cases.

You should inform your doctor if the symptoms of asthma do not improve or begin to worsen in the first few weeks of treatment.

Severe allergic reactions can occur when using Mometasone. If you experience the following symptoms of anaphylaxis with use then you must seek immediate emergency care:

  • Swelling of the mouth, face or throat
  • Difficulty breathing
  • Itching
  • Hoarseness
  • Rash

You may be instructed to carry a medical ID card with you at all times. This will help emergency services treating you by informing them of your condition.

This medication can cause a slowing of growth in children. You should discuss this with your doctor if you have any concerns about this.

You should check with your doctor if you suffer any changes to vision during your use of this medication. If your vision begins to change then you may need to visit an ophthalmologist for further examinations.

Do not take any other medications with this treatment unless you have been directed to by your doctor.

Storage

This medication should be stored at room temperature with the cap closed whenever it is not in use. You should keep it out of direct light, away from heat and moisture and away from significant changes in temperature. You should not keep this medication in a car where it may become very hot or very cold. With great heat or cold the canisters may explode.

You should never make a hole in the canister nor expose it to heat or fire, even when it is empty

The medication should be kept sealed until you are ready to use it and you must record the date of opening on the inhaler to ensure that you know when to replace it and dispose of the old inhaler.

Keep this medication out of the reach of children, even when the medication is for their treatment. Use should be supervised to prevent misuse or accidental overdose.

You should dispose of all outdated medication as directed to by your doctor and should not ever keep any unneeded treatments.

You should dispose of the inhalers once the counter reaches' or after 45 days of opening.

Summary

Mometasone is used in the prevention of asthma attacks. By taking this medication daily by inhalation certain substances that cause asthma to occur can be prevented from occurring in the lungs. With regular use the severity of asthma attacks and their regularity can be reduced to help control the condition.

This medication should not ever be used when an asthma attack has started. It should only ever be used as a preventative and other medications will be given to relieve asthma attack symptoms as they occur.

You must use this medication exactly as directed and should not ever take more of the treatment than prescribed. To do so can put you at serious risk. Once you have begun treatment you will also need to continue use indefinitely.