Asmanex twisthaler (Mometasone)
How does it work?
Asmanex twisthaler contains the active ingredient mometasone furoate, which is a type of medicine known as a corticosteroid.
Corticosteroids are hormones that are produced naturally by the adrenal glands. They have many important functions, including control of inflammatory responses. Mometasone is a synthetic corticosteroid and is used to decrease inflammation in the lungs. (NB. Corticosteroids are often simply called steroids, but it should be noted that they are very different from another group of steroids, called anabolic steroids, which have gained notoriety because of their abuse by some athletes and body builders.)
When mometasone is inhaled into the lungs it is absorbed into the cells of the lungs and airways. Here it works by preventing the release of certain chemicals from the cells. These chemicals are important in the immune system and are normally involved in producing immune and allergic responses that result in inflammation. By decreasing the release of these chemicals in the lungs and airways, inflammation is reduced.
In asthma, the airways tighten due to inflammation and can also be blocked by mucus. This makes it difficult for air to get in and out of the lungs. By preventing the inflammation and excess mucus formation, mometasone helps prevent asthma attacks. It is not used to treat an asthma attack.
Mometasone is taken using an inhaler device to treat asthma. Inhaling the medicine delivers it directly to the lungs where it is needed. It also reduces the potential for side effects occurring in other parts of the body, as the amount of medicine absorbed into the blood from the lungs is lower than if it was taken by mouth.
Mometasone taken by inhalation is known as a 'preventer'. This is because it is taken regularly every day to reduce the inflammation in the lungs and prevent asthma attacks. Symptoms usually start to get better between four to seven days after starting treatment. However, it is important to keep using this medicine regularly; even after your asthma symptoms have improved, in order to prevent them coming back.
What is it used for?
Asmanex is a preventer medicine that should be used regularly every day, even when you don't have symptoms, to help prevent asthma attacks.
How do I use it?
- Carefully follow the instructions that are provided with your inhaler. If you are unsure about how to use your inhaler you can talk to your doctor, pharmacist or asthma nurse, all of whom will be able to help you. Make sure you understand how to use your inhalers, as using them incorrectly may mean that you are not inhaling the full dose of medicine into your lungs, and this of course can make them less effective at controlling your asthma.
- Asmanex is usually used once or twice a day. Follow the instructions given by your doctor. If your doctor has asked you to use this inhaler once a day you should use it in the evening, as this has been shown to be more effective at keeping asthma under control.
- If you forget to take a dose don't worry, just take your next dose as usual when it is due. Do not take a double dose to make up for a missed dose.
- You should not suddenly stop taking this medicine unless your doctor tells you otherwise, as your asthma symptoms are likely to return.
- Inhaled corticosteroids can sometimes cause a fungal infection in the mouth called oral thrush. To minimise the chances of this you should rinse your mouth with water or clean your teeth after inhaling each dose of this medicine. Consult your doctor if you develop white patches in your mouth or throat, as these are symptoms of thrush and it may need to be treated.
- Inhalers may cause an unexpected increase in wheezing and difficulty breathing (paradoxical bronchospasm) straight after using them. If this happens, don't use the inhaler again, use your reliever inhaler to open your airways and consult your doctor.
- This medicine is known as a preventer and it should be taken regularly to prevent asthma attacks. It should not be used to relieve an asthma attack, as it will not work for this purpose. An asthma attack needs to be treated with a medicine that quickly opens the airways, such as salbutamol or terbutaline. These are known as relievers, and you should make sure you carry your reliever inhaler with you at all times to relieve an asthma attack if it happens. Consult your doctor if you need to use your reliever more frequently than normal, or if it becomes less effective at treating attacks, as this may indicate that your asthma is getting worse and your doctor may need to prescribe you another medicine.
- Do not exceed the dose of this medicine that your doctor has prescribed for you.
- Inhaled corticosteroids have considerably fewer side effects than steroids taken by mouth. However, when taken for long periods of time at high doses, inhaled steroids do have the potential to cause side effects such as glaucoma, cataracts, thinning of the bones (osteoporosis), slowed growth in children and adolescents, and to suppress the functioning of the adrenal glands (glands that produce natural steroid hormones). For this reason your doctor will prescribe the lowest effective dose to control your symptoms, and monitor for these side effects.
- It is recommended that children and adolescents receiving long-term treatment with corticosteroids have their growth monitored. If a child's growth appears to be slowed your doctor may refer them to a specialist respiratory paediatrician. For further information talk to your doctor or pharmacist.
Use with caution in
- Active or inactive tuberculosis infection affecting the lungs.
- Herpes simplex virus infection of the eye.
- Untreated viral, bacterial or fungal infection affecting the rest of the body.
Not to be used in
- Children under 12 years of age.
This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. The manufacturer states that it is not recommended for use in pregnancy unless considered essential by your doctor. However, it is important that asthma is well controlled in pregnant women. Wherever possible, asthma medications should be taken by inhaler, as this minimises the amount of medicine that enters the bloodstream and crosses the placenta. It is important to get medical advice from your doctor on how to control your asthma during pregnancy, but in general, inhaled medicines can be taken as normal during pregnancy.
- In general, the amount of corticosteroid that passes into the breast milk after using an inhaler is negligable and probably too small to be harmful to the baby. However, it is not known if mometasone passes into breast milk and you should seek medical advice from your doctor before breastfeeding while using this medicine.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Common (affect between 1 in 10 and 1 in 100 people)
- Yeast infection of the mouth and throat (oral thrush - see warning above).
- Hoarse voice.
- Inflammation of the throat (pharyngitis).
Uncommon (affect between 1 in 100 and 1 in 1000 people)
- Dry mouth and throat.
- Weight gain.
- Awareness of your heartbeat (palpitations).
- Unexpected narrowing of the airways (paradoxical bronchospasm - see warning section above).
- Allergic reactions such as narrowing of the airways (bronchospasm), swelling of the lips, throat and tongue (angioedema), itchy blistering rash or anaphylactic shock.
- Systemic effects (eg, Cushing's syndrome, adrenal suppression, slowed growth in children and adolescents, decreased bone mineral density, cataract and glaucoma) may occur after high doses for prolonged periods - see warning above.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
Tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.
The following medicines may increase the amount of mometasone that is found in the bloodstream after inhaling the medicine:
- protease inhibitors for HIV infection, such as nelfinavir or ritonavir.
Mometasone may be less effective at preventing asthma attacks for three to four days after taking the medicine mifepristone (used for termination of pregnancy or inducing labour if the baby has died in the womb).
Other medicines containing the same active ingredient
There are currently no other asthma medicines containing mometasone furoate available in the UK.
Other medicines that contain mometasone include Nasonex nasal spray (for hayfever), Elocon cream and ointment (for eczema) and Elocon scalp lotion (for dermatitis or psoriasis affecting the scalp).