1. Introduction
Mometasone is a corticosteroid used in inhaler form to manage asthma and other respiratory conditions. It works by reducing inflammation in the airways, preventing symptoms such as wheezing, shortness of breath, and coughing. Mometasone inhalers are prescribed for maintenance therapy and are not suitable for acute asthma attacks.
2. Indications
- Maintenance treatment of asthma in adults and children (≥4 years old).
- Prevention of asthma symptoms, such as wheezing, breathlessness, and chest tightness.
3. Dosage
Adults and Adolescents (≥12 years):
- Starting dose: 220 mcg once daily in the evening.
- For moderate to severe asthma: 220 mcg twice daily (maximum: 440 mcg/day).
Children (4–11 years):
- 110 mcg once daily in the evening.
4. Administration
- Use the inhaler regularly at the same time each day for best results.
- Rinse the mouth with water after each use to prevent oral thrush (candidiasis).
- Shake the inhaler well before each use, and ensure proper inhalation technique for effective delivery of the medication.
5. Forms Available
- Metered-dose inhalers (MDI): 110 mcg/dose, 220 mcg/dose
- Dry powder inhalers (DPI): 220 mcg/dose
6. Side Effects
6.1 Common Side Effects:
- Sore throat
- Hoarseness or voice changes
- Oral thrush (candidiasis)
- Cough
6.2 Less Common Side Effects:
- Headache
- Nasal congestion
- Sinusitis
6.3 Rare but Serious Side Effects:
- Adrenal suppression (with high doses or prolonged use)
- Glaucoma or cataracts
- Severe allergic reactions (rash, swelling, difficulty breathing)
7. Warnings
- Acute Asthma Attacks: Mometasone inhalers are not rescue inhalers and should not be used to treat acute bronchospasm.
- Adrenal Suppression: Prolonged use of high doses can suppress adrenal gland function.
- Growth Suppression: Monitor growth in children on long-term corticosteroid therapy.
8. Precautions
- Use cautiously in patients with a history of tuberculosis, glaucoma, or infections.
- Patients should be advised to carry a rescue inhaler (e.g., salbutamol) for acute asthma symptoms.
- Discontinue use and seek medical attention if symptoms of hypersensitivity occur.
9. Interactions
- CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): May increase systemic levels of mometasone, leading to side effects.
- Other corticosteroids: Risk of cumulative side effects such as adrenal suppression.
10. Monitoring Parameters
- Monitor asthma control and adjust dose as needed.
- Check for symptoms of oral thrush or hoarseness during follow-ups.
- Assess growth in children on long-term therapy.
- Monitor for signs of adrenal suppression in patients on high doses.
11. Use in Children
- Approved for children aged 4 years and older.
- Monitor for growth suppression during prolonged use.
12. Use in Pregnancy
- Classified as Category C. Use only if the benefits outweigh potential risks. Discuss with a healthcare provider before use.
13. Use in Elderly
- Generally well tolerated in elderly patients, but monitor for systemic side effects, especially with long-term use.
14. Use in Kidney Disease
- No dose adjustment is necessary as mometasone is not excreted by the kidneys.
15. Use in Liver Disease
- Use cautiously in patients with severe liver disease, as systemic absorption of inhaled corticosteroids may be increased.
16. Patient Counselling Points
- Use the inhaler daily as prescribed, even when symptoms are absent.
- Rinse your mouth with water and spit out after use to prevent oral thrush.
- This inhaler is for maintenance therapy and does not replace a rescue inhaler for acute asthma attacks.
- Regularly check the inhaler counter (if available) to ensure it contains sufficient doses.
- Inform your doctor if you experience vision changes, recurrent infections, or severe asthma symptoms.
17. Table of Brand Names, Manufacturer, and Prices in USD
Brand Name | Manufacturer | Strength/Dosage Form | Price (USD) |
---|---|---|---|
Asmanex Twisthaler | Merck | 220 mcg DPI | $290 (60 doses) |
Asmanex HFA | Merck | 100 mcg MDI | $280 (120 doses) |
Generic Mometasone | Various | 110 mcg DPI | $200 (60 doses) |
18. 15 FAQs (Frequently Asked Questions)
1. What is Mometasone inhaler used for?
Mometasone inhalers are used for the maintenance treatment of asthma by reducing airway inflammation.
2. How does Mometasone work?
It works as a corticosteroid, reducing inflammation in the airways and improving breathing.
3. Can Mometasone inhalers be used for an asthma attack?
No, Mometasone inhalers are not rescue inhalers and should not be used for acute bronchospasms.
4. What is the usual dose of Mometasone?
The typical dose for adults is 220 mcg once or twice daily, depending on asthma severity.
5. Can children use Mometasone inhalers?
Yes, they are approved for children aged 4 years and older, with a usual dose of 110 mcg once daily.
6. What are the common side effects of Mometasone inhalers?
Sore throat, hoarseness, and oral thrush are common side effects.
7. How should Mometasone inhalers be used?
Inhale the prescribed dose once or twice daily, rinse your mouth afterward, and avoid swallowing the rinse water.
8. Can Mometasone cause weight gain?
Weight gain is not common with inhaled corticosteroids but may occur with long-term high-dose use.
9. Can pregnant women use Mometasone inhalers?
They should be used only if the benefits outweigh the risks. Consult a healthcare provider.
10. Can Mometasone inhalers interact with other medications?
Yes, CYP3A4 inhibitors like ketoconazole can increase systemic corticosteroid levels.
11. What should I do if I miss a dose?
Take it as soon as you remember unless it is close to the next dose. Do not double the dose.
12. Can Mometasone inhalers cause oral thrush?
Yes, they can. Rinse your mouth after use to prevent this.
13. How long does it take for Mometasone to work?
Improvement in asthma control may be seen within 1–2 weeks of regular use.
14. How should Mometasone inhalers be stored?
Store at room temperature, away from direct sunlight and moisture.
15. Do I need a prescription for Mometasone inhalers?
Yes, Mometasone inhalers require a prescription.