Mometasone (Oral Inhalation)

Duration after discontinuation: Several days or more

Half-Life Elimination

Mean: 5 hours

Protein Binding

98% to 99%

Asthma: Maintenance treatment of asthma as prophylactic therapy in patients 4 years and older (Asmanex Twisthaler) and 12 years and older (Asmanex HFA)

Limitations of use: Not indicated for the relief of acute bronchospasm.

Guideline recommendations: A low-dose inhaled corticosteroid (in addition to an as-needed short-acting beta-2 agonist) is the initial preferred long-term control medication for children, adolescents, and adult patients with persistent asthma who are candidates for treatment according to a step-wise treatment approach (GINA 2016; NAEPP 2007).

Refer to adult dosing.

Asthma: Oral inhalation: Note: Dosage forms of Asmanex Twisthaler (110 mcg and 220 mcg Twisthaler) deliver 100 and 200 mcg mometasone furoate per actuation respectively. Maximum effects may not be evident for 1 to 2 weeks or longer; higher doses may provide additional asthma control in patients who do not respond adequately after 2 weeks of therapy. Doses should be titrated to the lowest effective dose.

Children 4 to 11 years: Asmanex Twisthaler: 110 mcg once daily in the evening (maximum: 110 mcg/day)

Children ≥12 years and Adolescents: Asmanex HFA and Asmanex Twisthaler: Refer to adult dosing.

Asthma Guidelines: National Asthma Education and Prevention Program guidelines (NAEPP 2007): Dry powder inhaler (refers to Asmanex 200 mcg strength available in United States) Note: 220 mcg inhaler delivers 200 mcg mometasone furoate per actuation; NAEPP uses doses based on delivery, while manufacturer recommended doses are based on inhaler amount.

Children ≥12 years and Adolescents: Refer to adult dosing.

Asmanex HFA: Shake well prior to each inhalation. Administer as 2 inhalations twice daily (morning and evening). Prime before first use by releasing 4 test sprays into the air, away from the face, shaking well before each spray. If the inhaler has not been used for more than 5 days, prime the inhaler again with 4 test sprays. Rinse mouth with water without swallowing. Clean mouthpiece with a dry wipe after every 7 days of use.

Asmanex Twisthaler: Exhale fully prior to bringing the Twisthaler up to the mouth. Place between lips and inhale quickly and deeply. Do not breathe out through the inhaler. Remove inhaler and hold breath for 10 seconds if possible. Rinse mouth after use.

Growth (adolescents and children via stadiometry); HPA axis suppression; signs/symptoms of oral candidiasis; ocular effects (eg, cataracts, increased intraocular pressure, glaucoma); hepatic impairment; bone mineral density; FEV1, peak flow, and/or other pulmonary function tests