Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.loxapine inhaledSerious - Use Alternative (1)mometasone inhaled increases toxicity of loxapine inhaled by Other (see comment). Avoid or Use Alternate Drug. Comment: Agents used to treat airway disease may enhance the toxic effect of inhaled loxapine.moxifloxacinMonitor Closely (1)mometasone inhaled and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.nefazodoneMonitor Closely (1)nefazodone will increase the level or effect of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increases riak for systemic corticosteroid side effectsnelfinavirMonitor Closely (1)nelfinavir increases levels of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.nirmatrelvirMonitor Closely (1)nirmatrelvir will increase the level or effect of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration may increase certain systemic corticosteroid concentrations. Increased risk for Cushing syndrome and adrenal suppression. Consider alternant corticosteroids, including beclomethasone and prednisolone).nirmatrelvir/ritonavirMonitor Closely (1)nirmatrelvir/ritonavir will increase the level or effect of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration may increase certain systemic corticosteroid concentrations. Increased risk for Cushing syndrome and adrenal suppression. Consider alternant corticosteroids, including beclomethasone and prednisolone).ofloxacinMonitor Closely (1)mometasone inhaled and ofloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir increases levels of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of Cushing's syndrome or adrenal suppression.saquinavirMonitor Closely (1)saquinavir will increase the level or effect of mometasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increases riak for systemic corticosteroid side effectstorsemideMonitor Closely (1)mometasone inhaled increases toxicity of torsemide by Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may increase hypokalemic effect of loop diuretics. >10% Headache (26%) Viral infection (14%) Pharyngitis (12%) Epistaxis (11%) 1-10% Cough (7%) Upper respiratory tract infection (6%) Dysmenorrhea (5%) Frequency Not Defined Loss of taste Muscle soreness Vision blurred Contraindications Hypersensitivity Immunosuppressed patients Tuberculosis Status asthmaticus or other acute asthma episode necessitating intensive measures Known hypersensitivity to milk proteins or any other ingredients Cautions Not a bronchodilator; not indicated for rapid relief of bronchospasm or other acute episodes of asthma; a short-acting beta2-agonist, such as albuterol, should be available at all times to treat acute asthma symptoms; instruct patients to contact their physician immediately if episodes of asthma that are not responsive to bronchodilators occur during course of treatment; during such episodes, patients may require therapy with oral corticosteroids Unmasking of allergic conditions previously suppressed by systemic corticosteroids may occur upon transferring from systemic corticosteroid therapy Respiratory tract tuberculosis, untreated fungal or bacterial infections, viral or parasitic infections, ocular herpes simplex Nasal septum perforation, epistaxis, wheezing Cataracts, glaucoma, increased intraocular pressure reported; consider referral to an ophthalmologist in patients who develop ocular symptoms or long term therapy Risk of more serious or fatal course of chickenpox and measles in susceptible individuals; avoid use in unvaccinated or immunologically unexposed children or adults Deaths from adrenal insufficiency have occurred after abrupt withdrawal of oral steroids; taper withdrawal gradually May retard growth in children Immunocompromised patients Excessive use may suppress hypothalamic-pituitary-adrenal function During periods of stress or severe status asthmaticus, patient may require supplementary systemic corticosteroids immediately; carry warning card to that effect Long-term administration reduces bone mineral density Fungal infections Localized infections of the mouth and pharynx with Candida albicans reported; if oropharyngeal candidiasis develops, treat with appropriate local or systemic (i.e., oral) antifungal therapy while remaining on treatment; at times therapy may need to be interrupted To reduce risk of oropharyngeal candidiasis, after dosing, advise patients to rinse their mouth with water and spit out the contents without swallowing Drug interaction overview Strong CYP3A4 inhibitors (eg, ritonavir): Use with caution; may cause increased systemic corticosteroid effects Pregnancy There are no randomized clinical studies in pregnant women Animal data In animal reproduction studies with pregnant mice, rats, or rabbits, mometasone furoate caused increased fetal malformations and decreased fetal survival and growth following administration of doses that produced exposures ~1/3 to 8 times the maximum recommended human dose (MRHD) on a mcg/m2 or AUC basis However, experience with oral corticosteroids suggests that rodents are more prone to teratogenic effects from corticosteroid exposure than humans Clinical considerations In women with poorly or moderately controlled asthma, there is an increased risk of several perinatal adverse outcomes such as preeclampsia in the mother and prematurity, low birth weight, and small for gestational age in the neonate Closely monitor pregnant women with asthma and adjust medication as necessary to maintain optimal asthma control Lactation There are no available data on the presence in human milk, the effects on the breastfed child, or the effects on milk production Other inhaled corticosteroids, similar to mometasone furoate, are present in human milk Consider developmental and health benefits of breastfeeding along with the mother’s clinical need and any potential adverse effects on the breastfed infant from mometasone inhaled or from the underlying maternal conditionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Corticosteroid with potent anti-inflammatory properties; exerts effects on various cells, including mast cells and eosinophils; also exerts effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines) Absorption Minimally absorbed Onset: 1-3 days Bioavailability: <0.1% Distribution Protein bound: 98-99% Metabolism Metabolized in liver by CYP3A4 Elimination Half-life: 5.8 hr Excretion: Urine, bile Oral Inhalation Administration Twisthaler Hold the inhaler straight up (upright position) with the colored portion (the base) on the bottom; remove cap of Twisthaler while it is in this upright position to make sure that you get the right amount of medicine with each dose Breathe out fully Place the mouthpiece in mouth, holding it in a horizontal (on its side) position; firmly close lips around mouthpiece and inhale dose Remove from your mouth and hold your breath for about 10 seconds, or as long as you comfortably can; do not breathe out into the inhaler HFA inhaler Oral inhalation only After each dose, rinse their mouth with water and, without swallowing, spit out the contents to help reduce the risk of oropharyngeal candidiasis Remove cap from the mouthpiece of the actuator before use Prime before using for the first time by releasing 4 test sprays into the air, away from the face, shaking well before each spray In cases where the inhaler has not been used for more than 5 days, prime inhaler again by releasing 4 test sprays into the air, away from the face, shaking well before each spray Do not use the mometasone HFA actuator with any other inhalation drug product. Do not use actuators from other products with the Asmanex HFA canister Storage Twisthaler Store in a dry place at 25ºC (77ºF); excursion between 15-30ºC (59-89ºF) HFA inhaler Store at room temperature 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF) Keep out of reach of children Do not use or store near heat or open flame; exposure to temperatures <120ºF may cause bursting; never throw container into fire or incinerator BRAND FORM. UNIT PRICE PILL IMAGE Sinuva sinus- 1,350 mcg implantAsmanex Twisthaler inhalation- 220 mcg/ actuation (14) aerosolAsmanex Twisthaler inhalation- 220 mcg/ actuation (120) aerosolAsmanex Twisthaler inhalation- 220 mcg/ actuation (60) aerosolAsmanex Twisthaler inhalation- 110 mcg/ actuation (30) aerosolAsmanex Twisthaler inhalation- 220 mcg/ actuation (30) aerosolmometasone topical- 0.1 % ointmentmometasone topical- 0.1 % creammometasone topical- 0.1 % creammometasone topical- 0.1 % ointmentmometasone topical- 0.1 % ointmentmometasone topical- 0.1 % creammometasone topical- 0.1 % creammometasone topical- 0.1 % ointmentmometasone topical- 0.1 % ointmentmometasone topical- 0.1 % solutionmometasone topical- 0.1 % ointmentmometasone topical- 0.1 % ointmentmometasone topical- 0.1 % creammometasone topical- 0.1 % creammometasone topical- 0.1 % ointmentmometasone topical- 0.1 % solutionmometasone topical- 0.1 % solutionmometasone topical- 0.1 % solutionAsmanex HFA inhalation- 100 mcg/actuation aerosolAsmanex HFA inhalation- 200 mcg/actuation aerosolAsmanex HFA inhalation- 50 mcg/actuation aerosolmometasone nasal- 50 mcg/actuation aerosolmometasone nasal- 50 mcg/actuation aerosolmometasone nasal- 50 mcg/actuation aerosolCopyright © 2010 First DataBank, Inc.Select a drug:mometasone inhalationmometasone nasalmometasone topicalPrint Patient Educationmometasone inhalation MOMETASONE POWDER - ORAL INHALATION (mow-MET-uh-sown) COMMON BRAND NAME(S): Asmanex USES: Mometasone is used to control and prevent symptoms (wheezing and shortness of breath) caused by asthma. This medication must be used regularly to be effective. It does not work right away and should not be used to relieve sudden asthma attacks. If an asthma attack occurs, use your quick-relief inhaler (such as albuterol, also called salbutamol in some countries) as prescribed.Mometasone belongs to a class of drugs known as corticosteroids. It works by reducing the irritation and swelling of the airways. Controlling symptoms of breathing problems can decrease time lost from work or school. HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. Follow the illustrated directions for the proper use of this medication and proper cleaning of the mouthpiece. If you have any questions, consult your doctor or pharmacist.Inhale this medication by mouth as directed by your doctor, usually once or twice a day. Do not breathe out (exhale) into the inhaler. The dosage is based on your medical condition, age, and response to treatment.If two inhalations/puffs are prescribed, wait at least one minute between them. If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication, and use this drug (the corticosteroid) last.To prevent dry mouth, hoarseness, and oral yeast infections from developing, gargle, rinse your mouth with water and spit out after each use. Do not swallow the rinse water.Use this medication regularly in order to get the most benefit from it. This medication works best if used at evenly spaced intervals. To help you remember, use it at the same time(s) each day. Do not increase your dose, use this medication more often, or stop using it without first consulting your doctor.Always have your quick-relief inhaler with you. Keep track of the number of inhalations you use. The inhaler should be discarded when every inhalation has been used (when the dose indicator reads ''00'') or if it has been 45 or 60 days (depending on your brand) after removal from its foil overwrap pouch, whichever comes first.If you are regularly taking a different corticosteroid by mouth (such as prednisone), you should not stop taking it unless directed by your doctor. Some conditions (such as asthma, allergies) may become worse when the drug is suddenly stopped. If you suddenly stop taking the drug, you may also have withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness). To help prevent withdrawal, your doctor may slowly lower the dose of your old medication after you begin using mometasone. Tell your doctor or pharmacist right away if you have withdrawal. See also Precautions section.It may take 1 to 2 weeks before you get the full benefit of this drug. Tell your doctor if your symptoms do not improve or if they worsen.Learn which of your inhalers you should use every day (controller drugs) and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, worsening peak flow meter readings, waking up at night with trouble breathing, if you use your quick-relief inhaler more often (more than 2 days a week), or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away. SIDE EFFECTS: See