[mometasone furoate inhalation powder]
|WHAT IS Asmanex? The Asmanex Twisthaler 220 mcg ( Mometasone furoate inhalation powder
) delivers anti-inflammatory medication for asthma through a dry powder delivery system.
Asmanex is a cap-activated inhalation-driven multi-dose dry powder inhaler containing
mometasone furoate and anhydrous lactose (which contains milk proteins). Each actuation of the
Asmanex Twisthaler 220 mcg inhaler provides a measured dose of 1.5 mg mometasone furoate
inhalation powder, containing 220 mcg of mometasone furoate.Asmanex(R) Twisthaler(R) 220mcg
is for the first-line maintenance treatment of asthma as preventive therapy in patients 12 years of
age and older.
HOW DOES ASMANEX WORK? The active ingredient in Asmanex is mometasone furoate.
Mometasone furoate is a corticosteroid demonstrating potent anti-inflammatory activity.
Inflammation is an important factor for asthma. The binding affinity of mometasone furoate for the
human glucocorticoid receptor is about 12 times that of dexamethasone, 7 times that of
triamcinolone acetonide and 5 times that of budesonide.
Asmanex helps manage symptoms. Clinical studies with Asmanex have shown improvement in lung
function, decreased use of rescue medication, decreased incidence of nighttime awakenings and
improvements in daytime symptoms such as coughing and wheezing.
STATISTICS ABOUT ASMANEX Genetics, environment, and immune system factors can all
contribute. Asthma triggers can include tobacco smoke and allergens such as dust mites, animal
dander, and cockroaches. Currently, about 20 million people suffer from asthma.
ASMANEX SIDE-EFFECTS The most common side effects of Asmanex include: headache, allergic
rhinitis, pharyngitis, upper respiratory infection, sinusitis, oral candidiasis, dysmenorrhea,
musculoskeletal pain, back pain, dyspepsia, myalgia, abdominal pain, and nausea.
RECENT CLINICAL FINDINGS ON ASMANEX (Mometasone furoate inhalation powder)
Fluticasone propionate and mometasone furoate have similar and very low systemic bioavailability
when administered intranasally using a high-dose regimen [of Asmanex]. [B1]
Mometasone furoate (MF) and fluticasone propionate (FP) are high potency inhaled
corticosteroids. The systemic bioavailability of MF is claimed to be negligible, leading to a minimal
potential for systemic adverse effects. [B2]
Asmanex Twisthaler therapy is contraindicated in the primary treatment of status asthmaticus or
other acute episodes of asthma where intensive measures are required.
SAFETY AND EFFECTIVENESS OF ASMANEX
Mometasone furoate microemulsion is a safe and effective therapy in the treatment of symptomatic
erosive-ulcerative oral lichen planus [B3].
Mometasone furoate does not affect mucociliary clearance in patients with perennial allergic
Mometasone furoate DPI, 400 microg every evening, provided comparable efficacy as fluticasone
propionate MDI, two 125-microg puffs twice daily, in subjects with moderate persistent asthma
previously treated with fluticasone propionate. [B5]
TASTE Compared with fluticasone propionate and mometasone furoate, triamcinolone acetonide
aqueous was associated with significantly less odor, less taste, less dryness of nose/throat, less
aftertaste, and greater overall liking. [B6]
As many as 20 million Americans have asthma, leading to 2 million emergeny room visits and more
than 5000 deaths annually. 
The FDA is planning to restrict use of Glaxo's Advair (another asthma treatment) as Advair may make some
asthma episodes more severe and shouldn't be used as a first-choice treatment. Advair, a combo of Serevent
and a steroid, is sold as Seretide in some markets. Thus, Merck's Singulair and Schering-Plough's Asmanex may
takes its market share. 
References for Asmanex Twisthaler :
Once-Daily Asthma Medicine Approved, WebMD Medical News, March 31, 2005 - Asmanex Twisthaler
Once-Daily Asthma Inhaler Approved Forbes.com. March 31, 2005 Product label, April 3, 2005 - Asmanex
Twisthaler  Once-Daily Asthma Inhaler Approved, womenshealth.gov Online Publication, November 25,
2005.  Glaxo Shares Fall on U.S. Plan to Restrict Advair Use (Update 5) Bloomberg.com, Nov 21, 2005 S1
FDA Staff Recommends Updated Warning For Asmanex > SGP wsj.com JUNE 19, 2009, 10:18 A.M. ET [B1]
Daley-Yates et al, Eur J Clin Pharmacol. 2004 Jun;60(4):265-8. Epub 2004 Apr 28 [B2] Fardon TC et al, Adrenal suppression with
dry powder formulations of fluticasone propionate and mometasone furoate, Am J Respir Crit Care Med. 2004 Nov 1;170(9):960-6.
Epub 2004 Jun 7. [B3] Aguirre JM, Efficacy of mometasone furoate microemulsion in the treatment of erosive-ulcerative oral lichen
planus: pilot study. J Oral Pathol Med. 2004 Aug;33(7):381-5. [B4] Pata YS et al, The effect of mometasone furoate on mucociliary
clearance in patients with perennial allergic rhinitis, Kulak Burun Bogaz Ihtis Derg. 2003 Oct;11(4):97-9.[B5] Wardlaw A Efficacy
and safety of mometasone furoate dry powder inhaler vs fluticasone propionate metered-dose inhaler in asthma subjects previously
using fluticasone propionate. Ann Allergy Asthma Immunol. 2004 Jul;93(1):49-55 [B6] Stokes M et al, Evaluation of patients'
preferences for triamcinolone acetonide aqueous, fluticasone propionate, and mometasone furoate nasal sprays in patients with
allergic rhinitis. Otolaryngol Head Neck Surg. 2004 Sep;131(3):225-31