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ASMANEX® HFA (mometasone furoate) Inhalation Aerosol 50 mcg, mcg, mcg
Asthma: The safety and efficacy of this medication have not been established for people with asthma. Indacaterol belongs to the class of medication called long-acting beta-agonists LABA. LABAs have been shown in a study to increase the risk of asthma-related deaths.
Indacaterol should not be used to treat asthma. Bronchospasm: Occasionally, inhaled medications may cause the airways to spasm and close up bronchospasm , which makes breathing even more difficult and can be life-threatening.
If you experience increased difficulty breathing after using a dose of indacaterol, seek immediate medical attention. Diabetes: Indacaterol may cause a loss of blood glucose control and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.
If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Heart problems: This medication can cause increased heart rate and blood pressure, as well as rapid or irregular heart beat or abnormal electrical signal called "prolonged QT interval".
These effects may worsen symptoms of heart disease. If you have heart disease such as angina, congestive heart failure, or arrhythmia, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Contact your doctor as soon as possible if you develop symptoms of heart problems such as shortness of breath, chest pain, rapid heartbeat, or swollen ankles.
Low potassium levels: Indacaterol may cause decreased levels of potassium in the blood. This can cause abnormal heart rhythms, weakness, fatigue, muscle cramps or constipation. If you experience any of these symptoms, contact your doctor. Lactose allergy: This medication contains lactose milk sugar and a small amount of milk proteins.
It is possible that people who have a severe milk protein allergy may have an allergic reaction to this medication. Speak to your doctor if you have any concerns. Seizures: If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you start developing acute symptoms such as breathlessness, wheezing, and cough, you should use your "reliever" medication for rapid relief of your symptoms. It is very important that you have your "reliever" medication with you at all times. Seek emergency medical help if your breathing problems worsen quickly or if you use your rescue medication but it does not relieve your breathing problems.
Thyroid gland problems: If you have thyroid disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks.
Rhinosinusitis: Establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg. Healthcare expenditures for sinusitis in contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin Immunol. Cost burden of chronic rhinosinusitis: a claims-based study. Epub Feb 3. Topical steroids in chronic rhinosinusitis without polyps: a systematic review and meta-analysis. Topical therapies in the management of chronic rhinosinusitis: an evidence-based review with recommendations.
Int Forum Allergy Rhinol. Epub Oct 8. Distribution of topical agents to the paranasal sinuses: an evidence-based review with recommendations. Epub May Local drug delivery.
Otolaryngol Clin North Am. Corticosteroid nasal irrigations after endoscopic sinus surgery in the management of chronic rhinosinusitis. Epub May 7. Bachert C, Meltzer EO. Effect of mometasone furoate nasal spray on quality of life of patients with acute rhinosinusitis. Efficacy and safety of mometasone furoate nasal spray in the treatment of chronic rhinosinusitis. Adv Ther. Derendorf H, Meltzer EO. Empagliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Enalapril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Ephedrine: Moderate Ephedrine may enhance the metabolic clearance of corticosteroids. Decreased blood concentrations and lessened physiologic activity may necessitate an increase in corticosteroid dosage. Ephedrine; Guaifenesin: Moderate Ephedrine may enhance the metabolic clearance of corticosteroids. Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Eprosartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Ertugliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Estrogens: Moderate Monitor for corticosteroid-related adverse events if corticosteroids are used with estrogens.
Concurrent use may increase the exposure of corticosteroids. Estrogens may decrease the hepatic clearance of corticosteroids thereby increasing their effect. Exenatide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Fluoxymesterone: Moderate Coadministration of corticosteroids and fluoxymesterone may increase the risk of edema, especially in patients with underlying cardiac or hepatic disease. Corticosteroids with greater mineralocorticoid activity, such as fludrocortisone, may be more likely to cause edema.
Administer these drugs in combination with caution. Fosamprenavir: Moderate Concomitant administration of fosamprenavir and mometasone may increase systemic exposure to mometasone, increasing the risk of corticosteroid-related adverse events.
Exercise caution when administering mometasone with fosamprenavir long-term and monitor closely for hypercorticism and adrenal suppression. Fosinopril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Glimepiride: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Glimepiride; Rosiglitazone: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary.
Glipizide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Glipizide; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary.
Glyburide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Glyburide; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Glycerol Phenylbutyrate: Moderate Corticosteroids may induce elevated blood ammonia concentrations. Corticosteroids should be used with caution in patients receiving glycerol phenylbutyrate.
Monitor ammonia concentrations closely. Grapefruit juice: Moderate Consumption of grapefruit or grapefruit juice while taking mometasone may increase systemic exposure to mometasone, increasing the risk of corticosteroid-related adverse events.
Avoid consistent consumption of grapefruit and its juice while on mometasone therapy; those who do consume grapefruit regularly should be monitored closely for hypercorticism and adrenal suppression.
Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Haloperidol: Moderate Caution is advisable during concurrent use of haloperidol and corticosteroids as electrolyte imbalance caused by corticosteroids may increase the risk of QT prolongation with haloperidol. Hemin: Moderate Hemin works by inhibiting aminolevulinic acid synthetase.
Corticosteroids increase the activity of this enzyme should not be used with hemin. Hydralazine; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Hydrochlorothiazide, HCTZ; Methyldopa: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Hydrochlorothiazide, HCTZ; Moexipril: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Moderate Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia. Ibritumomab Tiuxetan: Moderate Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia.
Idelalisib: Moderate Concomitant administration of idelalisib and mometasone or formoterol; mometasone may increase systemic exposure to mometasone. The risk of interaction in unclear; however, because of the potential for systemic absorption, avoidance of mometasone may be prudent. If these agents are given together, exercise caution with long-term concomitant use and monitor closely for hypercorticism and adrenal suppression.
Incretin Mimetics: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Indapamide: Moderate Additive hypokalemia may occur when indapamide is coadministered with other drugs with a significant risk of hypokalemia such as systemic corticosteroids.
Coadminister with caution and careful monitoring. Indinavir: Major As mometasone is a CYP3A4 substrate, concomitant use with indinavir, a potent inhibitor of CYP3A4, may increase plasma levels and related adverse effects of mometasone; caution is advised. Inebilizumab: Moderate Concomitant usage of inebilizumab with immunosuppressant drugs, including systemic corticosteroids, may increase the risk of infection. Consider the risk of additive immune system effects when coadministering therapies that cause immunosuppression with inebilizumab.
Insulin Degludec; Liraglutide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Insulin Glargine; Lixisenatide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Insulins: Moderate Monitor blood glucose during concomitant corticosteroid and insulin use; an insulin dose adjustment may be necessary.
Irbesartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Isoproterenol: Moderate The risk of cardiac toxicity with isoproterenol in asthma patients appears to be increased with the coadministration of corticosteroids. Intravenous infusions of isoproterenol in refractory asthmatic children at rates of 0. Isotretinoin: Minor Both isotretinoin and corticosteroids can cause osteoporosis during chronic use.
Patients receiving systemic corticosteroids should receive isotretinoin therapy with caution. Itraconazole: Moderate Concomitant administration of itraconazole and mometasone may increase systemic exposure to mometasone, increasing the risk of corticosteroid-related adverse events. Exercise caution when administering mometasone with itraconazole long-term and monitor closely for hypercorticism and adrenal suppression.
Ketoconazole: Moderate Monitor for steroid-related adverse reactions if coadministration of mometasone with ketoconazole is necessary, due to increased mometasone exposure; Cushing syndrome and adrenal suppression could potentially occur with long-term use.
Lansoprazole; Amoxicillin; Clarithromycin: Moderate Concomitant administration of clarithromycin and mometasone may increase systemic exposure to mometasone, increasing the risk of corticosteroid-related adverse events. L-Asparaginase Escherichia coli: Moderate Concomitant use of L-asparaginase with corticosteroids can result in additive hyperglycemia. Levoketoconazole: Moderate Monitor for steroid-related adverse reactions if coadministration of mometasone with ketoconazole is necessary, due to increased mometasone exposure; Cushing syndrome and adrenal suppression could potentially occur with long-term use.
Lidocaine; Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary. Linagliptin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Liraglutide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary.
Lisinopril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Lixisenatide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Lonafarnib: Moderate Monitor for steroid-related adverse reactions if coadministration of mometasone with lonafarnib is necessary, due to increased mometasone exposure; Cushing syndrome and adrenal suppression could potentially occur with long-term use.
Lonapegsomatropin: Moderate Corticosteroids can retard bone growth and therefore, can inhibit the growth-promoting effects of somatropin. If corticosteroid therapy is required, the corticosteroid dose should be carefully adjusted. Loop diuretics: Moderate Monitor potassium concentrations during concomitant corticosteroid and loop diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Both corticosteroids and loop diuretics cause increased renal potassium loss. Lopinavir; Ritonavir: Moderate Coadministration of mometasone with ritonavir a strong CYP3A4 inhibitor may cause mometasone serum concentrations to increase, potentially resulting in Cushing's syndrome and adrenal suppression. Losartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Macimorelin: Major Avoid use of macimorelin with drugs that directly affect pituitary growth hormone secretion, such as corticosteroids. Healthcare providers are advised to discontinue corticosteroid therapy and observe a sufficient washout period before administering macimorelin. Use of these medications together may impact the accuracy of the macimorelin growth hormone test.
Magnesium Salicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Mannitol: Moderate Corticosteroids may accentuate the electrolyte loss associated with diuretic therapy resulting in hypokalemia. Also, corticotropin may cause calcium loss and sodium and fluid retention. Mannitol itself can cause hypernatremia. Close monitoring of electrolytes should occur in patients receiving these drugs concomitantly. Mecasermin rinfabate: Moderate Additional monitoring may be required when coadministering systemic or inhaled corticosteroids and mecasermin, recombinant, rh-IGF In animal studies, corticosteroids impair the growth-stimulating effects of growth hormone GH through interference with the physiological stimulation of epiphyseal chondrocyte proliferation exerted by GH and IGF Dexamethasone administration on long bone tissue in vitro resulted in a decrease of local synthesis of IGF Similar counteractive effects are expected in humans.
If systemic or inhaled glucocorticoid therapy is required, the steroid dose should be carefully adjusted and growth rate monitored. Mecasermin, Recombinant, rh-IGF Moderate Additional monitoring may be required when coadministering systemic or inhaled corticosteroids and mecasermin, recombinant, rh-IGF Meglitinides: Moderate Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued.
Mepenzolate: Minor Anticholinergics, such as mepenzolate, antagonize the effects of antiglaucoma agents. Mepenzolate is contraindicated in patients with glaucoma and therefore should not be coadministered with medications being prescribed for the treatment of glaucoma.
In addition, anticholinergic drugs taken concurrently with corticosteroids in the presence of increased intraocular pressure may be hazardous.
Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Metformin; Repaglinide: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Moderate Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued.
Metformin; Rosiglitazone: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Metformin; Saxagliptin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Metformin; Sitagliptin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Methazolamide: Moderate Corticosteroids may increase the risk of hypokalemia if used concurrently with methazolamide. Methenamine; Sodium Acid Phosphate: Moderate Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia.
Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine: Moderate Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia. Methenamine; Sodium Salicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Methyclothiazide: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Metolazone: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Metoprolol; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Metyrapone: Major Medications which affect pituitary or adrenocortical function, including all corticosteroid therapy, should be discontinued prior to and during testing with metyrapone.
Patients taking inadvertent doses of corticosteroids on the test day may exhibit abnormally high basal plasma cortisol levels and a decreased response to the test. Although systemic absorption of nasal and topical corticosteroids is minimal, temporary discontinuation of these products should be considered if possible to reduce the potential for interference with the test results.
Micafungin: Moderate Leukopenia, neutropenia, anemia, and thrombocytopenia have been associated with micafungin. Patients who are taking immunosuppressives such as the corticosteroids with micafungin concomitantly may have additive risks for infection or other side effects.
In a pharmacokinetic trial, micafungin had no effect on the pharmacokinetics of prednisolone. Acute intravascular hemolysis and hemoglobinuria was seen in a healthy volunteer during infusion of micafungin mg and oral prednisolone 20 mg. This reaction was transient, and the subject did not develop significant anemia. Mifepristone: Major Mifepristone for termination of pregnancy is contraindicated in patients on long-term corticosteroid therapy and mifepristone for Cushing's disease or other chronic conditions is contraindicated in patients who require concomitant treatment with systemic corticosteroids for life-saving purposes, such as serious medical conditions or illnesses e.
For other situations where corticosteroids are used for treating non-life threatening conditions, mifepristone may lead to reduced corticosteroid efficacy and exacerbation or deterioration of such conditions.
This is because mifepristone exhibits antiglucocorticoid activity that may antagonize corticosteroid therapy and the stabilization of the underlying corticosteroid-treated illness. Mifepristone may also cause adrenal insufficiency, so patients receiving corticosteroids for non life-threatening illness require close monitoring. Because serum cortisol levels remain elevated and may even increase during treatment with mifepristone, serum cortisol levels do not provide an accurate assessment of hypoadrenalism.
Patients should be closely monitored for signs and symptoms of adrenal insufficiency, If adrenal insufficiency occurs, stop mifepristone treatment and administer systemic glucocorticoids without delay; high doses may be needed to treat these events.
Factors considered in deciding on the duration of glucocorticoid treatment should include the long half-life of mifepristone 85 hours. Mivacurium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy. Natalizumab: Major Ordinarily, patients receiving chronic immunosuppressant therapy should not be treated with natalizumab.
Treatment recommendations for combined corticosteroid therapy are dependent on the underlying indication for natalizumab therapy.
Corticosteroids should be tapered in those patients with Crohn's disease who are on chronic corticosteroids when they start natalizumab therapy, as soon as a therapeutic benefit has occurred. If the patient cannot discontinue systemic corticosteroids within 6 months, discontinue natalizumab.
The concomitant use of natalizumab and corticosteroids may further increase the risk of serious infections, including progressive multifocal leukoencephalopathy, over the risk observed with use of natalizumab alone.
In multiple sclerosis MS clinical trials, an increase in infections was seen in patients concurrently receiving short courses of corticosteroids. However, the increase in infections in natalizumab-treated patients who received steroids was similar to the increase in placebo-treated patients who received steroids. Short courses of steroid use during natalizumab, such as when they are needed for MS relapse treatment, appear to be acceptable for use concurrently.
Nateglinide: Moderate Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued.
Nefazodone: Moderate Concomitant administration of nefazodone and mometasone may increase systemic exposure to mometasone, increasing the risk of corticosteroid-related adverse events. Exercise caution when administering mometasone with nefazodone long-term and monitor closely for hypercorticism and adrenal suppression.
Nelfinavir: Moderate Concomitant administration of nelfinavir and mometasone may increase systemic exposure to mometasone, increasing the risk of corticosteroid-related adverse events. Exercise caution when administering mometasone with nelfinavir long-term and monitor closely for hypercorticism and adrenal suppression. Neostigmine: Moderate Concomitant use of anticholinesterase agents, such as neostigmine, and systemic corticosteroids may produce severe weakness in patients with myasthenia gravis.
If possible, anticholinesterase agents should be withdrawn at least 24 hours before initiating systemic corticosteroid therapy.
Neuromuscular blockers: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy.
Nirmatrelvir; Ritonavir: Moderate Coadministration of mometasone with ritonavir a strong CYP3A4 inhibitor may cause mometasone serum concentrations to increase, potentially resulting in Cushing's syndrome and adrenal suppression. Nonsteroidal antiinflammatory drugs: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and nonsteroidal antiinflammatory drug NSAID use. The Beers criteria recommends that this drug combination be avoided in older adults; if coadministration cannot be avoided, provide gastrointestinal protection.
Ofatumumab: Moderate Concomitant use of ofatumumab with corticosteroids may increase the risk of immunosuppression. Ofatumumab has not been studied in combination with other immunosuppressive or immune modulating therapies used for the treatment of multiple sclerosis, including immunosuppressant doses of corticosteroids.
Olmesartan; Amlodipine; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Olmesartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Ombitasvir; Paritaprevir; Ritonavir: Moderate Coadministration of mometasone with ritonavir a strong CYP3A4 inhibitor may cause mometasone serum concentrations to increase, potentially resulting in Cushing's syndrome and adrenal suppression.
Oxymetholone: Moderate Concomitant use of oxymetholone with corticosteroids or corticotropin, ACTH may cause increased edema.
Pancuronium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy. Pegaspargase: Moderate Monitor for an increase in glucocorticoid-related adverse reactions such as hyperglycemia and osteonecrosis during concomitant use of pegaspargase and glucocorticoids.
Penicillamine: Major Agents such as immunosuppressives have adverse reactions similar to those of penicillamine. Concomitant use of penicillamine with these agents is contraindicated because of the increased risk of developing severe hematologic and renal toxicity.
Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Photosensitizing agents topical : Minor Corticosteroids administered prior to or concomitantly with photosensitizing agents used in photodynamic therapy may decrease the efficacy of the treatment. Physostigmine: Moderate Concomitant use of anticholinesterase agents. If possible, withdraw anticholinesterase inhibitors at least 24 hours before initiating corticosteroid therapy.
Pimozide: Moderate According to the manufacturer of pimozide, the drug should not be coadministered with drugs known to cause electrolyte imbalances, such as high-dose, systemic corticosteroid therapy.
Pimozide is associated with a well-established risk of QT prolongation and torsade de pointes TdP , and electrolyte imbalances e. Pimozide is contraindicated in patients with known hypokalemia or hypomagnesemia. Topical corticosteroids are less likely to interact. Pioglitazone; Glimepiride: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary.
Pioglitazone; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Posaconazole: Moderate Concomitant administration of posaconazole and mometasone may increase systemic exposure to mometasone, increasing the risk of corticosteroid-related adverse events.
Exercise caution when administering mometasone with posaconazole long-term and monitor closely for hypercorticism and adrenal suppression. Potassium Phosphate; Sodium Phosphate: Moderate Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia.
Potassium-sparing diuretics: Minor The manufacturer of spironolactone lists corticosteroids as a potential drug that interacts with spironolactone. Intensified electrolyte depletion, particularly hypokalemia, may occur. However, potassium-sparing diuretics such as spironolactone do not induce hypokalemia.
Liver function: Mometasone may have increased effects on people who have cirrhosis of the liver. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using this medication, helps reduce the chances of developing thrush, a yeast fungal infection of the mouth or throat.
If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor. Osteoporosis: Over time, this medication can increase the risk of osteoporosis brittle bones , just as any corticosteroid can. Talk to your doctor about ways to help prevent osteoporosis. Your doctor will monitor your bone density if you need to take this medication for a long period of time. Steroid medication use: If you have taken or are still taking an oral steroid medication e.
In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again. Stopping medication: Do not stop this medication abruptly.
When this medication is stopped, it should be stopped gradually, as directed by your doctor. Thyroid disease: The effects of mometasone may be increased for people with decreased thyroid function hypothyroidism. If you have hypothyroidism, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Wheezing: This medication may cause the airways to spasm immediately after using the inhaler. If this happens, use your rescue inhaler as soon as possible to relieve the symptoms, then call your doctor as soon as possible. Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if mometasone passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: Inhaled mometasone may slow the growth and development of adolescents using this medication. This will be closely monitored by your child's doctor. The safety and effectiveness of inhaled mometasone has not been determined for children less than 4 years of age. If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:. An interaction between two medications does not always mean that you must stop taking one of them.
Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter non-prescription , and herbal medications you are taking. Also tell them about any supplements you take.
Mometasone belongs to the class of medications called corticosteroids. Mometasone inhalation is used to treat asthma for people 4 years of age and older.
It helps to control the symptoms of asthma and prevent asthma attacks by reducing the swelling in the airways of the lungs. When used regularly, it will help prevent and control asthma symptoms. It will not relieve an asthma attack once it has already started. Regular daily use is important for its effectiveness. This medication starts to work within 24 hours, but the full effects may not be seen for 1 to 2 weeks.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor.
Do not stop taking this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications.
If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. Your doctor may increase or decrease the dose, depending on how well it works for you. Once the breathing difficulties are under control, the dose should be decreased to the lowest possible dose that keeps the asthma under control. If asthma worsens while using this medication, your doctor may instruct you to increase the dose or use the medication more frequently.
The mometasone inhaler is breath activated. The amount of powder inhaled with each dose is very small. You may not be able to taste it or feel in going into your lungs. However, the medication will be getting into your lungs if you follow the instructions on how to use the inhaler. If you are not sure how to use your inhaler, ask your pharmacist or doctor to show you. Treatment with this medication should not be stopped abruptly.
It should be tapered off gradually to reduce the chance of the symptoms worsening. To reduce the risk of thrush yeast infection in the mouth, rinse and gargle with water after inhaling the medication. It is important to remember that this medication will not provide immediate relief for an asthma attack that has already started. This medication is intended for long-term relief. Inhalers that contain "reliever" medications with fast action e. This medication works best when it is used regularly.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. The device is packaged in a sealed foil pouch. Keep it in the sealed pouch until you are ready to begin using it. Discard the device and any remaining medication 2 months after opening the package. Do not dispose of medications in wastewater e. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Nonmedicinal ingredients: lactose anhydrous. Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication.
If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
Many of these side effects can be managed, and some may go away on their own over time. Contact your doctor if you experience these side effects and they are severe or bothersome. Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention. Check with your doctor as soon as possible if any of the following side effects occur:.
Stop taking the medication and seek immediate medical attention if any of the following occur:. Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication. Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health.
These factors may affect how you should use this medication. Asthma control: This medication is not for use as a "reliever" medication. If you start to have an asthma attack, be sure to use your "reliever" medication for rapid relief of your asthma symptoms.
Contact your doctor immediately if you find you are using your "reliever" medications e. This may mean your asthma is not controlled. Your doctor may want you to temporarily change the dose of this medication or may start you on an oral corticosteroid. Eye problems: Prolonged use of mometasone or other inhaled corticosteroids may cause glaucoma with possible damage to the optic nerves or it may produce cataracts. It may also increase the risk of eye infections due to fungi or viruses.
You should discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Infections: Mometasone may hide some signs of infection, and new infections may appear while mometasone is being used. Infections such as chickenpox and measles can be more serious for people taking medications such as mometasone.
Contact your doctor if you notice any symptoms of an infection e. Liver function: Mometasone may have increased effects on people who have cirrhosis of the liver.
If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using this medication, helps reduce the chances of developing thrush, a yeast fungal infection of the mouth or throat.
If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor. Osteoporosis: Over time, this medication can increase the risk of osteoporosis brittle bonesjust as any corticosteroid can.
Talk to your doctor about ways to help prevent osteoporosis. Your doctor will monitor your bone density if you need to take this medication for a long period of time. Steroid medication use: If you have taken or are still taking an oral steroid medication e. In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again. Stopping medication: Do not stop this medication abruptly. When this medication is stopped, it should be stopped gradually, as directed by your doctor.
Thyroid disease: The effects of mometasone may be increased for people with decreased thyroid function hypothyroidism. If you have hypothyroidism, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Wheezing: This medication may cause the airways to spasm immediately after using the inhaler. If this happens, use your rescue inhaler as soon as possible to relieve the symptoms, then call your doctor as soon as possible.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Breast-feeding: It is not known if mometasone passes into breast milk.
If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Children: Inhaled mometasone may slow the growth and development of adolescents using this medication. This will be closely monitored by your child's doctor. The safety and effectiveness of inhaled mometasone has not been determined for children less than 4 years of age. If you are taking any of these medications, speak with your doctor or pharmacist.
Depending on your specific circumstances, your doctor may want you to:. An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter non-prescriptionand herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know.
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Mometasone furoate nasal suspension ( mg per metered dose) 30 doses), mCg per actuation (14, 60, doses); contains lactose and milk proteins. This medicinal product contains lactose. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-. Lactose anhydrous (which contains trace amounts of milk protein). INDICATIONS AND CLINICAL USE. ASMANEX® Twisthaler® (mometasone furoate dry. Find answers to frequently asked questions about ASMANEX® HFA (mometasone furoate) Inhalation Aerosol 50 mcg, mcg, mcg. Mometasone furoate nasal spray (MFNS) is a INCS that is used in the management of The placebo will contain lactose monohydrate and will be supplied in. If you have hypothyroidism, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Fetal growth restriction and a significantly increased risk of low birthweight has been reported with use of potent or very potent topical corticosteroids during the third trimester, particularly when using more than grams. Contact your doctor if you notice any symptoms of an infection e.Study record managers: refer to the Data Element Definitions if submitting registration or results information. The placebo nasal spray will contain the same inert ingredients found in MF nasal spray: glycerin, microcrystalline cellulose and carboxymethylcellulose, sodium citrate, citric acid, benzalkonium chloride, and polysorbate The placebo nasal spray will be packaged identically to the mometasone nasal spray. Participants will be required to dissolve the contents of two capsules into an 8-ounce mL sinus rinse bottle along with the saline rinse.
All participants will be instructed to perform the following once daily: irrigation of both right and left nasal cavity with one-half of the contents of the nasal rinse followed by 2 sprays per nostril of the nasal spray. Drug: Mometasone Furoate Nasal Irrigation Participants will undergo an 8-week treatment course that includes nasal saline irrigation with mometasone powder and placebo nasal spray.
The placebo will contain lactose monohydrate and will be supplied in capsules identical to the budesonide capsules. Participants will be required to dissolve the contents of the two capsules into an 8-ounce mL sinus rinse bottle along with the saline rinse.
Drug: Mometasone Nasal Spray Participants will undergo an 8-week treatment course that includes placebo saline irrigation with mometasone nasal spray. All relevant time points used in the calculation in the Time Frame e. A board-certified otolaryngologist will perform a nasal endoscopic examination pre- and post-intervention and findings recorded using the Lund-Kennedy grading system.
The The Lund Kennedy System grades the pathologic state of the nasal cavity based on the presence of polyps, nasal discharge, and mucosal edema.
Scores are added for each side of the nose with a minimum score of 0 and maximum score of 12 with higher scores indicating more severe sinonasal inflammation. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below.
For general information, Learn About Clinical Studies. AND inflammation documented by one or more of the following findings:. We're building a better ClinicalTrials. Check it out and tell us what you think!
Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms.
Save this study. Warning You have reached the maximum number of saved studies Effectiveness of Mometasone Nasal Irrigation for Chronic Rhinosinusitis The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Listing a study does not mean it has been evaluated by the U. Federal Government. Read our disclaimer for details. Results First Posted : December 19, Last Update Posted : August 9, Study Description. Chronic rhinosinusitis CRS affects up to The recommended medical management of CRS includes large-volume, low-pressure saline lavage, systemic antibiotics, and intranasal corticosteroids INCS. The aim of this study is to evaluate the effectiveness of mometasone furoate large-volume, low-pressure nasal irrigation for surgery-naive CRS patients.
Detailed Description:. The overall goal of this proposed research project is to optimize topical delivery of MF to the paranasal sinuses in surgery-naive CRS patients through the use of high-volume, low-pressure nasal saline irrigation. The investigators will be conducting a single-site, double-blinded, placebo-controlled randomized clinical trial RCT in which we propose to evaluate the effectiveness of MF nasal irrigation compared to MF nasal spray.
Resource links provided by the National Library of Medicine Drug Information available for: Mometasone furoate Mometasone Mometasone furoate monohydrate. FDA Resources. Arms and Interventions. Participants will undergo an 8-week treatment course that includes nasal saline irrigation with mometasone powder and placebo nasal spray. Participants will undergo an 8-week treatment course that includes placebo saline irrigation with mometasone nasal spray.
Outcome Measures. Eligibility Criteria. Inclusion Criteria: weeks or longer of two or more of the following signs and symptom consistent with CRS: mucopurulent drainage anterior, posterior, or both nasal obstruction congestion facial pain-pressure-fullness and decreased sense of smell AND inflammation documented by one or more of the following findings: purulent mucus or edema in the middle meatus or ethmoid region radiographic imaging showing inflammation of the paranasal sinuses.
Exclusion Criteria: inability to speak or understand English nasal polyps history of nasal or sinus surgery comorbid mucociliary conditions dependence on prolonged corticosteroid therapy for comorbid conditions, such as asthma and chronic obstructive pulmonary disease history of oral or systematic antibiotic use in the past 2 weeks history of allergy to MF or other topical steroids pregnant or breastfeeding participants with a baseline SNOT score of 9 or less will be excluded due to inability to achieve a minimally clinically improved difference pre- and post-intervention.
Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials. More Information. Rhinosinusitis: Establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg. Healthcare expenditures for sinusitis in contributions of asthma, rhinitis, and other airway disorders.
J Allergy Clin Immunol. Cost burden of chronic rhinosinusitis: a claims-based study. Epub Feb 3. Topical steroids in chronic rhinosinusitis without polyps: a systematic review and meta-analysis. Topical therapies in the management of chronic rhinosinusitis: an evidence-based review with recommendations. Int Forum Allergy Rhinol.
Epub Oct 8. Distribution of topical agents to the paranasal sinuses: an evidence-based review with recommendations. Epub May Local drug delivery. Otolaryngol Clin North Am. Corticosteroid nasal irrigations after endoscopic sinus surgery in the management of chronic rhinosinusitis. Epub May 7. Bachert C, Meltzer EO. Effect of mometasone furoate nasal spray on quality of life of patients with acute rhinosinusitis. Efficacy and safety of mometasone furoate nasal spray in the treatment of chronic rhinosinusitis.
Adv Ther. Derendorf H, Meltzer EO. Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implications. National Library of Medicine U. National Institutes of Health U. Department of Health and Human Services. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Phase 4. Study Type :. Interventional Clinical Trial. Actual Enrollment :. Actual Study Start Date :.
Actual Primary Completion Date :. Actual Study Completion Date :. Experimental: Mometasone Furoate Nasal Irrigation The study intervention will be mometasone furoate powder 1. Other Name: Nasonex. October 15, Key Record Dates.
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