Asmanex is an inhaler with glucocorticosteroids used during asthma attacks.
Features of the preparation
Composition of Asmanex
Asmanex active substance is mometasone furoate - a hormonal drug. One dose contains 0.2 or 0.4 mg of active substance. As an additional substance, milk lactose is used( 1,161 or 2,321 mg).
Asmanex( photo)
Dosage forms and prices
Asmanex is a white( whitish) powder packed in 30 or 60 doses in aluminum foil, coated with a laminated film of polymeric materials. Dosage powders are packed in a cardboard box.
Asmanex is available at any commercial pharmaceutical point. The average cost of the drug is 60 doses - 850 rubles( 200 mcg) or 1530 rubles per drug with 60 doses - 400 mcg.
Pharmacological action
Pharmacodynamics
Secretion of inflammatory mediators after using mometasone furoate is slowed down. With the development of an allergic reaction in patients, leukocytes begin to release leukotrienes, which cause the development of an asthmatic attack. Studies outside the human body( in vitro) proved the inhibitory effect of mometasone furoate in relation to the pathology of the functional activity of leukocytes. In cultured cells, the active substance of Asmanex had an inhibitory effect on the secretion of interleukins of different systematic groups( Nos. 1, 5, 6).Mometasone furoate is a potent inhibitor of secretion of Th2-cytokines and interleukins # 4 from human cells( T-lymphocytes and CD4).
The mometasone derivative in a daily dose of 200-400 mg in terms of the highest expiratory flow rate increases the possibility of external respiration. The constant concentration of mometasone furoate in the blood reduces the manifestation of the clinical picture of asthma and allows you to suspend the use of β-2 blockers.
Asmanex improves the parameters of external respiration a day after its application. The maximum concentration of the mometasone derivative persists in the blood within 7-15 days after the drug is consumed. The parameters of external respiration during the treatment course remained stably satisfactory with the regular use of Asmanex for 4 weeks at a daily dose of 200 mg to 1200 mg.
During the treatment course in a daily dose, as well as exceeding the daily dose of Asmanex to 1600 mg, there was no reliable confirmation of the depression of the hypothalamic-pituitary-adrenocortical system in the course of the confirmed data of the morning concentration in the blood of the hormone cortisol.
Pharmacokinetics
When Asmanex hits the gastrointestinal tract, an extensive shooting range of intermediate metabolism is observed. Bioavailability of the drug begins to have traces of pharmacological action by the end of the first day after application. Low bioavailability is due to the lack of absorption of mometasone.
Indications
The main application of Asmanex is related to:
- with the therapeutic treatment of bronchial asthma at any stage of development. The treatment is suitable both for patients who did not use glucocorticosteroid preparations before the attack, and after treatment with glucocorticosteroids, which did not have the proper pharmacological effect. Suitable for changing glucocorticosteroids during long-term asthma treatment;
- with medium and severe forms of obstructive pulmonary disease in chronic form.
Below is an instruction on how to use Asmanex with video.
Instructions for Use
Asmanexom inhalations are administered through the mouth opening. The daily dose and the number of inhalations is determined by the attending physician, guided by the severity of the disease. Children under 12 years can not take a hormonal drug. Asthmatics with moderate to mild disease usually have a dose of 400 mg once a day.
- At not first receipt of glucocorticosteroids, the daily dose should be divided into 2 inhalations: evening and morning, at 0.2 mg per time.
- One-time use of Asmanex is best done in the evening hours.
- If the patient is able to bring a single dose to the minimum( 0.2 mg) and, at the same time, exercise complete control over the manifestations of asthma, a daily dosage reduction is performed.
During a severe course of bronchial asthma, the daily dose of Asmanex should be 2 times higher than with a mild or moderate course( 0.4 mg twice daily).The direction of treatment should be the same as with easier asthma flow( gradual decrease in dosage with preservation of the function of control over the symptoms).
Improvement of pulmonary parameters after the use of Asmanex in most patients occurs one day after the start of the drug. The remaining patients show a positive dynamics of treatment after 7-10 days after using Asmanex, sometimes up to 14 days.
The drug is opened after persuasion that the dose counter and the pointer are in a combined state. Turn the cap so that the lower colored mark does not rotate. Turn the cap in the direction counter-clockwise. As soon as the meter appears at the mark of one dose, the mouthpiece is tightly covered with lips and quickly inhaled, then the breath is held for 10 seconds. It is unacceptable to exhale back into the inhaler.
The cover of the inhaler after use is turned into place and returned to the beginning of the counter by turning the cap clockwise. Closure of the lid is judged on the characteristic click, followed after turning the lid with a soft push down. After the counter arrow has touched the lid pointer, the next dose is loaded.
After each procedure, it is necessary to rinse the oral cavity with running water to prevent the development of a fungal infection. If the number of doses used is not calculated by the patient, when the last use and turning the lid to the initial position, two digits "00" appear on the meter. The inhaler is then discarded. Outside, the inhaler should only be cleaned with dry gauze, it is inadmissible to get moisture, even in the form of a wet gauze.
This video will tell you how to use the Asmanex twister:
Contraindications
- The drug should be used with caution in pulmonary tuberculosis and viral( fungal) diseases.
- Patients with hypersensitivity to the auxiliary substance should abandon Asmanex, replacing it with a glucocorticosteroid without lactose.
Side effects of
- Individual patients with Asmanex have an increased heart rate, an increase in body weight, a violation of digestive processes, dryness of the mucous throat and oral cavity.
- Throat inflammation, hoarseness of the voice, pain in the head, fungal inflammation of the oral cavity are more common.
- Age is not a risk for the occurrence of side effects, except for children under 12 years old, studies on which are not fully understood.
- Immediately after using Asmanex, bronchopulmonary spasms and the intensity of wheezing in the lungs may increase.
- The long use of Asmanex negatively affects the condition of the cornea of the eye. Cataracts of the eye and increased intraocular pressure may develop.
- In the locomotor system, disruption of growth processes, demineralization of bone tissue is detected. The natural corticosteroid activity after Asmanex, as a rule, decreases.
- Do not exclude the appearance of dermatological problems: rashes, itching, etc.
Special instructions
- Asmanex is not used in case of problems in ophthalmology, as well as in cases of development of pathogenic bacteria and fungi on the oral mucosa.
- In Asmanex application, several calibration actions with a cap should be performed beforehand if the last use of the drug( or first use) was made for at least 2 weeks.
Interaction with other drugs
When combined with Asmanex with ketokenazole, an increased concentration of mometasone furoate in the blood plasma is allowed, although the physiological value does not have an elevated concentration of the active substance.
Reviews about the twisthailer Asmanex from patients are given below.
Reviews
- Patient Catherine fully characterizes the impact of Asmanex: "Asthma suddenly arrived after bronchitis in the winter. The picture was terrible, since I could not walk a few meters on foot, immediately began a severe shortness of breath. The allergist, having appointed or nominated means, did not suspect, that the suffocating status will disappear already on 3-rd day. Of course, the drug is expensive, but when it comes to life, the price does not matter. Only you do not need to quit treatment after relief. "
- A patient from Krasnoyarsk classically describes all the disappearance of symptoms, complaining only of an early rise, as he was prescribed a morning inhalation.
- Oksana writes that in comparison with other drugs that were prescribed earlier in the fight against bronchial asthma, Asmanex was the most effective. Dissatisfied unless cost.
Analogues
Drugs with ATC code level 4: Aldecine, Flicktosid, Budesonide, Elokom, etc.
Even more useful recommendations for inhalation in children will be given by Dr. Komarovsky in this video: