Usual Adult Dose for Asthma - Maintenance

Inhalation Aerosol Powder:
Previous therapy with bronchodilators alone, or inhaled corticosteroids:

• Initial dose: 220 mcg inhaled orally in the evening
• Maximum dose: 440 mcg in divided doses of 220 mcg twice a day, or as 440 mcg once daily.

Previous therapy with oral corticosteroids:

• Initial dose: 440 mcg inhaled orally twice a day
• Maximum dose: 880 mcg

Inhalation Aerosol:
Previous therapy with inhaled medium-dose corticosteroids:

• 2 inhalations of 100 mcg orally twice a day

Previous therapy with inhaled high-dose or oral corticosteroids:

• 2 inhalations of 200 mcg orally twice a day
• Maximum dose: 800 mcg per day

For Patients Currently Receiving Chronic Oral Corticosteroid Therapy:

• Prednisone should be weaned slowly, beginning after at least 1 week of therapy with this drug.
• Monitor for signs of asthma instability, including serial objective measures of airflow, and for signs of adrenal insufficiency during steroid taper and following discontinuation of oral corticosteroid therapy.

Comments:

• The time to onset and degree of symptom relief varies based on individual patient.
• Maximum benefit may not be achieved for 1 week or longer.
• After asthma stability has been achieved, titrate to the lowest effective dosage to reduce side effects.
• If there is no response to the starting dose after 2 weeks of therapy, higher doses may provide additional asthma control.
• Re-evaluate therapy and consider additional therapeutic options (e.g., initiating an inhaled corticosteroid and long-acting beta2-agonist combination product, or initiating oral corticosteroids) if asthma control is not achieved.
• Doses above the recommended should not be used.

Use: Maintenance treatment of asthma as prophylactic therapy

Usual Pediatric Dose for Asthma - Maintenance

Inhalation Aerosol Powder:
Less than 4 years: Not approved for this age.

4 to 11 years: 110 mcg inhaled once a day, in the evening

12 years and older:
Previous therapy with bronchodilators alone or inhaled corticosteroids:
Initial dose: 220 mcg inhaled orally in the evening
Maximum dose: 440 mcg in divided doses of 220 mcg twice a day, or as 440 mcg once daily.
Previous therapy with oral corticosteroids:
Initial dose: 440 mcg inhaled twice a day
Maximum dose: 880 mcg

Inhalation Aerosol:
Less than 5 years: Not approved for this age.

5 to 11 years: 2 inhalations of 50 mcg twice a day
Maximum dose: 200 mcg per day

12 years or older:
No current inhaled corticosteroid: 2 inhalations of 100 mcg twice a day
Current use of chronic oral corticosteroids: 2 inhalations of 200 mcg twice a day
Maximum dose: 800 mcg per day

For Patients Currently Receiving Chronic Oral Corticosteroid Therapy:

• Prednisone should be weaned slowly, beginning after at least 1 week of therapy with this drug.
• Monitor for signs of asthma instability, including serial objective measures of airflow, and for signs of adrenal insufficiency during steroid taper and following discontinuation of oral corticosteroid therapy

Comments:

• The time to onset and degree of symptom relief varies based on individual patient.
• Maximum benefit may not be achieved for 1 week or longer.
• After asthma stability has been achieved, titrate to the lowest effective dosage to reduce side effects.
• For patients older than 12 years, if there is no response to the starting dose after 2 weeks of therapy, higher doses may provide additional asthma control.
• Re-evaluate therapy and consider additional therapeutic options (e.g., initiating an inhaled corticosteroid and long-acting beta2-agonist combination product, or initiating oral corticosteroids) if asthma control is not achieved.
• Doses above the recommended should not be used.

Use: Maintenance treatment of asthma as prophylactic therapy

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

No adjustment recommended.

Dose Adjustments

The dose of mometasone should be individualized and titrated to the lowest effective dose for the control of asthma.

Precautions

CONTRAINDICATIONS:

• Status asthmaticus or other acute asthma episodes requiring intensive measures
• Hypersensitivity to any of the ingredients

Inhalation aerosol powder: Safety and efficacy have not been established in patients younger than 4 years.

Inhalation aerosol: Safety and efficacy have not been established in patients younger than 5 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For oral inhalation only.
• Inhale rapidly and deeply.
• After each inhalation, rinse mouth with water without swallowing.
• Once a day dose should be taken only in the evening.
• If a dose is missed, take the next dose at the regular time.

Reconstitution/preparation techniques:

• The pressurized metered dose aerosol inhaler should be primed before using for the first time and if not used for more than 5 days.
• To prime the pressurized aerosol, release 4 test sprays into the air, away from the face, shaking well before each spray.
• The manufacturer product information should be consulted.

General:

• Limitations of Use: This drug is not indicated for the relief of acute bronchospasm.
• This drug is not a bronchodilator and should not be used to treat status asthmaticus or to relieve acute asthma symptoms.
• Acute asthma symptoms should be treated with an inhaled, short-acting beta2-agonist.

Monitoring:

• Respiratory: Asthma signs, symptoms, instability
• Gastrointestinal: Signs of adverse effect on the oral cavity
• Musculoskeletal: Decrease in bone mineral density (BMD), growth in pediatric patients
• Ocular: Changes in vision, increase of intraocular pressure, glaucoma, cataracts

Patient advice:

• Use this drug at regular intervals, since its effectiveness depends on regular use.
• Contact physician if symptoms get worse, more inhalation of the rescue inhaler than usual is needed, significant decrease in lung function as outlined by the physician.
• Therapy with this drug should not be stopped without physician advice since symptoms may recur after discontinuation.

Frequently asked questions

• What causes Plaque Psoriasis?