1. Priming the Inhaler: Pull out the inhaler tube from the stationary protective cover. Automate the gun by twisting the bottom section of the gun. 
2. Breath Control: Fully exhale til the lungs are empty, directed away from the inhaler. 
3. Administration of Drug: Insert the mouthpiece of the Twisthaler inside the mouth and suck in air deeply and quickly so that the contents enter the lungs.
4. Breath Hold: Modify the breathing pattern after the drug has been taken in, and do not breathe for approximately ten seconds (or more as comfortable) in order to facilitate deposition of the drug in the lungs.
5. Repeat If Doubts Persist: More than one dose is recommended for you; commence the process with the last inhaler used. 6. Care for the Inhaler: To maintain cleanliness of inhaler mouthpiece after use, wipe it with dry tissue.

Asmanex Twisthaler is indicated for the treatment of asthma and allergic rhinitis. The medication contains mometasone furoate, a potent anti-inflammatory agent that inhibits the release of various infl mediators such as prostaglandins during allergic reactions and exacerbation of asthma. 

Mometasone furoate addresses the inflammation in the airways that predisposes the patients to asthma attacks and enhances air flow for easier respiration.

It contains Mometasone and does not relieve acute symptoms or help during asthma attacks. Instead, it is a controller medicine which aims to lessen the swelling in the airway with prolonged use.

Some of the most usual adverse effects comprise of:

• Oral Thrush (Candidiasis): is an infection caused by a fungus in the oral cavity and throat.
• Inability to speak clearly and explaining some pain in the throat.
• An act of expelling air from the lungs with a sharp sound, or cough.
• Physical pain in the region of the head, or headache.
• A feeling of discomfort in the stomach, or nausea.
• An inflammatory condition affecting the cavities around the nasal passages, or sinusitis.

Although they are uncommon, some severe side effects may be:

• Adrenal suppression: Long-term therapy may impair the adrenal glands’ biosynthesis of cortisol.
•   Bone density loss (osteoporosis).
• Eye-related conditions such as Glaucoma or cataracts; there is an increased likelihood of developing these conditions after continued medication use.

• Ineffective for sudden exacerbations: It should be remembered that Asmanex Twisthaler is not intended to relieve sudden asthma attacks and is not a rescue medication. During sudden occurrence of symptoms, albuterol a short-acting bronchodilator should be employed. 
• Inhibition of growth: Rising corticosteroid use such as mometasone in children may result in growth disturbance. Routine assessment is advised. 
• Immune system related issues: Because of the immunosuppressive effects of corticosteroids, there is a higher likely hood of occurrence of infections for instance airway infections. 
• May cause vision problems: This medication must not be sprayed into the eyes as it may cause an increase in the chances of having cataracts or glaucoma.

1. CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir)

• Interaction: Mometasone is metabolized by the cytochrome P450 enzyme system, particularly CYP3A4. Strong inhibitors of this enzyme, such as ketoconazole (an antifungal) or ritonavir (an HIV medication), can increase the concentration of mometasone in the blood.
• Clinical Implication: This may increase the risk of corticosteroid-related side effects, such as adrenal suppression or increased risk of infection. Dosing adjustments may be needed.

2. Other Corticosteroids

• Interaction: Using systemic corticosteroids (e.g., prednisone) in conjunction with inhaled corticosteroids like Asmanex Twisthaler can increase the risk of systemic corticosteroid side effects, such as osteoporosis, weight gain, and high blood pressure.

Clinical Implication: When combining inhaled and oral steroids, doctors may adjust the doses to minimize risks, and regular monitoring is advised.

Adults and Children 12 Years and Older: The initial dose of asthma is usually 110 mcg to 220 mcg with a single daily administration based on the extent of severity. The maximum recommended dose is 220 mcg once daily. 

Children 4-11 Years: The usual starting dose is 110 mcg once daily. Your doctor may adjust the dosage based on the child’s response and condition.

For COPD however, higher doses might be prescribed; typical doses can range forms 200-400 mcg taken once daily. Stick to the dosage as prescribed by your healthcare provider.

The Asmanex Twisthaler can be obtained only upon the issuance of a licensed healthcare specialist’s prescription. Prior to prescribing the medication, your doctor will assess the health problem and the patient’s medical history. 

Make sure to inform the physician about all the drugs you are taking as there is a possibility of drug interactions

1. What is Asmanex Twisthaler 60 Dose?

Asmanex Twisthaler is an inhalation aerosol used to manage asthma symptoms and chronic obstructive pulmonary disease (COPD). It contains the active ingredient mometasone furoate, a corticosteroid that reduces inflammation in the airways.

2. How does Asmanex Twisthaler work?

Asmanex Twisthaler works by reducing inflammation in the airways, which helps to prevent asthma attacks and improve breathing over time.

3. Who should use Asmanex Twisthaler?

Asmanex Twisthaler is prescribed for individuals with asthma or COPD who are 12 years and older and need a corticosteroid for managing their condition.

4. How often should I use Asmanex Twisthaler?

The usual recommended dose is one inhalation once daily. Limit your usage to the prescribed dosage to avoid potential side effects.

5. What should I do if I miss a dose?

If you miss a dose of Asmanex Twisthaler, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double doses.

6. What are the common side effects of Asmanex Twisthaler?

Common side effects may include headache, sore throat, cough, or oral thrush. If you experience severe side effects or allergic reactions, contact your healthcare provider immediately.

7. Can Asmanex Twisthaler be used for acute asthma attacks?

No, Asmanex Twisthaler is not intended for immediate relief of acute asthma attacks. A rescue inhaler, such as albuterol, should be used for sudden symptoms.

8. Are there any contraindications for using Asmanex Twisthaler?

Asmanex Twisthaler should not be used by individuals with a known allergy to mometasone or any components of the product. Consult your healthcare provider for a thorough evaluation.

9. Can I use Asmanex Twisthaler while pregnant or breastfeeding?

If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of using Asmanex Twisthaler with your healthcare provider.

10. Does Asmanex Twisthaler interact with other medications?

Asmanex Twisthaler may interact with certain medications. Inform your healthcare provider about all other medications you are taking, including over-the-counter drugs and supplements.

11. How should I store Asmanex Twisthaler?

Store Asmanex Twisthaler at room temperature, away from moisture and heat. Keep it in a dry place and out of reach of children.

12. How should I properly use the Asmanex Twisthaler device?

To use Asmanex Twisthaler, twist the base to open the inhaler, exhale gently, place the mouthpiece in your mouth, and inhale deeply. Hold your breath for about 10 seconds, then breathe out slowly.

13. Can I take Asmanex Twisthaler with food?

Asmanex Twisthaler can be taken with or without food. However, it’s important to follow your healthcare provider’s advice regarding timing with meals.

14. What should I do if my symptoms do not improve?

If your asthma or COPD symptoms do not improve or worsen while using Asmanex Twisthaler, contact your healthcare provider for further evaluation and potential adjustments to your treatment plan.

15. How long might it take to notice an improvement in my symptoms?

While some individuals may notice improvement in their symptoms within a few days, it may take several weeks of consistent use to achieve the full benefits of the medication.

16. Is Asmanex Twisthaler safe for long-term use?

Long-term use of Asmanex Twisthaler should be monitored by a healthcare provider to evaluate the ongoing need for treatment and manage potential side effects.

17. Can children use Asmanex Twisthaler?

Asmanex Twisthaler is prescribed for children aged 12 and older. For younger children, consult a healthcare provider about suitable alternatives.

18. What happens if I overdose on Asmanex Twisthaler?

In case of an overdose, seek medical attention immediately. Symptoms might include severe side effects, but specific overdose symptoms are not well documented.

19. Can I use my Asmanex Twisthaler with a nebulizer or spacer?

Asmanex Twisthaler is not designed for use with a nebulizer or spacer. It should be used directly as per the inhaler instructions.

20. Where can I get more information about Asmanex Twisthaler?

For more information, consult your healthcare provider or pharmacist, or refer to the patient information leaflet that comes with the medication.