Indications for ASMANEX HFA:
Maintenance treatment of asthma as prophylactic therapy.
Limitations of Use:
Not for relief of acute bronchospasm.
≥12yrs: Currently not on inhaled corticosteroids: initially 2 inh of 100mcg twice daily (AM & PM). Currently receiving chronic oral corticosteroid therapy (eg, prednisone): initially 2 inh of 200mcg twice daily (AM & PM). If inadequate response after 2 weeks, may increase dose for additional control. Max: 800mcg/day (2 inh of 200mcg twice daily). Rinse mouth after use.
<5yrs: not established. 5–<12yrs: 2 inh of 50mcg twice daily (AM & PM). Max: 200mcg/day.
Primary treatment of status asthmaticus or acute asthma attacks.
Maintain regular regimen. Prescribe a short-acting, inhaled β2-agonist for acute symptoms; monitor for increased need. Re-evaluate immediately during rapidly deteriorating asthma; may need oral corticosteroid therapy. Immunosuppressed. Untreated infections (eg, fungal, bacterial, viral, parasitic), TB, ocular herpes simplex. If exposed to chickenpox or measles, consider anti-infective prophylactic therapy. Transferring from systemic steroids: taper gradually. If adrenal insufficiency exists following systemic corticosteroids, replacement with inhaled steroids may exacerbate symptoms of adrenal insufficiency (eg, lassitude). Monitor for bone mineral density if other osteoporosis risk factors exist; and for growth suppression in children; hypercorticism and HPA axis suppression (if occurs, reduce gradually). Glaucoma, increased intraocular pressure, and cataracts: consider eye evaluation if ocular symptoms develop or in long term use. Severe hepatic impairment. Labor & delivery. Pregnancy. Nursing mothers: not recommended.
Potentiated by ketoconazole or other strong CYP3A4 inhibitors (eg, ritonavir, cobicistat-containing products, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin); use caution and monitor.
Nasopharyngitis, headache, sinusitis, bronchitis, influenza; oropharyngeal candidiasis, hypersensitivity reactions, paradoxical bronchospasm; discontinue if occurs.
Fecal (major), renal (minor). Half-life: 25 hours.
Inhaler—13g (120 inh)