Asmanex Twisthaler

Maintain regular regimen. Prescribe a short-acting, inhaled β2-agonist for acute symptoms. Re-evaluate immediately if episodes of asthma not responsive to bronchodilators; 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). May unmask previously suppressed allergic conditions. 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. Pregnancy. Nursing mothers.