Mometasone Gives You Relief From Breathing Difficulty And Asthma Attacks

Asthma is a type of recurring inflammatory disease of the lungs, or to put it simply, a type of allergy. As simple as the name suggests, the disease is but a severe one which can even turn fatal. Asthmatic patients find it hard to lead a normal life as they can be allergic to practically any type of trigger. The normal physical activities and even sleep are affected. It is particularly disheartening for children as their young age is spent under highly controlled exposure and the fight will continue throughout their lifetime. Their normal life is mostly under the control of inhalers which provide only temporary relief from asthma attacks and not a permanent cure. One of the most common medicines prescribed by the doctor will be an oral inhaler containing Mometasone.

Triggers and causes of asthma

Asthmatic symptoms are characterized by episodes of wheezing, coughing, tightening of the chest and breathlessness. The symptoms usually aggravate during physical activities like running or exercise, sleeping and on exposure to irritants and allergens. The most common factors identified to cause asthma are:

  • Hereditary or genetic
  • Environmental factors like pollution and allergens
  • Certain medications containing beta-blockers and aspirin

Prevention and control of symptoms

The primary step for prevention of symptoms of asthma is by avoiding exposure to agents which can possibly trigger an allergy. The medical way of preventing it is by the regular use of corticosteroids as inhalers. If symptoms continue to persist even after the administration of corticosteroids,  combining it with Long-acting beta agonists (LABA) or antileukotriene agents may be used. If the symptoms still continue to worsen, take corticosteroid powder by mouth and an inhaled short-acting beta-2 agonist.

Intravenous administration of magnesium sulphate is used for very severe cases and if none of the above treatments are working, the patient needs to be hospitalized. Among the most prescribed corticosteroid is Mometasone furoate (HFA).

Mometasone: Mode of action

Mometasone furoate is the prodrug form of the freeform mometasone and is used in the prevention of various inflammatory disorders including asthma (inhalation), skin inflammation (topical), and allergic rhinitis (topical). The mode of action of the drug is the prevention of release of substances by certain lung cells and breathing airway that trigger allergy and decreases swelling and irritation in the airways. The drug is actively metabolized in the liver.

The drug has to be inhaled regularly for the prevention of occurring of symptoms and does not work on usage after an episode of asthmatic attack has started. It should not be taken during the asthmatic attack.

Dosing forms and strengths

Mometasone oral inhalation does not cure asthma. Its regular use as oral inhalation prevents and controls the episodes of symptoms such as is wheezing, coughing, tightness of the chest and shortness of breath in adults and children above 12 years of age. Mometasone powder for oral inhalation is used in adults and children of and above 4 years of age.

Methods of administration

Mometasone furoate is available in the following dosage forms:

  • Aerosol for inhalation by mouth using inhaler, usually inhaled twice daily
  • Powder to inhale by mouth, usually twice in a day once per day in the evening
  • Topical application as cream and ointment

The timing of inhalation is important and should be used more or less at around the same time daily. It is a steroid drug to be used only on the advice of a doctor for administration and dose management. The drug is approved for usage as a single active agent and in different forms in combination with other salts for various indications including asthma, allergic rhinitis, nasal congestion and inflammatory diseases of the skin such as psoriasis and eczema. The steroid is sold under legal rights as different brands through pharmacy outlets only under prescription.

Synthesis, Production, and Purification of Mometasone Furoate

In one of the methods, Mometasone furoate is produced by the esterification of 17 hydroxy group of free form mometasone by reacting it with an excess of 2-furoyl chloride in the presence of a tertiary amine in an inert nonpolar, water immiscible solvent such as dichloromethane. The temperature of the reaction is maintained between 0 to 25°C and usually takes 10 to 15 hours for completion.

For the isolation of Mometasone furoate, aqueous washes remove the water soluble materials from the reacted mixture and the solvent is replaced by an alcohol with lower molecular weight such as methanol or ethanol. The product then crystallizes in a pure form. By subsequent use of other solvents like acetone, methanol and ethanol, the product can be further recrystallized.

Contraindications

Mometasone is a Category C drug, which means risk is not ruled out for adverse reactions due to usage in pregnancy and lactation. Animal studies have shown the drug to have adverse effects and sufficient clinical studies are not available to prove its safety. The drug should not be used if you are allergic to it or should be used only after consultation with the doctor if you have severe allergies. It should not be used in children below 4 years of age and in those who are allergic to milk protein. Usage in elderly has not yet reported being causing serious adverse effects. Use of mometasone has to be cautious if you suffer from diseases such as

  • Glaucoma,
  • Cataract,
  • Osteoporosis,
  • Chickenpox And Measles,
  • Other Infections Caused By External Infectious Agents,
  • Tuberculosis,
  • Hepatic Disease

Drug interactions

Mometasone use should be careful if you are using any of the following drugs:

  • Cardiovascular medications: quinidine, nicardipine
  • Medications fo seizures, nefazodone
  • Antibiotics like clarithromycin, telithromycin
  • AntifungalS such as itraconazole, ketoconazole, voriconazole etc
  • Antiviral medicines for hepatitis C or HIV protease inhibitors -atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, boceprevir, cobicistat, delavirdine, fosamprenavir.
  • Oral steroids like dexamethasone, methylprednisolone, and prednisone

Side effects

Common side effects include

the following, which if severe should be reported to your doctor:

  • Cough
  • Body aches or pain, headache
  • cold or flu-like symptoms
  • congestion, stuffy or runny nose
  • cough
  • dry throat or sore throat or swelling
  • stuffy nose
  • swelling of nose, sinuses

     Other less common side effects

  • nausea
  • fever or chills
  • Abdominal or stomach pain
  • diarrhea
  • loss of appetite
  • pain in the lower back or side

A rare side effect is the occurrence of painful white patches in the mouth or throat.