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Pulmicort vs Asmanex
Introduction
For patients with chronic respiratory conditions such as asthma, certain medications that help control and prevent the symptoms are crucial. Pulmicort and Asmanex are two such drugs that are often prescribed for managing asthma. They each impact different aspects of lung function, but both aim to reduce inflammation in the airways and improve breathing ability. Pulmicort (budesonide) is a corticosteroid that works by decreasing inflammation in the lungs which makes breathing easier. Asmanex (mometasone), on the other hand, is also a type of corticosteroid medication primarily used to control symptoms of asthma in adults and children who are at least 4 years old, it reduces swelling within airways thus improving airflow.
Pulmicort vs Asmanex Side By Side
| Attribute | Pulmicort | Asmanex |
|---|---|---|
| Brand Name | Pulmicort | Asmanex |
| Contraindications | Should not be taken if being treated for fungal, bacterial, viral infections or tuberculosis without discussing with a doctor. Affects growth rate in children and may elevate liver enzymes in patients with liver disease. | Should not be taken if being treated for fungal, bacterial, viral infections or tuberculosis without discussing with a doctor. Affects growth rate in children and may elevate liver enzymes in patients with liver disease. |
| Cost | $250 for 30 doses (180 mcg per dose) | $225 for 30 doses (220 mcg) |
| Generic Name | Budesonide | Mometasone Furoate |
| Most Serious Side Effect | Signs of allergic reaction, vision problems, increased wheezing or shortness of breath immediately after use, electrolyte imbalance, severe nervous system reactions. | Signs of a serious allergic reaction, changes in vision or eye pain, increased thirst or urination, severe stomach/abdominal pain, unusual weight loss, mental/mood changes, unusually fast heartbeat. |
| Severe Drug Interactions | Not specified in the article, but typically involves interactions with certain antifungals, HIV antivirals, and antibiotics. | Not specified in the article, but typically involves interactions with certain antifungals, HIV antivirals, and antibiotics. |
| Typical Dose | 200-2400 mcg/day, commonly 400 mcg/day for mild persistent asthma | 220 mcg/day for adults and adolescents, can be increased to 440 mcg/day. For children 4-11 years, 110 mcg once daily. |
What is Pulmicort?
Budesonide (the generic name for Pulmicort) is a corticosteroid that reduces inflammation in the lungs, hence improving breathing and reducing asthma symptoms. It was first approved by the FDA in 1990. Pulmicort works by inhibiting inflammatory cells and releasing substances that cause inflammation in the airways, effectively "trapping" them from causing an asthmatic response. The drug is prescribed to control and prevent symptoms such as wheezing and shortness of breath caused by asthma.
Mometasone (Asmanex), on the other hand, belongs to a class of drugs known as corticosteroids too; it functions similarly to Budesonide but with subtle differences. Asmanex has selective influence on certain types of inflammatory responses with only minor effects on others which results in having fewer side effects than Pulmicort that might have stronger effect on these other types of inflammations.
What conditions is Pulmicort approved to treat?
Pulmicort is approved for the treatment of various types of asthma:
- Maintenance and prophylactic therapy in adults, adolescents, and children 1 year to 8 years old with persistent asthma
- Asthma symptoms that require oral corticosteroid use (in combination with a long-term asthma control medication)
- Reduction in or elimination of flare-ups and the need for additional medicine in patients aged six years or older.
How does Pulmicort help with these illnesses?
Pulmicort helps to manage asthma by reducing inflammation in the airways of the lungs. It does this through its active ingredient, budesonide, which is a corticosteroid. Corticosteroids work by mimicking hormones that are naturally produced by our adrenal glands. These hormones have powerful anti-inflammatory effects and can reduce swelling and irritation in the walls of small air passages in the lungs, helping you breathe more easily. Inflammation plays a crucial role in asthma attacks where it causes narrowing of air passages leading to shortness of breath, wheezing, chest tightness and coughing. Therefore, by decreasing inflammation with Pulmicort (budesonide), we can limit these negative effects and help patients manage their condition effectively.
What is Asmanex?
Asmanex, with the generic name mometasone furoate, is a corticosteroid medication used to manage and prevent asthma symptoms. It works by reducing inflammation in the lungs which improves breathing and decreases the frequency of asthma attacks. Asmanex was first approved by the FDA in 2004.
Unlike Pulmicort (budesonide), Asmanex does not cause substantial systemic absorption when inhaled, meaning it has fewer steroid-related side effects such as weight gain or mood changes. Side effects specific to Asmanex are generally mild but may include headaches, viral respiratory infections or sore throat. When administered properly through an inhaler device, Asmanex can provide significant relief for individuals who do not respond well to other typical asthma medications like budesonide-based products like Pulmicort.
What conditions is Asmanex approved to treat?
Asmanex is approved for the treatment of asthma in patients who are at least 4 years old. It's important to note that this medication is not a rescue inhaler and will not work fast enough to treat an asthma attack. Asmanex works by reducing inflammation and swelling in the airways, improving breathing and helping control symptoms such as:
- Wheezing
- Shortness of breath
- Tightness in the chest
- Coughing caused by asthma
How does Asmanex help with these illnesses?
Asmanex, like Pulmicort, is a corticosteroid used in the management of asthma. It works by reducing inflammation and swelling in the airways to improve breathing. Corticosteroids mimic the effects of hormones your body naturally produces in your adrenal glands. When prescribed at low doses as inhalers or nasal sprays (like Asmanex), corticosteroids have a more direct effect on the respiratory tract and less impact on other parts of the body. Asmanex may be recommended for patients who do not get adequate control of their symptoms with other asthma medications, or those who prefer once-a-day dosing offered by this medication compared to multiple daily doses required with some alternatives like Pulmicort.
How effective are both Pulmicort and Asmanex?
Budesonide (Pulmicort) and mometasone furoate (Asmanex) are both corticosteroid inhalers used for the management of asthma, and they were approved by the FDA within a decade of each other. These medications help to reduce inflammation in the lungs, thereby reducing symptoms like shortness of breath or wheezing.
A 2006 study found that when compared head-to-head over a three-month period, budesonide and mometasone have similar efficacy in terms of improving lung function as well as comparable safety profiles. Each drug showed significant improvement from baseline pulmonary function without substantial differences between them.
In terms of side effects, Pulmicort has been shown to be generally well-tolerated with common adverse reactions including respiratory infection, throat irritation and coughing while Asmanex can cause headache, allergic rhinitis and upper respiratory tract infection among others. It's worth noting that these medications should not be used for acute bronchospasm or status asthmaticus; rather they serve as maintenance therapy for chronic asthma.
A 2010 review indicated that budesonide seems to provide better control over nocturnal symptoms than other inhaled corticosteroids due to its prolonged duration action. Nonetheless it's typically considered only after non-steroidal anti-inflammatory drugs fail to control symptoms.
On the other hand, data confirming mometasone’s efficacy is robust given it was designed specifically for once-daily dosing which improves compliance rates among patients who find multiple daily doses challenging . Furthermore despite being slightly more expensive than budesonide , Asmanex may offer cost savings long term due its reduced rate of exacerbation leading to fewer hospital admissions.
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At what dose is Pulmicort typically prescribed?
Inhaled dosages of Pulmicort for adults can range from 200-2400 mcg/day, but it has been observed that 400 mcg/day is sufficient for managing mild persistent asthma in most individuals. For children and adolescents with asthmatic symptoms, the starting dosage may be set at 200 mcg/day. The dosage may be increased after a few weeks if there is no significant improvement in symptoms. However, the maximum daily dose should not exceed 2400 mcg under any circumstances.
At what dose is Asmanex typically prescribed?
Asmanex treatment typically begins with a dosage of 220 mcg/day for adults and adolescents (12 years of age and older). The dose can then be increased to 440 mcg/day, divided into two doses morning and evening. For children aged between 4-11 years old, the starting dose is usually lower at 110 mcg once daily in the evening. If there are insufficient improvements in asthma symptoms after a few weeks or if an individual experiences frequent exacerbations, healthcare providers may consider increasing the dosage. However, it's crucial not to exceed the maximum recommended dose without medical supervision as this could lead to unnecessary side effects.
What are the most common side effects for Pulmicort?
Common side effects of Pulmicort include:
- Respiratory infection
- Throat irritation or pain
- Hoarseness (changes in the voice)
- Cough
- Sinusitis (inflammation of the sinus cavities in the head)
- Oral thrush, a fungal infection in the mouth
- Upper respiratory tract infection
On the other hand, Asmanex may cause similar but also some different side effects such as:
- Headache
- Nasal allergies symptoms like sneezing and runny nose
- Sore throat
- Upper respiratory tract infection
- Sinusitis
Remember that if any of these side effects persist or worsen, you should contact your healthcare professional right away.
Are there any potential serious side effects for Pulmicort?
In rare cases, Pulmicort can cause potentially serious side effects, which include:
- Signs of allergic reaction such as difficulty breathing; swelling of your face, lips, tongue or throat
- Vision problems: blurred vision, tunnel vision, eye pain or swelling
- Increased wheezing or shortness of breath immediately after use
- Electrolyte imbalance - headache, confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady
- Severe nervous system reactions with symptoms like high fever sweating confusion fast heartbeat tremors
On the other hand Asmanex has its own set of potential adverse effects including:
- Allergic reactions: hives; difficult breathing; swelling in your face or throat
- Symptoms suggestive of serotonin syndrome: agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea
- Chest pain or tightness and trouble breathing.
While both medications are generally safe when used correctly under a doctor's supervision you should always be aware that these risks exist. If you experience any unusual symptoms while using either medication discontinue usage and seek immediate medical attention.
What are the most common side effects for Asmanex?
Asmanex, a commonly prescribed medication for asthma, has its own potential side effects which might include:
- Dry mouth or throat irritation
- Headache, dizziness
- Sinus pain and congestion
- Nausea or upset stomach
- Hoarseness or deepening of the voice
- Changes in menstrual periods
- Coughing after inhaling the medicine While these are common adverse reactions to Asmanex, it's crucial to note that not all individuals will experience these symptoms. However, if they persist or worsen over time, you should reach out to your healthcare provider immediately.
Are there any potential serious side effects for Asmanex?
While Asmanex is generally well-tolerated, it's important to be aware of potential serious side effects. These may include:
- Signs of a serious allergic reaction: rash, itching/swelling (particularly affecting the face/tongue/throat), severe dizziness and difficulty breathing
- Changes in vision or eye pain
- Increased thirst or urination
- Severe stomach/abdominal pain
- Unusual weight loss
- Mental/mood changes such as depression or mood swings -Unusually fast heartbeat
If you experience any of these symptoms while using Asmanex, seek immediate medical attention.
Contraindications for Pulmicort and Asmanex?
Both Pulmicort and Asmanex, similar to most inhaled corticosteroids, can cause unwanted side effects like oral thrush. If you notice symptoms of oral candidiasis such as white patches in your mouth or a change in the taste of food, please consult with your healthcare provider immediately.
Neither Pulmicort nor Asmanex should be taken if you are being treated for fungal, bacterial, viral infections or tuberculosis without discussing it with your doctor first. Always inform your physician about any medications you are taking; some drugs may require a specific period to clear from the system to avoid hazardous interactions with Pulmicort and Asmanex.
Pulmicort and Asmanex have been known to affect growth rate in children so parents should discuss this risk thoroughly with their child's healthcare provider. In addition, patients suffering from liver disease need special consideration because these drugs can elevate certain liver enzymes that could lead to more severe health issues.
How much do Pulmicort and Asmanex cost?
For the brand name versions of these drugs:
- The price of 30 doses (180 mcg per dose) of Pulmicort Flexhaler averages around $250, which works out to approximately $8.33/day.
- The price for Asmanex Twisthaler (220 mcg) is about $225 for 30 doses, working out to roughly $7.50/day.
Hence, if you are using the recommended dosage for either drug (i.e., one inhalation daily), then Asmanex tends to be slightly less expensive on a per-day treatment basis. However, remember that cost should not be your primary consideration in determining which of these medications is right for you.
As it pertains to the generic versions:
Unfortunately, as of now there are no FDA-approved generics available in the United States for either Pulmicort Flexhaler (budesonide) or Asmanex Twisthaler (mometasone). Therefore, costs remain relatively high compared with many other classes of medication where generic options exist.
Popularity of Pulmicort and Asmanex
Budesonide, in its generic form as well as the brand name Pulmicort, was estimated to have been prescribed to about 3.4 million people in the US in 2020. Budesonide accounted for just over 13% of corticosteroid prescriptions used for respiratory conditions like asthma and COPD (Chronic Obstructive Pulmonary Disease) in the US. The prevalence of budesonide has been gradually increasing since its introduction due to its effectiveness and lower risk of side effects compared to older corticosteroids.
Mometasone, including brand versions such as Asmanex, was prescribed to around 2.5 million people in the USA in 2020. In the US, mometasone accounts for just under 10% of inhaler-based corticosteroid prescriptions for managing chronic respiratory diseases such as asthma or COPD. Mometasone's prevalence has been steadily growing over time because it requires fewer daily doses than many other similar medications which can lead to increased compliance with treatment plans among patients.
Conclusion
Both Pulmicort (budesonide) and Asmanex (mometasone furoate) have a long-standing history of use in the management of asthma, supported by multiple clinical trials demonstrating their efficacy over placebo treatments. In some scenarios, these drugs may be used together for an additive effect but this should always be under the careful guidance of a physician due to potential interactions. Both medications are corticosteroids, acting primarily by reducing inflammation in the airways; however, they can be prescribed differently depending on individual patient's needs and response to treatment.
Pulmicort is typically used as a maintenance therapy and has been available for longer than Asmanex which can result in more familiarity among prescribers. On the other hand, Asmanex might be chosen based on its once-daily dosing regimen or if patients did not respond well to initial therapies like budesonide.
Both medications are also available in generic form leading to significant cost savings especially for those who must pay out-of-pocket. It might take some time before seeing noticeable improvement from both Pulmicort and Asmanex usage.
The side effects profile between these two drugs is fairly similar with common ones being throat irritation and dry mouth although neither drug tends to produce systemic side effects prevalent with oral steroids due to their inhalation route. Regardless of treatment choice, it remains crucial that patients closely monitor breathing patterns when starting treatment or adjusting doses; any worsening of asthma symptoms should prompt immediate medical consultation.
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Refrences
- McCormack, P. L., & Plosker, G. L. (2006). Inhaled Mometasone Furoate. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200666080-00011
- Ichinose, M. (2008). 4. Clinicalpathology and Treatment of Bronchial Asthma. Nihon Naika Gakkai Zasshi. Japanese Society of Internal Medicine.http://doi.org/10.2169/naika.97.603
- Harnest, U., Price, D., Howes, T., & Sussman, G. (2008, January). Comparison of Mometasone Furoate Dry Powder Inhaler and Fluticasone Propionate Dry Powder Inhaler in Patients with Moderate to Severe Persistent Asthma Requiring High-Dose Inhaled Corticosteroid Therapy: Findings from a Noninferiority Trial. Journal of Asthma. Informa UK Limited.http://doi.org/10.1080/02770900801890646
- Emami, M., Tayebi, A., Gharipour, M., Farzamnia, S., & Temyarti, A. (2014). Comparing clinical efficacy of Symbicort versus Pulmicort in reducing asthma symptom and improving its control. Advanced Biomedical Research. Medknow.http://doi.org/10.4103/2277-9175.127999
- Tinkelman, D. G., Bronsky, E. A., Gross, G., Schoenwetter, W. F., & Spector, S. L. (2003, January). Efficacy and Safety of Budesonide Inhalation Powder (Pulmicort Turbuhaler®) During 52 Weeks of Treatment in Adults and Children with Persistent Asthma. Journal of Asthma. Informa UK Limited.http://doi.org/10.1081/jas-120020186