Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Zenhale.
Asthma attacks: Zenhale is not a "reliever" medication. If you start developing asthma symptoms, be sure to use your reliever medication for rapid relief of your asthma symptoms. It is very important that you have your reliever medication with you at all times. If you persistently use more of your reliever medication, contact your doctor.
Diabetes: Both formoterol and mometasone may cause an increase in blood sugar levels. If you have diabetes, you may find it necessary to monitor your blood sugar more frequently while using Zenhale. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Zenhale may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zenhale, and whether any special monitoring is needed.
Eye problems: If you are at risk of developing glaucoma or cataracts, have your eyes checked by your doctor before starting long-term treatment with Zenhale. You should have your eyes monitored at regular intervals while using Zenhale.
Heart rhythm: Beta-agonists such as formoterol can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death.
Formoterol may cause a fluttering of the heartbeat (atrial fibrillation) or rapid heartbeat, increased blood pressure, chest pain, and decreased oxygen reaching the heart muscle.
If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels), discuss with your doctor how Zenhale may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zenhale, and whether any special monitoring is needed.
Infections: Corticosteroids, such as mometasone, can reduce your body’s ability to fight infections and may hide signs of infection that is developing. Infections such as Chickenpox and Measles can be more serious for people taking medications such as fluticasone. If you are exposed to someone with chickenpox or measles, contact your doctor.
Inhalation-induced bronchospasm: Inhaled forms of medications may cause spasms of the airways, which make breathing difficult. If you experience this problem when using formoterol - mometasone, stop using Zenhale immediately. Speak to your doctor if you experience any problems with breathing while taking this or other inhaled medication.
Medical conditions: Discuss with your doctor how Zenhale may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zenhale, and whether any special monitoring is needed, if you have any of the following conditions:
- herpes simplex (virus) infection of the eye
- liver disease
- low levels of potassium in the blood
- problems with Thyroid or adrenal glands
- tuberculosis
- any other type of untreated infection
Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using Zenhale, helps reduce the chances of developing a yeast infection of the mouth or throat (thrush). If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.
Osteoporosis: Long-term use of corticosteroids, including inhaled corticosteroids such as mometasone, may increase the risk of bone loss and osteoporosis. If your doctor recommends that you use Zenhale for a lengthy period of time, talk to your doctor about supplements and strategies to slow down and reduce bone loss.
Risks of similar medications: The results of a large clinical trial showed an increased risk of asthma-related death for patients who used another long-acting bronchodilator (salmeterol) in addition to their usual asthma therapy when compared to patients who used placebo (an inactive medication) in addition to their usual asthma therapy. Formoterol fumarate dihydrate (one of the active ingredients is Zenhale) is also a long-acting bronchodilator. It is unknown whether this product would have similar results.
Steroid medication use: If you have taken oral steroid medications over the last several months or are still taking oral corticosteroids, consult with your doctor before using Zenhale. In times of stress or during a severe asthma attack, your doctor may want you to start your oral steroid medication again.
Stopping the medication: Zenhale contains an inhaled corticosteroid, mometasone furoate. Abruptly stopping inhaled corticosteroids can make asthma worse. Do not stop Zenhale suddenly. Instead, speak to your doctor about how to stop the medication safely by gradually reducing the dose.
Worsening symptoms: If you find you need to use your short-acting ("rescue") inhaler more often or if your condition seems to worsen, call your doctor. If you have not been given instructions beforehand, contact your doctor immediately about what to do if any of the following situations occur (they may be signs of seriously worsening asthma):
- decreased effectiveness of short-acting, inhaled bronchodilators such as salbutamol, terbutaline, or fenoterol (less than 4 hours of relief)
- need for more inhalations than usual of short-acting, inhaled bronchodilators
- peak flow meter showing results in the below-normal range
Pregnancy: Zenhale should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Zenhale, contact your doctor immediately.
Breast-feeding: It is not known if Zenhale passes into breast milk. If you are a breast-feeding mother and are taking Zenhale, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children less than 12 years of age.
