[Close]Chrome, Firefox and Edge do not support opening, entering data and saving this type of PDF in the browser. Save to your computer and use Adobe Acrobat Reader for full functionality. The "Please wait…" message you may get when clicking on it is an error message in disguise.

To download from the "Please wait" page, move your cursor to the top right, click on the download icon, and choose where to save it on your computer. Once saved, you will be able to open with Adobe Acrobat Reader and use all of the features of the action plan. Email GetAsthmaHelpInfo@gmail.com for more help.

Medication Detail

image of medication detailed on this page

Medication Type

Long Term Control, should be taken every day as prescribed

Generic Names


Brand Names

Asmanex® Twisthaler, Asmanex® HFA


This medication is an inhaler that is used daily for the long term control of asthma symptoms. It prevents irritation and swelling in the airways.


Dry Powder inhaler
Metered dose inhaler


  • Asmanex Twisthaler cannot be used with a spacer.
  • Asmanex HFA can be used with a spacer.


Children 12 years of age and older/Adults
Patients taking inhaled steroid treatments for the first time:
  • Asmanex® Twisthaler: Initially 1 inhalation (220 mcg) daily (maximum: 2 inhalations or 440 mcg/day)
  • Asmanex® HFA: Two puffs twice daily (100 mcg per puff) (maximum 800 mcg daily)
Previous therapy with inhaled medications:
  • Asmanex® Twisthaler: Initially 1 inhalation (220 mcg) daily (maximum: 2 inhalations or 440 mcg/day); may be given in the evening or in divided doses twice daily.
  • Asmanex® HFA: Two puffs twice daily (100-200 mcg per puff) (maximum 800 mcg daily)
Previous therapy with long-term oral corticosteroids:
  • Asmanex® Twisthaler: Initially 440 mcg twice daily (maximum: 880 mcg/day)
  • Asmanex® HFA: 400 mcg twice daily (maximum 800 mcg daily)
Children 4 to 11 years old:
  • Asmanex® Twisthaler: 1 inhalation (110 mcg) once daily in the evening
Children 5 to 11 years old:
  • Asmanex® HFA: Two puffs twice daily (50 mcg per puff) (maximum 200 mcg daily)

Proper Use

  • See instructions for proper use.
  • Use this medication every day, even if you are feeling well.
  • Asmanex HFA: Shake well prior to each inhalation. Prepare inhaler before first use by releasing 4 test sprays into the air, away from the face, shaking well before each spray. If the inhaler has not been used for more than 5 days, prepare the inhaler again with 4 test sprays. Rinse mouth with water without swallowing. For proper inhaler technique visit our inhaler page.
  • Asmanex Twisthaler: After removing from foil pouch, record the date of opening on the cap label. Remove the inhaler cap while holding inhaler upright. Exhale fully before bringing the Twisthaler up to the mouth. Place between lips and inhale quickly and deeply. Remove inhaler and hold breath for 10 seconds if possible. Do not breathe out through the inhaler. Wipe mouthpiece dry, replace cap, and rotate until you hear a "click". Rinse mouth after use to reduce risk of mouth or throat infection.


  • Do NOT use this drug to treat an asthma attack.
  • If you have been taking this drug for many weeks, talk with your doctor before stopping. You may want to slowly stop this drug.
  • Avoid being near anyone with chickenpox or measles.
  • Talk with your doctor if you have high blood sugar (diabetes), glaucoma or cataracts, high blood pressure, are being treated for an infection, have kidney disease, liver disease, soft or brittle bones (osteoporosis), seizures, stomach ulcers, thyroid disease, tuberculosis, or a weak heart.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast feeding.

Common Interactions

This medication may interact with other medication you are taking.

Tell your doctor and pharmacist about all of your medications and health problems so they can check for any interactions.

Possible Side Effects

Possible side effects include headache, nose stuffiness, runny nose, sore throat, and upset stomach.

Tell your doctor or seek medical attention if you notice any signs of an allergic reaction (rash, hives, wheezing, tightness in the chest or throat, trouble breathing or swelling of the face), any signs of infection including redness or white patches in mouth or throat, or feeling tired or weak. Rinsing your mouth out after using this medication will decrease risk of mouth or throat infection.

Proper Storage

  • Store at room temperature.
  • Protect from heat, light, and water.
  • Do not store in a bathroom.
  • Keep HFA inhaler away from open flame. Do not puncture canister. Do not store in extreme temperatures, such as in a parked car. Do not use the "float test" to test if canister is empty. Use dose counter to check number of doses remaining in the inhaler. Throw away HFA inhaler when dose counter reaches 0.
  • Throw away any part of Twisthaler not used within 45 days of opening the foil pouch or when the dose counter reads zero, whichever comes first.

Return to List of Medications