Zenhale®

Zenhale®

This product is manufactured by Merck Canada and is a combination of two ingredients, formoterol fumarate and mometasone furoate.

This product is taken via MDI (metered dose inhaler).


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MDI (metered dose inhaler)

Why is it prescribed?

Zenhale®is indicated for asthma that is not controlled with a controller medication (e.g., low to medium-dose inhaled corticosteroid) plus an as- needed short-acting beta2-agonist (salbutamol).
It is also indicated for asthma severe enough to require initiation of two controller therapies. It is approved for patients 5 years of age and older.

Your doctor has prescribed Zenhale® to help control asthma.
Zenhale® is used twice a day to help people 5 years of age or older who need treatment for asthma and the doctor recommends a combination product.
Zenhale® is not a rescue medication. Your doctor should prescribe a rescue medication for you. Use the rescue medication if you have sudden asthma symptoms.

Zenhale® is for patients with asthma that:

  • was not well controlled with other asthma controlling medications or
  • is severe enough that the doctor recommends starting asthma treatment with two asthma medications

The inhaler must be primed before the first use, and if the inhaler has not been used for over five days. Priming is done by spraying four sprays into the air, away from the face.
Since Zenhale® is a suspension, patients must shake the inhaler before each priming spray or inhalation.
The inhaler has a dose counter to count down the number of inhalations remaining.


Alternatives

See other products used in the treatment of •bronchospasm associated with COPD •chronic bronchitis (COPD) •COPD •emphysema (COPD) •asthma •allergic rhinitis •hay fever •nasal polyps •perennial rhinitis •rhinitis •seasonal allergies •seasonal rhinitis •year-round allergies •sleep apnea •

Ages 12 years and older:  Zenhale® is available in three strengths, 50/5, 100/5 and 200/5; delivering 50 mcg, 100 mcg and 200 mcg of mometasone furoate (MF), respectively, and 5mcg of formoterol fumarate dihydrate (F) per actuation.
Recommended dose for Zenhale® treatment based on prior asthma therapy:

  • Previously using inhaled low dose glucocorticosteroids: Zenhale® 50/5, 2 inhalations twice daily
  • Previously using medium dose glucocorticosteroids: Zenhale®100/5, 2 inhalations twice daily
  • Previously using high dose glucocorticosteroids: Zenhale® 200/5, 2 inhalations twice daily

Ages 5 to less than 12 years:

  • The dosage is 2 inhalations of Zenhale® 50/5 twice daily. 

Mometasone, an anti-inflammatory corticosteroid, and formoterol, a long-acting beta2-agonist, help prevent asthma symptoms by preventing inflammation and bronchoconstriction.


Along with its desired effect, Zenhale® may have some unwanted effects. The most common of these include:

  • headache
  • sore throat
  • hoarseness
  • sinusitis
  • dry mouth
  • nausea
  • tremor
  • shakiness
  • nervousness
  • dizziness
  • disturbed sleep
  • muscle cramps

  • As with all long-acting beta2-agonists and beta2-agonist/corticosteroid combinations, Zenhale® carries a warning that long-acting beta2-agonists have been associated with asthma death. These warnings are based on a U.S. study using salmeterol.
  • Extra monitoring may be required in patients switching from oral corticosteroids (eg. prednisone tablets) to Zenhale®.
  • Inhaled corticosteroids should be tapered rather than discontinued suddenly due to risk of worsening asthma.

Use with caution if you:

  • are diabetic
  • have high blood pressure
  • have ever had a heart problem, such as rapid or irregular heart beat or abnormal electrical signal called “prolongation of the QT interval”
  • have liver disease or cirrhosis
  • have problems with your thyroid or adrenal glands
  • have low levels of potassium in your blood
  • have or have ever had tuberculosis
  • have a fungal infection (thrush) in your mouth or throat
  • have eye disorders such as glaucoma or cataracts

Monitor at-risk patients for glaucoma and cataracts.

Drug Interactions - Talk to your pharmacist or doctor if you are on the following:

  • Beta-blockers (eg propranolol, metoprolol)
  • water pills
  • medicines for a fast or uneven heartbeat
  • tricyclic antidepressants or MAOIs
  • other medicines containg a long-acting beta-agonist
  • terfenadine or astemizole

Use in pregnancy and breastfeeding: Human data is limited.  Consult your pharmacist or doctor before use.