Duova Inhaler

Duova Inhaler general information

What is Duova Inhaler used for?

Duova inhaler is a combination treatment used for the long-term maintenance treatment of chronic obstructive pulmonary disease (COPD), which is a progressive obstructive airways disease that usually gets worse with time. The symptoms of COPD are caused by bronchospasm and are similar to asthma, including tightness of the chest, wheezing and shortness of breath, as well as chronic cough with sputum production because the lung tissues have become damaged. Duova Inhaler provides improved action to open airways and improve breathing, which helps relieve symptoms, where a single medication has not been sufficiently effective.

How does Duova Inhaler work?

Duova Inhaler contains two bronchodlators that are used for long-term treatment of chronic obstructive pulmonary disease (COPD). Formoterol in Duova Inhaler is a potent, selective, long-acting beta-agonist that acts locally in the lungs and works as a bronchodilator by relaxing the smooth muscle in the airway walls to widen the airways. Tiotropium in Duova Inhaler is a long-acting anticholinergic that acts on specific receptors (muscarinic receptors) in the bronchioles of the lung and inhibits the interaction of acetylcholine (a neurotransmitter or chemical messenger of the nervous system) with muscarinic receptors, which prevents spasm of the airway wall caused by acetylcholine. The synergistic action (interacting to enhance the action of each other) of the two drugs working together by different mechanisms, reduces bronchospasm (contraction of the airways) to a greater extent than would be provided by each drug alone and increases air flow into the lungs, relieving symptoms of COPD such as chronic cough with sputum production, tightness of the chest, wheezing and shortness of breath.

What does Duova Inhaler contain?

Duova Inhaler is a metered dose inhaler containing a combination of two active ingredients; formoterol fumarate dihydrate (9mcg), a long-acting beta-agonist, and tiotropium bromide monohydrate (6mcg) a long-acting anticholinergic used to treat chronic obstructive pulmonary disease (COPD). Each dose delivers an inhalation aerosol containing 9mcg formoterol and 6mcg tiotropium. Each inhalation canister contains 200 doses.

Treating chronic obstructive pulmonary disease (COPD) with Duova Inhaler

Duova Inhaler contains two bronchodlators, formoterol and tiotropium that are used in combination for long-term treatment of chronic obstructive pulmonary disease (COPD). Formoterol and tiotropium in Duova Inhaler work synergistically by different mechanisms, to relax the muscles of the airways, reducing bronchospasm (narrowing of the airways) and increasing air flow into the lungs. Formoterol is a potent, selective, long-acting beta-agonist that acts locally in the lungs and works as a bronchodilator by relaxing the smooth muscle in the airway walls to widen the airways. Tiotropium is a long-acting anticholinergic that acts on specific receptors (muscarinic receptors) in the bronchioles of the lung and inhibits the interaction of acetylcholine (a neurotransmitter or chemical messenger of the nervous system) with muscarinic receptors, which prevents spasm of the airway wall caused by acetylcholine. Chronic obstructive pulmonary disease (COPD) is a progressive obstructive airways disease that usually gets worse with time, with symptoms similar to asthma caused by bronchospasm, including tightness of the chest, wheezing and shortness of breath, as well as chronic cough with sputum production because the lung tissues have become damaged. Duova Inhaler provides improved action to open airways and improve breathing, which helps relieve symptoms, where a single medication has not been sufficiently effective.

What are the side effects of Duova Inhaler?

The most commonly reported side effects when taking Duova Inhaler include: dry mouth and throat, cough, rapid heartbeat (tachycardia), blurred vision, high pressure in the eye (glaucoma), oral candida (thrush), dizziness, nausea, constipation, upset stomach, stuffy nose, dysphonia (hoarse voice), sinusitis, viral Infection, bronchitis, chest pain, tremors, dizziness, insomnia, tonsillitis, rash. Paradoxical bronchospasm is uncommon but can occur in which your inhaler worsens your breathing. Also hypokalaemia (low blood potassium) is an uncommon but serious side effect.

When should Duova Inhaler not be used?

You should not use Duova Inhaler if you:

• are allergic to atropine or its derivatives like ipratropium, tiotropium, formoterol, or any ingredients in Duova Inhaler
• are pregnant or are breastfeeding
• have kidney disease
• are having an acute episode of bronchospasm, as Duova is not intended for rescue therapy
• have glaucoma, urinary problems, irregular heartbeat, or prostate or kidney disease
• have any of the following condition without discussion with your doctor: heart disease, high blood pressure, or congestive heart failure, epilepsy, diabetes, overactive thyroid
• are taking medicines that interact with Duova Inhaler, including: other beta-agonists like pseudoephidrine in cold medications, beta-blockers like atenolol, MAOIs like phenelzine, tricyclic antidepressants (TCAs) like amitriptyline, diuretics like furosemide or hydrochlorothiazide

What medications interact with Duova Inhaler?

Several medications interact with Duova Inhaler and should either not be taken while you are taking Duova Inhaler or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Duova Inhaler: anticholinergics like atropine, other beta-agonists like pseudoephidrine in cold medications, diuretics like furosemide or hydrochlorothiazide
• Drugs that affect Duova Inhaler: beta-blockers like atenolol
• Drugs that are affected by Duova Inhaler: beta-blockers like atenolol

How should Duova Inhaler be taken?

You should use your Duova Inhaler as recommended by your doctor, usually two puffs once daily. If required, use the spacer device recommended by this manufacturer. You should continue to use your Duova Inhaler continually for as long as your doctor recommends. You should not stop taking your Duova Inhaler, even if you feel better.

How to use your Duova inhaler

Follow the instruction provided with your Duova inhaler.

1. Shake the inhaler vigorously for at least 10 seconds before use.
2. Remove the mouthpiece cover.
3. Breathe out as far as is comfortable and then place the mouthpiece in your mouth
4. Start to inhale and press down on the top of the inhaler to release a dose of and formoterol and tiotropium while still breathing in through your mouth until your lungs are full and hold your breath for a few seconds.
5. Remove the inhaler and breathe normally.
6. Replace the mouthpiece cover.

Note: You can use a spacer device to help you inhale correctly.

How long should you take Duova Inhaler?

You should continue to use your Duova Inhaler continually for as long as your doctor recommends. You should not stop taking your Duova Inhaler, even if you feel better.

Missed dose of Duova Inhaler

If you miss a dose of Duova Inhaler take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Duova Inhaler be stored?

You should store your Duova Inhaler below 25°C in a cool dry place. Protect your inhaler from frost, it will not work properly if it gets cold and keep away from direct sunlight. Always replace the mouthpiece cover when you are not using your inhaler.