Triohale Inhaler 200 Doses/Pack

Triohale Inhaler general information

What is Triohale Inhaler used for?

Triohale Inhaler is a combination medication used for treating the obstructive airways disease known as chronic obstructive pulmonary disease (COPD). This combination therapy is used for long-term management of severe COPD to treat symptoms where repeated exacerbation of significant symptoms has not improved despite regular therapy with a single medication. COPD is a progressive chronic disease of the airways that usually gets worse with time and includes conditions such as emphysema and chronic bronchitis. COPD has symptoms similar to asthma and is characterised by inflammation of the airways and increased mucus production, because the lung tissues have become damaged, which causes symptoms like chronic cough with phlegm production and breathlessness. Triohale Inhaler helps relieve symptoms of COPD and reduces the frequency of exacerbations to improve exercise tolerance and health-related quality of life, but it cannot cure COPD.

How does Triohale Inhaler work?

Triohale Inhaler contains a combination of three medications that work by different mechanisms of action to control obstructive airways disease in chronic obstructive pulmonary disease (COPD). Ciclesonide is a corticosteroid and anti-inflammatory medication that blocks Inflammation, one of the underlying causes of asthma, by inhibiting the production of inflammatory chemicals released in the airways in response to asthma trigger, such as an allergens or irritants in the air. This reduces inflammation and swelling of the airways, as well as excess mucus production, which can cause blockage of the airways. Formoterol is a rapid-onset and long-acting selective beta-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways. This reduces bronchospasm (constriction or narrowing of the airways) and provides relief for up to 12 hours. Tiotropium is a long-acting anticholinergic that acts on specific muscarinic receptors in the bronchioles of the lung to inhibit the interaction of acetylcholine (a neurotransmitter or chemical messenger of the nervous system) with muscarinic receptors, preventing spasm of the airway wall caused by acetylcholine. Blocking the action of acetylcholine in the airways, causes the smooth muscle in the airway walls to relax and allows the airways to dilate (widen) which increases air flow into the lungs and relieves bronchospasm. The combination of medications in Triohale Inhaler helps target the different aspects of COPD by different mechanisms to improve symptoms and long-term management.

What does Triohale Inhaler contain?

Triohale Inhaler contains the active ingredients tiotropium bromide monohydrate equivalent to (9 mcg), formoterol fumarate dehydrate (6 mcg) and ciclesonide (200 mcg), suspended in propellant HFA 227 and used to treat COPD. Triohale is a metered dose inhaler that delivers 200mcg ciclesonide, 6mcg formoterol and 9 mcg tiotropium as an aerosol into your lungs each time your actuate (press down) your inhaler. Each inhaler contains at least 200 actuations.

Treating chronic obstructive pulmonary disease (COPD) with Triohale Inhaler

Triohale Inhaler contains a combination of three medications, tiotropium, formoterol and ciclesonide that are used together for long-term maintenance therapy of severe chronic obstructive pulmonary disease (COPD) for people who are using a bronchodilator but are still having frequent symptoms and a history of exacerbations. COPD is a chronic disease of the airways and includes conditions such as emphysema and chronic bronchitis, characterised by inflammation of the airways and increased mucus production, which cause symptoms like cough with phlegm production and breathlessness. Ciclesonide is a corticosteroid and anti-inflammatory medication that reduces inflammation and swelling of the airways, as well as excess mucus production, which can cause blockage of the airways. Formoterol is a rapid, long-acting beta-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways. This reduces bronchospasm (constriction or the airways) making breathing easier, and provides relief for up to 12 hours. Tiotropium is a long-acting anticholinergic that blocks the action of acetylcholine preventing spasm of the airway wall caused by acetylcholine, which causes the smooth muscle in the airway walls to relax and allows the airways to dilate (widen) which increases air flow into the lungs and relieves bronchospasm. The combination of medications in Triohale Inhaler helps target the different aspects of COPD by different mechanisms to improve symptoms and long-term management. Triohale Inhaler helps relieve symptoms of COPD and reduces the frequency of exacerbations to improve exercise tolerance and health-related quality of life, but it cannot cure COPD.

What are the side effects of Triohale Inhaler?

The most commonly reported side effects when taking Triohale Inhaler include: a sore throat or tongue, which may be due to candida infection (thrush), hoarseness or throat irritation, dry mouth and throat, cough nasopharyngitis, headache, tachycardia (rapid heartbeat), tremor (shaky or tense feeling), palpitations, blurred vision, high pressure in the eye (glaucoma), dizziness, nausea, constipation, upset stomach, stuffy nose, nosebleed. 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. Long term use of Triohale may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently.

When should Triohale Inhaler not be used?

You should not use Triohale Inhaler if you:

• are allergic to tiotropium, ciclesonide or formoterol or any ingredients in Triohale Inhaler
• are pregnant or are breastfeeding
• have a history of hypersensitivity to atropine or its derivatives, (ipratropium or oxitropium)
• have severe kidney disease
• are having an acute episode of bronchospasm, as Trihale is not intended for rescue therapy
• have glaucoma, urinary problems, irregular heartbeat, or prostate or kidney disease
• have cardiovascular disease, including heart failure ischaemic heart disease or tachyarrythmias (rapid heartbeat)
• have diabetes, thyroid problems or problems with your potassium levels, without discussion with your doctor
• have pulmonary tuberculosis or infection of the airways
• are taking medicines that interact with Triohale Inhaler 200/6, including: other beta-adrenergic stimulants or sympathomimetic amines such as ephedrine; the antifungals ketoconazole and itraconazole; beta blockers including eye drops for glaucoma, the antiarrhythmics quinidine, disopyramide and procainamide; phenothiazines in antipsychotics, the antihistamine terfenadine; monoamine oxidase inhibitors and tricyclic antidepressants, xanthines found in stimulants, mineralocorticosteroids for Addisons disease, diuretics for water retention

What medications interact with Triohale Inhaler?

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

• Drugs that cause a serious reaction with Triohale Inhaler: other beta-adrenergic stimulants or sympathomimetic amines such as ephedrine, the antiarrhythmics quinidine, disopyramide and procainamide, phenothiazines in antipsychotics, the antihistamine terfenadine, monoamine oxidase inhibitors and tricyclic antidepressants; xanthines found in stimulants, mineralocorticosteroids for Addisons disease, diuretics for water retention
• Drugs that affect Triohale Inhaler: beta blockers (including eye drops)
• Drugs that are affected by Triohale Inhaler: the antifungals ketoconazole and itraconazole.

How should Triohale Inhaler be taken?

You should take two inhalations (puffs) of your Triohale Inhaler once daily, at the same time each day morning or evening. Triohale Inhaler is intended for long-term use and you should use your Triohale Inhaler every day for as long as your doctor recommends.

How to use your Triohale inhaler?

Follow the instruction provided with your Triohale inhaler.

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

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

How long should you take Triohale Inhaler?

Triohale Inhaler is intended for long-term use and you should use your Triohale Inhaler every day for as long as your doctor recommends.

Missed dose of Triohale Inhaler

If you miss a dose of Triohale 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 Triohale Inhaler be stored?

You should store your Triohale Inhaler below 25°C in a cool dry place.