INTRODUCTION

TRIOHALE INHALER is a combination of Ciclesonide, Formoterol and Tiotropium which belongs to the group of medicines called Steroids and Bronchodilators respectively. It is indicated in the symptomatic treatment of severe COPD (Chronic Obstructive Pulmonary Disease) and a history of repeated exacerbations, having significant symptoms despite regular treatment with long-acting bronchodilators.

Before taking TRIOHALE INHALER, inform your doctor if you have kidney or heart diseases, active or inactive pulmonary tuberculosis, fungal, viral, or bacterial infections, increased pressure in the eye, an enlarged prostate, thyrotoxicosis, or bladder-neck obstruction.

TRIOHALE INHALER should be used with caution in pregnant or breastfeeding women. TRIOHALE INHALER should not be used by children under the age of 12. Headache, muscle cramps, faster heart rate, dry mouth, oropharyngeal candidiasis (fungal), hoarseness, and cough are the most common side effects of using TRIOHALE INHALER. Ask for your doctor’s advice if any of these worsen or don’t improve.

USES OF TRIOHALE INHALER

• Treats the symptoms associated with COPD
• Treats patients having a history of repeated exacerbations
• Treats symptoms even after using other bronchodilators

HOW TRIOHALE INHALER WORKS

TRIOHALE INHALER helps in the treatment of symptoms of COPD where Ciclesonide is a glucocorticoid which possesses anti-inflammatory action. It inhibits the potent factors that cause inflammation such as prostaglandins and leukotrienes.

Formoterol is an Adrenergic beta-2 Receptor Agonist, which acts on the receptors present in the airways called beta-receptors and causes the relaxation of muscles in the airways resulting in easy breathing. It also suppresses the release of agents that cause hypersensitivity (histamine and leukotrienes).

Tiotropium is an Anticholinergic drug which causes relaxation of the muscles in the airways and bronchodilation. Together, they help in easy breathing and decrease inflammation.

DIRECTIONS FOR USE

Always use TRIOHALE INHALER as directed by your physician. It is for inhalational use only. Your doctor will advise the correct dose and duration of TRIOHALE INHALER for you depending upon your age, condition and body weight.

SIDE EFFECTS OF TRIOHALE INHALER

HOW TO MANAGE SIDE EFFECTS

Headache

Try to take a rest and don’t involve yourself in exertive activities. Apply a pain-relieving balm on your forehead. If the symptom does not improve, consult with your doctor.

WARNING & PRECAUTIONS

PREGNANCY

Risky

There are no adequate studies on the use of TRIOHALE INHALER in pregnant women. It should only be given if the expected benefit to the mother is greater than any risk to the foetus. Consult your doctor before taking it.

BREASTFEEDING

Risky

It is not known whether TRIOHALE INHALER passes through breast milk or not. It should only be given if the expected benefit to the mother is greater than any possible risk to the child. Consult your doctor before taking it.

KIDNEY

Use with Caution

TRIOHALE INHALER should be used with caution in patients having moderate to severe kidney diseases. Consult with your doctor before taking it.

ALLERGY

Contraindicated

Do not take TRIOHALE INHALER if you are allergic to Ciclesonide, Formoterol or Tiotropium.

HEART DISEASE

Use with Caution

TRIOHALE INHALER should be used with caution in patients having heart diseases such as Ischaemic heart disease, irregular heartbeat, 3rd-degree atrioventricular block, severe cardiac decompensation (sudden onset of symptoms of heart failure), idiopathic subvalvular aortic stenosis (reduced blood flow in the heart due to obstruction), hypertrophic obstructive cardiomyopathy (abnormally thickening of heart muscles). Consult with your doctor before taking it.

USE IN PEDIATRICS

Contraindicated

TRIOHALE INHALER is not recommended for use in children below 12 years of age. Consult your doctor before taking.

USE IN GERIATRICS

Consult your doctor

Your doctor will decide the correct dose and duration of the treatment with TRIOHALE INHALER for you depending upon your age, condition and body weight. Consult your doctor.

INTERACTIONS

A. Drug–Drug Interactions:

Before taking TRIOHALE INHALER, inform your doctor if you are taking any of the following medicines:

• other anticholinergic drugs such as atropine (used to treat asthma), xanthine derivatives such as theobromine and methylxanthines (used to treat bronchospasm)
• steroids such as prednisolone (used to reduce inflammation and pain)
• diuretics such as spironolactone, and furosemide (used to get rid of extra fluid from the body)
• monoamine oxidase inhibitors such as isocarboxazid, tricyclic antidepressants such as amitriptyline, and doxepin (used to treat depression)
• ketoconazole, itraconazole (used to treat fungal infections)
• ritonavir, nelfinavir (used to treat HIV infection)

Overdosage:

If you or anyone else accidentally take too much of TRIOHALE INHALER, consult your doctor immediately or visit the nearby hospital.

SYNOPSIS

MORE INFORMATION

• Keep TRIOHALE INHALER out of reach from children
• Store below 30°C

FAQs ABOUT TRIOHALE INHALER

Q: What is TRIOHALE INHALER and why is it prescribed?

A: TRIOHALE INHALER is a combination of Ciclesonide, Formoterol, and Tiotropium, which belong to the groups of medicines called steroids and bronchodilators, respectively. It is indicated in the symptomatic treatment of severe COPD with a history of repeated exacerbations and significant symptoms despite regular treatment with long-acting bronchodilators.

Q: Can TRIOHALE INHALER cause dry mouth?

A: Yes. TRIOHALE INHALER can cause dry mouth. This can increase the likelihood of dental caries occurring. It is advised to always rinse your mouth after taking TRIOHALE INHALER.

https://www.pcrs-uk.org/sites/pcrs-uk.org/files/RespInhalerTable_FINAL_0.pdf

Q: How to use TRIOHALE INHALER

A: Always use TRIOHALE INHALER as directed by your physician. It is for inhalational use only. Your doctor will advise the correct dose and duration of TRIOHALE INHALER for you depending upon your age, condition, and body weight.

Q: Is TRIOHALE INHALER a steroid?

A: TRIOHALE INHALER is a combination of three medicines, namely, clesonide, formoterol, and tiotropium. Ciclesonide is a steroid that has an anti-inflammatory action. It inhibits the potent factors that cause inflammation, such as prostaglandins and leukotrienes.

Q: Is it safe for children to TRIOHALE INHALER?

A: TRIOHALE INHALER should not be used by children under the age of 12. Consult your doctor before taking it.

REFERENCES

1. K.D. Tripathi. Drugs Acting on ANS, Drugs for Bronchial Asthma and Cough. Essentials of medical pharmacology. Seventh edition. 2013. Page – 117, 224 & 231.

2. Salvi SS, Vaidya AJ, Kodgule RR, Gogtay JA. A randomized, double-blind study comparing the efficacy and safety of a combination of formoterol and ciclesonide with ciclesonide alone in asthma subjects with moderate-to-severe airflow limitation. NIH National Library of Medicine, National center for biotechnology information. Pubmed Central. May-June 2016. [Accessed on 8th July 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857562/

3. NIH National Library of Medicine, National center for biotechnology information. Pubchem. Ciclesonide. [Accessed on 8th July 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Ciclesonide

4. NIH National Library of Medicine, National center for biotechnology information. Pubchem. Formoterol. [Accessed on 8th July 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Formoterol

5. NIH National Library of Medicine, National center for biotechnology information. Pubchem. Tiotropium. [Accessed on 8th July 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Tiotropium

6. Dr Anna Murphy. Primary Care Respiratory Society UK. Respiratory Inhalers. [Revised in December 2014]. [Accessed on 8th July 2022] https://www.pcrs-uk.org/sites/pcrs-uk.org/files/RespInhalerTable_FINAL_0.pdf

7. Cipla Ltd. Triohale Rotacaps. Ciplamed. [Revised in December 2015]. [Accessed on 8th July 2022] https://www.ciplamed.com/content/triohale-rotacaps

8. Cipla Ltd. Triohale Inhalers. Ciplamed. [Revised in December 2015]. [Accessed on 8th July 2022] https://www.ciplamed.com/content/triohale-inhaler

USEFUL DIAGNOSTIC TESTS

• Chest Xray
• Complete Blood Count

AUTHOR DETAILS

Written By Dr. Dhivakaran R, BDS
Last updated on 22 Feb 2023 | 12:56 PM(IST)