Antiasthmatic Inhalers

Each capsule contains:

• Beclomethasone Dipropionate IP : 200 mcg
• Levosalbutamol Sul­phate equivalent to Levosalbutamol :  200 mcg
• Excipients : Q.S Indications

Aerocort Forte Rotacaps is indicated in the treatment of asthma, once the need for inhaled cortico­steroid and bronchodilator therapy has been established.

 

Dosage & Administration for Aerocort Forte Rotacaps

 

• Aerocort Forte Rotacaps are for inhalation use, only through the Cipla Rotahaler/ Revolizer
  

Adults:

• One Aerocort Forte rotacaps, three or four times daily

Contraindication:

• Hypersensitivity to any of the components

Packaging Information:

• Aerocort Forte Rotacaps : 30 Rotacaps

3 years storage and handling instructions

Store below 30â°c. Do not freeze packaging information

Aerocort inhaler sales pack available in 120 metered doses

Asthalin Inhaler is indicated for the treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease.

Contraindications

Hypersensitivity to any of the components.

Rare cases of hypersensitivity reactions including urticaria, angioedema and rash have been reported after the use of salbutamol.

Packaging Information

Asthalin Inhaler  Canister containing 200 metered doses

Indications Bronchospasm

Asthalin Rotacap are indicated for the treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease.

Exercise-Induced Bronchospasm

Asthalin Rotacap are indicated for the prevention of exercise induced bronchospasm in patients 4 years of age and older.

Dosage and Administration

Asthalin Rotacap are for inhalation use, only through the Cipla Rotahaler/ Revolizer.

Adults (Including the Elderly)

Adults: 
For relief of acute episodes of bronchospasm:
1 Rotacap as a single dose

To prevent allergen- or exercise-induced bronchospasm: 
1 Rotacap, 15 minutes prior to exercise or exposure to allergen

The maximum dose up to 800 mcg in 24 hours

Children: 
For relief of acute episodes of bronchospasm:
1 Rotacap as a single dose

To prevent allergen- or exercise-induced bronchospasm: 
1 Rotacap, 15 minutes prior to exercise or exposure to allergen

The maximum dose up to 800 mcg in 24 hours

Contraindications

Hypersensitivity to any of the components.

Rare cases of hypersensitivity reactions including urticaria, angioedema and rash have been reported after the use of salbutamol.

Indications

Prophylactic management of mild, moderate or severe asthma.

Dosage and AdministrationAdults:Starting and maintenance dose:

It is important to gain control of asthma symptoms and optimise pulmonary function as soon as possible. When patients' symptoms remain under satisfactory control, the dose should be titrated to the lowest dose at which effective control of asthma is maintained.To be effective, inhaled Beclate Inhaler must be used on a regular basis even when patients are asymptomatic.

Therapy in new patients should be initiated at the following dosages

Mild asthma : 100 to 200 micrograms per day in two divided doses.
Moderate asthma : 200 to 400 micrograms per day in two divided doses.
Severe asthma : 400 to 800 micrograms per day in two divided doses.

Children:

There are no data to date on Beclate Inhaler in children under 12 years of age, hence no definitive dosage recommendation can be made.

Special patient group:

No special dosage recommendations are made for elderly patients

Contraindications

Hypersensitivity to beclometasone dipropionate or to any of the excipients.

Packaging Information

Beclate 100 Inhaler Canister containing 200 metered doses
Beclate 200 Inhaler Canister containing 200 metered doses

Indications

Severe asthma requires regular medical assessment as death may occur. Patients with severe asthma have constant symptoms and frequent exacerbations, with limited physical capacity, and PEF values below 60% predicted at baseline with greater than 30% variability, usually not returning entirely to normal after a bronchodilator. These patients will require high dose inhaled or oral corticosteroid therapy. Sudden worsening of symptoms may require increased corticosteroid dosage which should be administered under urgent medical supervision.

Contraindications

Beclate Rotacap is contraindicated in patients with a history of hypersensitivity to any of the components of the drug product.

Special care is necessary in patients with active or quiescent pulmonary tuberculosis.

Bekform  is the rationale, guideline recommended, cost-effective combination of Inhaled corticosteroid + Long acting beta 2 agonist (ICS+LABA), preferably catering to the need of primary care practitioner. 

Bekform combines the time tested ICS Beclomethasone (BDP) and rapid acting bronchodilator formoterol fumarate. 

The major concern of primary care is about the high cost of asthma medication which may act as a barrier for initiating and adhering with asthma therapy leading to uncontrolled asthma, disability and absenteeism. 

Bekform is the first brand in respiratory market, available in pack of ten Rotacaps, making asthma treatment accessible to all asthmatic patients. Bekform provides a cost effective therapy, which reduces the initial outlay for the patient & thus prevents the patient from discontinuing the medication due to high cost. 

BDP the first inhaled corticosteroid introduced in 1972, represented a significant therapeutic advance as its low oral bioavailability, high systemic clearance and inhalation formulation imparted a much wider therapeutic ratio than any oral corticosteroid. Over the past 30-35 years a number of clinical trials published on beclomethasone have well established this molecule. BDP gets metabolised by esterase enzymes to beclomethasone-17-monopropionate, which is the active metabolite and has potent anti inflammatory activity. BDP administered by inhaled route acts exclusively in the airways and at usual doses, has no systemic effects and does not suppress the hypothalamic-pituitary-adrenal axis (HPA). One of the characteristics of beclomethasone, is its hepatic metabolization into inactive metabolite; thus reducing the systemic availability of the drug. 

Formoterol, a selective beta2- agonist, produces effective dose proportional bronchodilation in patients with reversible obstructive airway disease. Formoterol is a highly potent, long-acting beta2- agonist, combining the clinical advantages of rapid onset of action which is similar to salbutamol with the advantage of longer duration of action around 12 hr. Formoterol is approximately 107 times more potent than salmeterol and 323 times more potent than salbutamol in relaxing isolated human bronchi. 

Indication
Bekform is indicated in the regular treatment of asthma, where use of a combination (long-acting beta2-agonist and inhaled corticosteroid) has been found to be appropriate. 

Terbutaline (Bricanyl) is an adrenergic agonist which selectively stimulates beta-2- 
receptors, thus producing relaxation of bronchial smooth muscle, inhibition of the release of 
endogenous spasmogens, inhibition of oedema caused by endogenous mediators and increased 
mucociliary clearance. 
Indications: For the relief of bronchospasm in bronchial asthma, chronic bronchitis, emphysema and 
other diseases of the lung where bronchoconstriction is a complicating factor. Management of preterm 
Precautions: Patients with thyrotoxicosis should use terbutaline with caution. Terbutaline should be 
given with care-as any other sympathomimetic amine - to patients with cardiovascular diseases or 
diabetes and to patients with a record of hypersensitivity to sympathomimetic amines. 
Adverse Effects: The frequency of side effects with oral terbutaline is low. Those recorded e.g. tremor 
and palpitations are characteristic of all sympathomimetic amines. Tremor diminishes on continued 
treatment. Tremor and palpitations subside if the dose is lowered. 
Dosage Adults : Bricanyl® Tablets 2.5 mg 2-3 times a day. In most patients the optimum single dose is 
5 mg. In patients who are usually sensitive to sympathomimetic amines, it is advisable to initiate 
treatment with 2.5 mg two-three times a day. If adequate bronchodilation is not obtained the dose can 
be increased. Children: 7-15 years: 1 Bricanyl® Tablets 2.5 mg, 2-3 times a day.; 3-6 years: 1/2 
Bricanyl ® Tablets 2.5 mg, 2-3 times a day.

Indications

BUDECORT INHALER is indicated for the maintenance treatment of asthma as prophylactic therapy in adult and pediatric patients. It is also indicated for patients requiring oral corticosteroid therapy for asthma. Many of those patients may be able to reduce or eliminate their requirement for oral corticosteroids over time.

BUDECORT INHALER is not indicated for the relief of acute bronchospasm.

Dosage and AdministrationAdults (including elderly) and children over 12 years

200-1,600 mcg daily, in divided doses.

200 micrograms twice daily, in the morning and in the evening. During periods of severe asthma the daily dosage can be increased up to 1600 micrograms.

In patients whose asthma is well controlled, the daily dose may be reduced below 400 micrograms but should not go below 200 micrograms.

Patients should be maintained on the lowest dose that will effectively control symptoms.

Children (2 – 12 years)

200–800 mcg daily, in divided doses.

The dose should be reduced to the minimum needed to maintain good asthma control.

Contraindications

History of hypersensitivity to budesonide or any of the excipients.

BUDECORT INHALER is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required.

Budecort Rotacaps is indicated for the maintenance treatment of asthma as prophylactic therapy in adult and pediatric patients five years of age or older. It is also indicated for patients requiring oral corticosteroid therapy for asthma. Many of those patients may be able to reduce or eliminate their requirement for oral corticosteroids over time.

Budecort Rotacaps are not indicated for the relief of acute bronchospasm.

Contraindications

History of hypersensitivity to budesonide or any of the excipients.

Budecort Rotacaps are contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required.

 

Duolin Inhaler is indicated for use in patients with COPD on a regular aerosol bronchodilator, who continue to have evidence of bronchospasm and require a second bronchodilator.

Duolin Rotacaps are indicated for use in patients with COPD, who are on a regular bronchodilator, or who continue to have evidence of bronchospasm and require a second bronchodilator.

Duoset Rotacaps are indicated for use in patients with COPD, who are on a regular bronchodilator, or who continue to have evidence of bronchospasm and require a second bronchodilator.

Indications

Duova Inhaler is indicated in the maintenance treatment of COPD (chronic obstructive pulmonary disease).

Dosage and Administration

The recommended dosage is the inhalation of two puffs, once daily. It is recommended to use Duova Inhaler with theCipla Zerostat VT Spacer.

Contraindications

Duova Inhaler is contraindicated in patients with a hypersensitivity to atropine or its derivatives (e.g., Ipratropium and Oxitropium), Formoterol, or any other component of the product.

Duova

Indications

Duova Rotacaps are indicated in the maintenance treatment of COPD (chronic obstructive pulmonary disease).

Dosage and Administration

The recommended dosage is the inhalation of the contents of one rotacap, once daily.

It is recommended to use Duova Rotacaps only with the  Cipla Rotahaler/ Revolizer device. Duova Rotacaps must not be swallowed.

Contraindications

Duova Rotacaps are contraindicated in patients with a hypersensitivity to atropine or its derivatives (e.g., ipratropium and oxitropium), Formoterol, lactose monohydrate, or any other component of the product.

Flohale Inhaler is indicated in patients with mild to severe, persistent bronchial asthma. It is also indicated for patients requiring oral corticosteroid therapy for asthma. Many of these patients may be able to reduce or eliminate their requirement for oral corticosteroids over time. Flohale Inhaler is not indicated for the relief of acute bronchospasm.

FLOHALE Rotacaps are indicated in patients with mild to severe, persistent bronchial asthma. It is also indicated for patients requiring oral corticosteroid therapy for asthma. Many of these patients may be able to reduce or eliminate their requirement for oral corticosteroids over time. FLOHALE Rotacaps are not indicated for the relief of acute bronchospasm.

IndicationsAsthma

Foracort Forte Inhaler is indicated in the regular treatment of asthma where use of a combination (inhaled corticosteroid and long-acting beta2-agonist) is appropriate:

• Patients not adequately controlled with inhaled corticosteroids and “as needed” inhaled short-acting beta₂-agonists OR
• Patients already adequately controlled on both inhaled corticosteroids and long-acting beta₂-agonists.

COPD

Symptomatic treatment of patients with severe COPD (FEV₁ < 50% predicted normal) and a history of repeated exacerbations, who have significant symptoms despite regular therapy with long-acting bronchodilators.

Indications

Foracort Inhaler is indicated in the regular treatment of asthma, where the use of a combination (long-acting, beta₂-agonist and inhaled corticosteroid) has been found to be appropriate. It is also indicated in the symptomatic treatment of severe Chronic Obstructive Pulmonary Disease (COPD), with a history of repeated exacerbations despite regular therapy with long-acting bronchodilators.

Indications

Foracort Rotacaps are indicated in the regular treatment of asthma, where the use of a combination (long-acting, beta₂-agonist and inhaled corticosteroid) has been found to be appropriate. It is also indicated in the symptomatic treatment of severe Chronic Obstructive Pulmonary Disease (COPD), with a history of repeated exacerbations despite regular therapy with long-acting bronchodilators.

Indications

FULLFORM ROTACAPS is indicated in the regular treatment of asthma, where use of a combination (long acting beta₂-agonist and inhaled corticosteroid) has been found to be appropriate.

Dosage and Administration

FULLFORM ROTACAPS are for inhalation use, only through the Cipla Rotahaler/Revolizer.

Contraindications

FULLFORM ROTACAPS is contraindicated in patients with a history of hypersensitivity to any of the components of the drug product.

Indications

FULLFORM INHALER is indicated in the regular treatment of asthma, where use of a combination (long acting beta2-agonist and inhaled corticosteroid) has been found to be appropriate.

Indications

For the treatment of chronic reversible airways obstruction, particularly in chronic bronchitis and asthma.

Dosage and AdministrationAdults (>12 years)

1 or 2 rotacaps, three or four times daily.

Children (<12 years)

Not recommended.

The recommended dose should not be exceeded.

Ipravent - Rotacaps are for inhalation use, only through the Cipla Rotahaler/ Revolizer. Ipravent - Rotacaps must not be swallowed.

Contraindications

Hypersensitivity to atropine or its derivatives, or to any component of the product. Hypersensitivity to soya lecithin or related food products such as soya beans or peanuts.

Ipravent Inhaler is indicated for the regular treatment of reversible bronchospasm associated with chronic obstructive pulmonary disease (COPD) and chronic asthma.

Dosage and AdministrationAdults (Including the Elderly)

Usually 1 or 2 puffs, three or four times daily, although some patients may need up to 4 puffs at a time to obtain maximum benefit during early treatment.

Children (6–12 years)

1 or 2 puffs (20 or 40 micrograms) two times daily

Below 6 Years 
1 puff (20 micrograms) three times daily.

The recommended dose should not be exceeded.

Contraindications

Ipravent Inhaler should not be taken by patients with known hypersensitivity to atropine or its derivatives, or to ipratropium bromide or to any other component of the product.

Maxiflo Inhaler is indicated in the regular treatment of asthma, where use of a combination (long-acting beta₂-agonist and inhaled corticosteroid) has been found to be appropriate, and in patients with severe COPD.

Dosage and Administration Asthma

Adults and Adolescents (12 years and older): 
Maxiflo-125 Inhaler: 1-2 inhalations twice daily
Maxiflo-250 Inhaler: 1-2 inhalations twice daily

COPD

Maxiflo-125 Inhaler: Two inhalations twice daily 
Maxiflo-250 Inhaler: Two inhalations twice daily

Maxiflo Inhaler may be used with a Zerostat VT Spacer device in patients who find it difficult to synchronize aerosol actuation with inspiration of breath.

Contraindications

Maxiflo Inhaler is contraindicated in patients with a history of hypersensitivity to formoterol or any other component of the drug product.

Maxiflo Rotacaps are indicated in the regular treatment of asthma, where use of a combination (long-acting beta₂-agonist and inhaled corticosteroid) has been found to be appropriate, and in patients with severe COPD.

Description: Pulmiocort, active ingredient budesonide, is is a corticosteroid used to prevent bronchial asthma. It is not used to relieve an asthma attack. It may also be used to treat other conditions as determined by your doctor.

Before Using This Medicine: WARNING: If you have switched from an oral corticosteroid (e.g., prednisone tablets) to this inhaler within the past 12 months, your body may not produce enough natural steroids. You may need to start taking additional corticosteroids, especially if your body is stressed due to major infections such as stomach infections (gastroenteritis), surgery, or injury. Deaths have occurred during such stresses, due to low steroid levels. Consult your doctor or pharmacist now for specific advice regarding stress situations; you may need to carry a supply of corticosteroid tablets as a precaution. Routine blood tests may be performed (e.g., morning cortisol levels). Seek immediate medical attention if you experience any of the following signs of low steroid levels: unusual weakness, sudden weight loss, vomiting, fainting or severe dizziness. Carry a warning card or medical ID bracelet that identifies your need for oral corticosteroids during times of stress as noted. Inform your doctor or pharmacist of all prescription and over-the-counter medicine that you are taking. Inform your doctor of any other medical conditions such as: glaucoma, cataracts, and any illnesses or infections. Inform your doctor of any recent exposure to contagious diseases such as chickenpox and measles. Also, tell your doctor about any allergies, pregnancy, or breast-feeding.

Revolizer TM is a novel DPI device, which is the result of a design and development programme to address the critical requirements of an ideal inhalation device. It provides accurate dosing and greater lung deposition even at low inspiratory flow rates combined with ease of use. It provides an improved respirable fraction while adding style and modern design to give patients a revolution in inhalation therapy. 

Revolizer TM is an extremely simple device. The user has to open the device, insert the rotacap, shut the device and then inhale. Revolizer is used to open capsules containing powder. Revolizer can be used only with Cipla Rotacaps.

Features of the Revolizer TM : 

* Does not require co-ordination between actuation and inhalation 
* Easy and convenient to use 
* Easy to teach, learn and remember how to use correctly 
* Accurate, consistent, and effective at delivering medications to the lung even at low inspiratory flow rates 
* Ready to use - it needs no priming or shaking 
* Portable 
* Gives patient feedback due to the taste of lactose in the mouth 
* Robust 
* Visually appealing to the patient

Description:
The world`s first transparent Rotahaler TM is a dry powder inhaler (DPI). Rotahaler TM is used with Rotacaps, which is premetered single dose medication for inhalation. DPI`s are breath-actuated devices and eliminate the need for co-ordination of actuation and inspiration. DPI`s are emerging as cost-effective, simple-to-use and environmentally preferred devices for pulmonary drug delivery. 

The unique and highly efficient design of Rotahaler TM offers many benefits not found in other DPI devices: 

* High performance: optimum drug delivery 
* Ease of use: just 3 simple steps i.e. insert, rotate and inhale 
* Avoids coordination problems 
* Confirmation of dosing: due to transparency, audio and visual feedback 
* High emitted dose: upto 90% 
* Fine particle deposition: drug delivered is as high as 40% 
* Versatile: Single device for multiple therapies 
* Consistency: high level of dose uniformity 
* Low resistance: low inspiratory effort required 
* Safe: Accidental double dosing avoided 
* Convenience: Portable, easy to clean and reassemble after use 

Three simple steps to use the Rotahaler 

Step 1: Insert a rotacap, transparent end first, into the raised square hole of the rotahaler. 

Step 2: Rotate the base of the Rotahaler in order to separate the two halves of the rotacap. 

Step 3: Breathe in as deeply as you can*. Hold your breath for 10 seconds. Breathe out slowly. 

*Note: If you are breathing correctly, you will hear the soft rattling sound of the rotacap.
  

Packing: 60 100mcg/50mcg doses 

Description: Seretide Accuhaler is used to help with asthma and chronic obstructive pulmonary disease (COPD) in people who need regular treatment. Asthma is a condition affecting the lungs. Symptoms of asthma include shortness of breath, wheezing, chest, tightness and cough. Two main causes of asthma symptoms are bronchoconstriction (tightening of the muscle surrounding the airways) and inflammation (swelling and irritation of the airways).

Seroflo is indicated in the regular treatment of asthma, where use of a 
combination (bronchodilator and inhaled corticosteroid) has been found 
to be appropriate. 

Dosage and Administration 
In patients who find the correct use of a pressurised MDI difficult, a Cipla 
spacer/zerostat spacer device may be used with Seroflo inhalers. 
Seroflo Inhalers 
Adults and adolescents 12 years and over 
Seroflo-50: 2 inhalations twice daily or Seroflo-125: 2 inhalations twice 
daily or Seroflo-250: 2 inhalations twice daily 
Children 4 years and older 
Seroflo-50: 2 inhalations twice daily 

Contraindications 
Seroflo is contraindicated in patients with a history of hypersensitivity to 
any of the ingredients.

How does Seroflo work? 
Seroflo, or Generic Advair, is used to treat asthma. The fluticasone in Seroflo reduces inflammation in the air passages. Fluticasone propionate is one of a group of medicines called corticosteroids, often referred to as steroids. Corticosteroids are used to treat breathing problems because they have an anti-inflammatory action. Corticosteroids also help to prevent attacks of asthma. The salmeterol in Seroflo relaxes and opens the air passages. This is a preventative medication, taken twice a day. 

Use: 
Prevents shortness of breath, wheezing, and breathing difficulties associated with asthma. 

Possible side effects : Headache , Sinus pain , Cough , Upset stomach , Vomiting , Diarrhea, Runny nose, Sneezing, Sore throat, Hoarseness, Stomach pain, Muscle/bone pain, Throat/nose irritation 

Precautions: If you answer "Yes" to any of the following questions tell your doctor about this before taking your medicine. Are you pregnant or likely to become pregnant soon? Are you breast-feeding? Have you been told you are allergic to Serevent or salmeterol xinafoate? Have you been told that you are allergic to Flixotide or fluticasone propionate? Have you ever had thrush in your mouth? Are you being or have you ever been treated for tuberculosis (TB)? Are you having treatment for a thyroid condition? Are you having treatment for high blood pressure or a heart problem? Are you taking ritonavir, a medicine used in the treatment of HIV (AIDS)? Make sure your doctor knows what other medicines you are taking, including those that you have bought yourself from a pharmacy, supermarket or health food shop. Do not use Generic Advair after the expiry date (EXP) printed on the pack. If you use it after the expiry date has passed, it may not work as well. Do not use Seretide if the packaging is torn or shows signs of tampering. If you're not sure whether you should be using Seretide, talk to your doctor.

Indications

Simply One Rotacaps are indicated in the regular treatment of asthma, where use of a combination (long acting beta₂-agonist and inhaled corticosteroid) has been found to be appropriate.

Dosage and AdministrationAsthma

Adults and Adolescents (12 years and older) 
Simply One200 Rotacaps
1 to 2 Rotacaps twice daily

Simply One 400 Rotacaps
1 Rotacap twice daily

The dose of Simply One Rotacaps is individual and adjusted according to disease severity. The maximum recommended dose for ciclesonide is 640 mcg. When control has been achieved, the dose should be titrated to the lowest effective dose, which could include Simply One Rotacaps given once daily.

Contraindications

SIMPLYONE Rotacaps are contraindicated in patients with a history of hypersensitivity to any of the components of the drug product.

Singuair is used in mild to moderate asthma to decrease the symptoms of asthma and the number of acute asthma attacks. However, this medicine should not be used to relieve an asthma attack that has already started. This medicine is also used to treat the symptoms (sneezing, runny nose, itching, wheezing) of seasonal (short-term) allergies.

Special precautions

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For Singuair , the following should be considered:

Allergies tell your doctor if you have ever had any unusual or allergic reaction to Singuair . Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Singuair has not been studied in pregnant women. However, it has been studied in animals and has not been found to cause birth defects or other problems. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding It is not known whether Singuair passes into breast milk in humans. However, it does pass into breast milk in animals. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children No information is available regarding use of Singuair in infants younger than 12 months of age.

Older adults many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. There is no specific information comparing use of Singuair in the elderly with its use in other age groups. However, it has been used in some elderly patients and no differences in effectiveness or side effects were seen from those that occurred in younger adults.

Other medicines although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking or using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

ndications

TIOVA Inhaler is indicated in the maintenance treatment of COPD.

Dosage and Administration

The recommended dosage of tiotropium bromide is 2 puffs of TIOVA Inhaler once daily.

TIOVA Inhaler may be used with a Zerostat VT Spacer device in patients who find it difficult to synchronize aerosol actuation with inspiration of breath.

The recommended dose should not be exceeded.

Contraindications

TIOVA Inhaler is contraindicated in patients with hypersensitivity to tiotropium bromide, atropine or its derivatives.

Packaging Information

TIOVA Inhaler Each canister contains 120 metered doses.

Indications

TIOVA Rotacaps are indicated for the long-term, once-daily maintenance treatment of bronchospasm associated with COPD, including chronic bronchitis and emphysema.

Dosage and Administration

The recommended dosage of TIOVA Rotacaps is one Rotacap inhaled once daily, using the Cipla Rotahaler/ Revolizer.

No dosage adjustment is required for geriatric, hepatically-impaired, or renally-impaired patients. However, patients with moderate to severe renal impairment, who are being treated with TIOVA Rotacaps should be monitored closely.

TIOVA Rotacaps are for inhalation only and must not be swallowed.

Contraindications

TIOVA Rotacaps are contraindicated in patients with a history of hypersensitivity to atropine or its derivatives, including ipratropium, or to any component of this product.

Indications

Symptomatic treatment of patients with severe COPD (FEV₁ < 50% predicted normal) and a history of repeated exacerbations, who have significant symptoms despite regular therapy with long-acting bronchodilators.

Dosage and Administration Triohale Inhaler

Adults 
The recommended dosage is the inhalation of two puffs, once daily. Triohale Inhaler may be used with a Zerostat VT Spacer device in patients who find it difficult to synchronize aerosol actuation with inspiration of breath.

Contraindications

Triohale Inhaler should not be used in patients with hypersensitivity to Tiotropium bromide, atropine or its derivatives, e.g. ipratropium or oxitropium, Formoterol fumarate or Ciclesonide or to the excipients in the Inhaler.

A major cause of morbidity and mortality, Chronic Obstructive Respiratory Disease (COPD) has now been identified as a multi-component disease with airway structural changes, mucociliary dysfunction, and airway inflammation with systemic effects in addition to airflow limitation, which suggests the need for a multi-targeted treatment approach.

Triohale rotacaps contain 18 mcg of tiotropium, 12 mcg of formoterol and 400 mcg of ciclesonide. With the combination of an anticholinergic, long acting beta2 agonist and corticosteroid, Triohale rotacaps target the multiple components of COPD. Triohale is already available as a pressurized metered dose inhaler (pMDI).

Evidence from clinical studies suggests that triple drug therapy is associated with improvements in lung function and the quality of life, reduction in the number of exacerbations and use of reliever medications.

The availability of a triple drug combination of tiotropium, formoterol with ciclesonide would be an advance over the currently available range of products for COPD, especially for patients with severe COPD who currently have to use multiple devices. This would be coupled with the added benefit of increased compliance with treatment as a combination would ensure all the three drugs would be taken and a possible reduction in cost of therapy.

The recommended dosage of Triohale rotacaps is one rotacap inhaled once daily, using the Cipla Rotahaler/ Revolizer.

Description:

Spacers (sometimes also called holding chambers) are devices that hold the medication for a few seconds after it has been released from the MDI. They serve two main purposes: 

1. Overcome the need for synchronization between firing the aerosol and inhalation. This allows full benefit of the pMDI 
2. Slow down the aerosol spray before it reaches the mouth, thus allowing the propellants to evaporate and larger particles to settle in the spacer. This leads to less deposition in the oropharynx and greater deposition in the lungs. Decreased oropharyngeal deposition is particularly important for inhaled steroid since this reduces the incidence of oral thrush and also the amount of drug that is swallowed. This may reduce any systemic side effect that may occur. 

The Zerostat Spacer has been designed to help you obtain full benefit from the medicine released by your inhaler. 

The Zerostat Spacer is a holding chamber into which the dose of the medication from your inhaler is released for inhalation. It helps to hold the aerosol for a few seconds to make it easier for you to inhale the medication. 

The Zerostat Spacer also allows the medication to reach the lung with minimal deposition in the mouth or throat.

Description:

ZerostatVT TM spacer 

ZerostatVT TM spacer is a unique static free transparent spacer with a valve mechanism which increases the drug fraction reaching the lungs. It is both a spacer (extends the space between the inhaler and the mouth) as well as a holding chamber (acts as a reservoir where the actuated aerosol cloud can be held prior to inhalation). It has all the features which a spacer should ideally have i.e. static free, transparent, flow gate valve, shape of an aerosol plume and volume 250-300ml. 

Transparent ZerostatVT TM spacer is designed to provide visual confirmation that the dose is delivered. ZerostatVT TMspacer ensures that patient receives a high and consistent quantity of medication dose after dose. The time available for inhalation is prolonged by using polyamide, which is a static free material. Unidirectional flow from the holding chamber is achieved by using a one-way valve. 

Added Features of ZerostatVT TM : 

* Reduces ‘cold freon` effect 
(A cold feeling in the throat as the propellant spray hits the back of the throat) 
* Small, portable, easy to carry and child friendly 
* Prevents the risk of dilution of dose 
* Robust and durable 
* Functional even at low insipriatory or expiratory flow rates

(Doxofylline) is indicated in the treatment of bronchial asthma and chronic obstructive pulmonary disease (COPD).