Duova Inhaler (Tiotropium/Formoterol)

This medicine is prescribed for:

• Chronic obstructive pulmonary disease (COPD)
• Asthma not controlled by a single medicine
• Chronic bronchitis
• Emphysema
• Long-term wheezing, chest tightness, and breathing difficulty
• Maintenance treatment of respiratory diseases

This medicine is not intended for sudden breathing attacks.

This medicine works through two active ingredients:

• Tiotropium relaxes the muscles in the airways by blocking certain receptors.
• Formoterol stimulates beta-2 receptors to widen the air passages.

Together, they provide long-lasting relief from wheezing and breathing difficulty and help keep the lungs functioning better throughout the day.

• Shake the inhaler well before use if instructed on the pack.
• Remove the cap and breathe out fully.
• Place the mouthpiece in your mouth and press the inhaler while breathing in deeply.
• Hold your breath for about 10 seconds, then breathe out slowly.
• If more than one puff is prescribed, wait about 30 seconds before the next puff.
• Use this medicine regularly at the same time every day.
• Do not stop using the inhaler suddenly without consulting your doctor.

Usual Dose:

• Usually 1 to 2 puffs once or twice daily as prescribed by your doctor
• The exact dose depends on the inhaler strength and your medical condition

Missed Dose:
If you miss a dose, use it when you remember. If it is almost time for the next dose, skip the missed dose. Do not take extra puffs to make up for the missed dose.

Overdose:
Taking too much may cause dry mouth, rapid heartbeat, chest pain, tremors, dizziness, blurred vision, or difficulty passing urine. Seek medical attention immediately if overdose is suspected.

Minor Side Effects:

• Dry mouth
• Throat irritation
• Cough
• Headache
• Dizziness
• Tremors or shakiness
• Fast heartbeat
• Constipation

Major Side Effects:

• Chest pain
• Irregular heartbeat
• Severe allergic reaction
• Swelling of face, lips, tongue, or throat
• Difficulty passing urine
• Blurred vision or eye pain
• Sudden worsening of breathing

Stop using this medicine and seek immediate medical help if you develop any serious side effects.

• This medicine is not for emergency relief during sudden asthma attacks.
• Tell your doctor if you have heart disease, high blood pressure, glaucoma, enlarged prostate, diabetes, thyroid disorder, or difficulty urinating.
• Use with caution during pregnancy and breastfeeding.
• If you need to use this inhaler more often than prescribed, contact your doctor.
• Use the inhaler exactly as directed to get the best effect.
• Store the inhaler in a cool, dry place away from direct heat.
• Keep out of reach of children.

Several medicines with similar ingredients or action may be available, including:

• Tiova-F Inhaler
• Combihale FT Inhaler
• Tiotropium + Formoterol Inhaler (generic brands)
• Foracort + Tiotropium combinations
• Spiriva + Formoterol combinations

The exact substitute depends on the prescribed strength and availability. Consult your doctor before changing to another brand.

1. Is this medicine a steroid?
No. This medicine does not contain a steroid. It contains two bronchodilators: Tiotropium and Formoterol.

2. Can this medicine be used during a sudden breathing attack?
No. This medicine is for long-term control and not for sudden severe attacks.

3. Why does this medicine cause dry mouth?
Dry mouth is a common side effect of Tiotropium.

4. Can this medicine be used for asthma?
Yes. It may be prescribed for asthma when one medicine alone is not enough.

5. What should I do if I have chest pain after using this medicine?
Stop using the inhaler and seek immediate medical help.

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