Triohale Inhaler (Tiotropium/Formoterol/Ciclesonide)

This medicine contains Ciclesonide 200 mcg, Formoterol Fumarate 6 mcg, and Tiotropium Bromide 9 mcg. It is a triple-combination inhaler used for long-term treatment of chronic obstructive pulmonary disease (COPD) and severe asthma when symptoms are not controlled with one or two medicines alone. It helps improve breathing, reduce wheezing, coughing, and chest tightness.

• Chronic obstructive pulmonary disease (COPD)
• Severe COPD not controlled with a single inhaler
• Frequent breathing difficulty, wheezing, and chest tightness
• Severe asthma, if recommended by a doctor
• Long-term maintenance treatment to reduce flare-ups

This medicine is mainly prescribed in severe COPD when other inhalers are not providing enough control. 

This medicine works through three active ingredients:

• Ciclesonide reduces swelling and inflammation in the airways.
• Formoterol relaxes the muscles of the airways and helps keep them open.
• Tiotropium further widens the airways and helps prevent airway narrowing.

Together, these medicines make breathing easier and reduce long-term breathing problems. 

• Shake the inhaler well before use.
• Breathe out fully before placing the mouthpiece in your mouth.
• Press the inhaler and breathe in deeply at the same time.
• Hold your breath for 10 seconds after inhalation.
• Rinse your mouth with water after use to reduce the risk of fungal infection.
• Use this medicine exactly as prescribed and at the same time every day.

This medicine should not be swallowed and should not be used for sudden breathing attacks. 

Common Strength:
Ciclesonide 200 mcg + Formoterol 6 mcg + Tiotropium 9 mcg per inhalation.

Usual Dose:
Usually 1 to 2 puffs once daily or as directed by your doctor. In some cases, the doctor may advise two inhalations once daily. 

Missed Dose:
Take the missed dose as soon as you remember. If it is nearly time for the next dose, skip the missed dose. Do not take two doses together.

Overdose:
Overdose may cause fast heartbeat, tremor, dry mouth, blurred vision, dizziness, or difficulty passing urine. Seek medical attention immediately if overdose is suspected. 

Minor Side Effects:

• Dry mouth
• Cough
• Throat irritation
• Hoarse voice
• Headache
• Nasal congestion
• Constipation

Major Side Effects:

• Fast heartbeat
• Chest pain
• Difficulty passing urine
• Severe allergic reaction
• Blurred vision or glaucoma symptoms
• Sudden worsening of breathing

Reported side effects include dry mouth, blurred vision, chest pain, urine retention, and rapid heartbeat.

• This medicine is not for sudden asthma or COPD attacks.
• Tell your doctor if you have glaucoma, enlarged prostate, heart disease, diabetes, or kidney disease.
• Use carefully during pregnancy and breastfeeding.
• Avoid getting the medicine into your eyes.
• Do not stop using this medicine suddenly without medical advice.
• Always rinse your mouth after use.

Important precautions include avoiding use in patients with glaucoma, urinary retention, or severe heart disease unless advised by a doctor. 

Currently available similar triple-combination inhalers include:

• Tiomate Transhaler
• Trelegy Ellipta
• Trimbow Inhaler

Total commonly used substitute options: 3

These alternatives may contain similar long-acting bronchodilator and steroid combinations but can differ in exact ingredients and inhaler type. Confirm the correct strength and inhaler device before switching. 

• 100% genuine respiratory medicines from trusted manufacturers
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