Triohale Rotacaps (Tiotropium/Formoterol/Ciclesonide)

This medicine contains Ciclesonide, Formoterol Fumarate, and Tiotropium Bromide. It is a triple-combination Rotacap used for long-term treatment of chronic obstructive pulmonary disease (COPD) and, in some cases, severe asthma when symptoms are not adequately controlled with a single inhaler.

This medicine is supplied as Rotacaps and must be used only with a Rotahaler or Revolizer device. The Rotacap should never be swallowed. Current references describe the composition as Ciclesonide 160 mcg, Formoterol 12 mcg, and Tiotropium 18 mcg per Rotacap. 

• Chronic obstructive pulmonary disease (COPD)
• Severe COPD with frequent flare-ups
• Chronic bronchitis and emphysema
• Severe asthma not controlled with other inhalers
• Long-term maintenance treatment to reduce breathlessness and wheezing

This medicine is prescribed when a doctor wants the benefit of a steroid and two bronchodilators in a single Rotacap.

• Ciclesonide reduces swelling and inflammation inside the airways.
• Formoterol relaxes airway muscles and helps keep the breathing passages open.
• Tiotropium widens the airways further and prevents tightening of the breathing tubes.

Together, these three medicines make breathing easier and help prevent future breathing problems. 

• Do not swallow the Rotacap.
• Insert one Rotacap into a Rotahaler or Revolizer device.
• Twist the device until the capsule is pierced.
• Breathe out fully away from the device.
• Place the mouthpiece between your lips and inhale deeply.
• Hold your breath for about 10 seconds.
• If powder remains, inhale once again.
• Rinse your mouth after use because this medicine contains a steroid.

Current manufacturer guidance recommends one Rotacap inhaled once daily using a Rotahaler or Revolizer device. 

Common Strength:
Ciclesonide 160 mcg + Formoterol 12 mcg + Tiotropium 18 mcg per Rotacap.

Usual Dose:
One Rotacap inhaled once daily, or as directed by your doctor. :contentReference[oaicite:5]{index=5}

Missed Dose:
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not use two doses together.

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

Minor Side Effects:

• Dry mouth
• Cough
• Throat irritation
• Hoarse voice
• Headache
• Constipation
• Mild fungal infection in the mouth

Major Side Effects:

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

• This medicine should not be used 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 powder into your eyes.
• Always rinse your mouth after use to reduce the chance of fungal infection.
• Do not stop using this medicine suddenly without medical advice.

1. Can this medicine be swallowed?
No. The Rotacap must only be inhaled through a Rotahaler or Revolizer device.

2. Is this medicine used every day?
Yes. This medicine is usually used once daily for long-term control of COPD or asthma. :contentReference[oaicite:9]{index=9}

3. Can this medicine be used during sudden breathlessness?
No. It is not a rescue medicine. Use a quick-relief inhaler if prescribed by your doctor.

4. Why should I rinse my mouth after using this medicine?
Rinsing helps prevent mouth infection and throat irritation caused by the steroid component.

5. Can I stop this medicine when I feel better?
No. Continue using it regularly unless your doctor tells you to stop.

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