Duova Rotacaps (Formoterol + Tiotropium)

Introduction of Duova Rotacaps (Tiotropium + Formoterol)

Tiotropium bromide and Formoterol fumarate combination drug is involved in making breathing easier for the people suffering from, chronic obstructive pulmonary disorder. It is available in the dosage form of capsules containing a dry powdered formulation of the two drugs Tiotropium and formoterol that is intended for the oral inhalation only with the help of an inhalation product. Tiotropium bromide is an anticholinergic bronchodilator that relieves the discomfort caused by COPD i.e. chronic obstructive pulmonary disease (chronic bronchitis and emphysema). Formoterol on the other hand is a long-acting bronchodilator.

The ailments it is used for:

This combination therapy is used for long term management of severe COPD to treat symptoms but it is not used for acute exacerbation.

How it works?

The drug acts as a bronchodilator, producing the dilatory effect on smooth muscles and increases the mucus secretion from the nasal passage and bronchioles. Formoterol and Tiotropium bromide both are rapid-onset and long-acting selective beta-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways.

When should you avoid it?

You should not take this drug if you:

• Are pregnant, the doctor must be consulted in an urgency to take the medicine to avoid any harm to the fetus
• Hypersensitivity to Ipratropium or Tiotropium
• Are younger than 10 years of age, as the safety of the medicine is not yet established in children
• Have any type of renal or hepatic impairment
• Having angioderma(swelling of lips, throat and tongue)

How much to take?

The dose intake is prescribed by the Doctor depending upon the severity and demand of the disease condition. Always follow doctor’s instructions.

What are the strengths available?

The drug Tiotropium bromide and formoterol fumarate is available in the following strength:

Duova inhaler 9mcg + 6mcg

Who is the manufacturer?

This drug Duova and its various dosage forms are manufactured by a well known pharmaceutical company, Cipla. It is available on our websites in various pack sizes of 200, 400 and 600 doses.

How to use?

Do not swallow the capsules as they are for inhalation purpose only. Following are the ways to take the medicine:

• Always check the mouthpiece before using, it should always be clean and dirt free
• Place the inhaler in and upright position and shake well
• Now empty your lungs by exhaling the air completely out of the lungs
• Put the mouthpiece in your mouth and close your lips
• Take a deep breath through your mouth and press the canister to get puff of the medicine
• Remove the inhaler and hold your breath for 10 seconds
• Now breathe out through nose
• Replace the cap and if needed take the second dose by repeating the steps as mentioned above.

When to take?

Take your drug dose at the same time every day as this will become a habit and will be less forgotten by the patient. Take your doctor’s advice about the time of dosage if there is any confusion about the dosage time.

For how long should it be taken?

This medicine controls your condition, but does not cure it. It is thus advised to take the drug as long as recommended by the doc tor even in the case you find yourself well. Do not stop the drug without doctor’s advice.

What if you take too much (overdose)?

Too much this drug may be disturbing or serious in many cases. Due to the overdose of the drug you may have a fast or irregular heartbeat; dry mouth or blurred vision. In such a case visit nearest healthcare center or call your doctor.

What if you miss the dose?

In case you forget to take the dose, take it as soon as you remember, as long as it is at least 12 hours before your next dose. Do not double up the dose for the missed one.

What are the side effects?

Tell your doctor as soon as possible if you notice any of the following:

• Breathing difficulty or worsening of your breathing problems
• Bilateral conjunctivitis
• Dry mouth
• Pounding heart beat
• Wheezing or troubled breathing
• Stuffy nose, nosebleed
• Drowsiness
• White patches in your mouth or throat.
• In such cases you must go for immediate medical help. Do not get alarmed by the list. You may /may not experience all of them.

Are there any possible drug interactions?

You should ask your doctor about the full list of the drugs to be avoided or that you should be careful of while taking this drug. There are very few adverse drug interactions encountered with this drug yet the co-administration of this drug with other may cause harmful sideffects to other people.

What are the things to be taken care of?

• Rinse your mouth after using the inhaler to prevent dry mouth and throat irritation.
• Do not swallow these Rota caps by mouth
• Clean the device once in a month with water
• This medication must be used regularly to be effective

Expert advice

• Do not use formoterol inhalation to treat an asthma attack that has already begun.
• Do not use this drug, if you are allergic to formoterol.
• Never place a capsule in the mouthpiece of the inhaler.
• Consult your doctor before taking formoterol, If you are pregnant, planning to become pregnant or breast feeding.
• It should be taken as an inhaler or nebulizer after clearly following instructions of the doctor and the instructions given in the patient information leaflet in the medication box.

Frequently asked questions

Formoterol
Q.Is formoterol a st**d?
Formoterol belongs to a class of medication called long acting beta agonists. It is not a st**d; however it is available in combination with st**ds as an inhaler.

Q.How does formoterol work? How long does it take to work and how long does it stay in the body?
Formoterol belongs to a class of medication called long acting beta agonists. It helps in relaxing the muscles of the air passages, thus widening it and making it easier to breathe. Formoterol works best if taken before exercising or heavy work and another dose should not be taken in the next 12 hours. It is a long acting drug which is known to be effective for 12 hours in the body.

Q.What form does formoterol come in? What is formoterol fumarate/formoterol fumarate dihydrate/formoterol and budesonide/formoterol and advair?
Formoterol comes as a powder filled capsule for inhaler and a solution for nebulizer use. Formoterol fumarate and formoterol fumerate dihydrate are different formulations of formoterol. Budesonide is a st**d which may be prescribed by the doctor along with formoterol. Advair is another long acting beta agonist which is the brand name for salmeterol and fluticasone.

Q. Is formoterol safe?
Formoterol is safe when taken as per the directions of the doctor.

Q. is formoterol banned?
Formoterol is not banned.

Q. Does formoterol cause weight gain?
There are no studies showing that formoterol causes weight gain.

Q. Does formoterol cause death/asthma-related death?
Formoterol may increase risk of asthma-related death. It depends on the condition and co-morbidities and is individual response.

Q. Should formoterol be taken by pregnant women?
Formoterol should be taken by pregnant women only under the strict instructions and guidance of a doctor.
Tiotropium
Q. Is tiotropium safe in pregnancy?
Tiotropium should only be used if the potential benefits justify the potential risk to the baby. Please follow your doctor's advice regarding its use.

Q. Is it safe to use tiotropium during breastfeeding?
Tiotropium should be given only if the potential benefit justifies the potential risk to the infant. Please follow your doctor's advice regarding its use.

Q. Is tiotropium a st**d, an opiate, anticholinergic or narcotic?
Tiotropium is anticholinergic drug which opens the airways and makes it easier to get air in and out of the lungs, thereby relieving breathlessness. It doesn’t contain st**d, opiate or narcotic components.

Q. Tiotropium approved for asthma?
Tiotropium has already been approved for asthma in EU (European Union), it is under review for approval in US. Tiotropium is available in India.

Q. Is tiotropium the same as ipratropium? Is tiotropium generic?
Tiotropium is not same as ipratropium. However, they belong to the same class, have the same mechanism of action, and act similarly to relieve breathlessness. Tiotropium is available in generic form.

Q. Does tiotropium cause weight gain?
Tiotropium is not known to cause weight gain.

Q. Is tiotropium LABA/LAMA?
Tiotropium is not a long acting beta agonist (LABA). It is a long acting muscarinic antagonist (LAMA) which acts on muscarinic receptors on the smooth muscles of airways, opens the airways and makes it easier to get air in and out of the lungs, thereby relieving breathlessness.