Tiomate Inh

TIOMATE INH by LUPIN LTD is a combination bronchodilator medication used for the long-term management of respiratory conditions.

Name

• Brand Name: TIOMATE INH, also known as Tiomate Transhaler or Tiomate HFA Inhaler.
• Manufacturer: LUPIN LTD.

Composition

TIOMATE INH is a fixed-dose combination containing two active ingredients:

• Tiotropium Bromide: A long-acting anticholinergic bronchodilator.
• Formoterol Fumarate: A long-acting beta2-agonist (LABA) bronchodilator. Common strengths include Tiotropium 9 mcg/dose + Formoterol Fumarate 6 mcg/dose or Tiotropium 18 mcg + Formoterol 12 mcg in transcaps.

Uses

This medication is primarily prescribed for:

• Chronic Obstructive Pulmonary Disease (COPD): Including chronic bronchitis and emphysema, to relieve symptoms such as wheezing, shortness of breath, chest tightness, and coughing.
• Asthma: For long-term control of breathing problems, often in combination with other long-term medicines.
• Prevention of exercise-induced bronchospasm.

Dosage and Administration

TIOMATE INH is for inhalation only and should be used as directed by a physician.

• Typical Guidance: Often recommended twice a day.
• Method: It is typically a capsule with powdered medication placed in a special inhaler device (like a Rotahaler/Transhaler). Shake the inhaler, place the mouthpiece between your teeth, close your lips, press to release medicine, inhale deeply, and hold your breath for about 10 seconds.
• Important: Rinse your mouth with water and spit it out after each use to help prevent fungal infections in the mouth and throat. Do not swallow the capsule.

Side Effects

Common Side Effects:

• Dry mouth
• Headache
• Increased heart rate (palpitations, trembling)
• Dizziness
• Nausea, upset stomach, diarrhea, constipation
• Sore throat, throat irritation, hoarseness of voice, cough
• Insomnia (difficulty sleeping)
• Nasopharyngitis (inflammation of the throat and nasal passages)

Serious Side Effects (Seek immediate medical attention if you experience these):

• Chest pain or fast heartbeat
• Swelling of face, lips, tongue, or throat
• Wheezing or trouble breathing shortly after using the inhaler
• Blurred vision or eye pain (potential narrow-angle glaucoma)
• Difficulty or pain when urinating (may suggest prostate or bladder issues)

Precautions

• Allergies: Contraindicated if allergic to Tiotropium, Formoterol, any other ingredients, or severe hypersensitivity to milk proteins.
• Not for Acute Attacks: This medication is for maintenance treatment and should not be used for sudden, severe breathing problems or as a rescue inhaler.
• Pre-existing Conditions: Use with caution and inform your doctor if you have a history of heart disease (including high blood pressure, irregular heartbeat, coronary insufficiency, cardiac arrhythmias), diabetes (monitor blood glucose levels), glaucoma, enlarged prostate, bladder blockage, urinary retention, kidney problems, thyroid problems (thyrotoxicosis/hyperthyroidism), or seizure disorders.
• Pregnancy and Breastfeeding: Caution is advised. Consult your doctor if you are pregnant, planning pregnancy, or breastfeeding, as potential risks and benefits need to be evaluated.
• Children: Not recommended for use in children under 18 years of age (or under 5 years, depending on the source), as safety and effectiveness have not been established.
• Driving and Operating Machinery: May cause dizziness or blurred vision; avoid these activities if affected.
• Alcohol: Interaction with alcohol is not well-known; consult your doctor.

Storage

Store at room temperature, away from excess heat, moisture, and direct sunlight. Keep out of the sight and reach of children.

What is TIOMATE INH used for?

TIOMATE INH (inhaler) is primarily used for the long-term management and prevention of symptoms associated with Chronic Obstructive Pulmonary Disease (COPD), including chronic bronchitis and emphysema. It helps to relieve symptoms such as wheezing, shortness of breath, chest tightness, and coughing by widening the air passages in the lungs. In some cases, it may also be used to treat asthma.

How does TIOMATE INH work?

TIOMATE INH is a combination medicine containing Formoterol and Tiotropium. Formoterol is a long-acting bronchodilator (specifically a long-acting beta2-agonist), and Tiotropium is a long-acting anticholinergic. Together, these active ingredients work by relaxing the muscles in the airways and widening them, which makes breathing easier.

What is the usual dosage for TIOMATE INH?

The exact dosage of TIOMATE INH should be determined by your doctor. Typically, it is recommended to take the inhaler once or twice a day. For instance, as an inhalation capsule, the usual dose can be 12 mcg twice daily, potentially increasing to 24 mcg twice daily in severe cases. As a dry powder inhaler, it might be 6 or 12 mcg once or twice daily, up to 24 mcg twice daily in severe cases. It's crucial to use it regularly at the same time each day for maximum effectiveness, even if you don't have symptoms.

What are the possible side effects of TIOMATE INH?

Common side effects can include nausea, diarrhea, dry mouth, vomiting, dizziness, nasopharyngitis (inflammation of the throat and nasal passages), insomnia (difficulty sleeping), headache, trembling, increased heart rate, hoarseness, and throat irritation. You can help prevent some symptoms like dry mouth and throat irritation by rinsing your mouth and throat with water or brushing your teeth after using your inhaler.

More serious but less common side effects that require immediate medical attention include chest pain, a very fast heartbeat, feeling faint, swelling of the face, lips, tongue, or throat, wheezing or trouble breathing shortly after using the inhaler, blurred vision or eye pain (potentially indicating narrow-angle glaucoma), and pain or difficulty urinating (which may suggest prostate or bladder issues).

Is TIOMATE INH safe during pregnancy or breastfeeding?

Pregnancy: TIOMATE INH may be unsafe to use during pregnancy. Animal reproduction studies have shown adverse effects on the fetus, and there are limited human studies. It falls under Pregnancy Category C. You should consult your doctor if you are pregnant or planning pregnancy, who will weigh the potential benefits against the risks before prescribing it.

Breastfeeding: TIOMATE INH is probably safe to use during breastfeeding if prescribed by a doctor, as limited human data suggests it does not pose a significant risk to the baby. However, it is not definitively known if the drug passes into breast milk, so it's advised to consult your doctor before using it while breastfeeding.

Can TIOMATE INH be taken with other medications?

TIOMATE INH can interact with certain medications. For example, other anticholinergic medications (like ipratropium), beta-blockers (such as propranolol and atenolol), and diuretics (like hydrochlorothiazide and furosemide) may interact with it. It is important to inform your doctor about all medications you are currently taking, including over-the-counter drugs, herbal supplements, and other asthma medications, to avoid potential interactions.

What precautions should be taken while using TIOMATE INH?

Several precautions should be considered:

• TIOMATE INH is a maintenance medication and should not be used for sudden, severe breathing attacks; a rescue inhaler should be used for such emergencies.
• Rinse your mouth with water and spit it out after each use to prevent oral fungal infections.
• Exercise caution if you have underlying conditions such as heart disease (including high blood pressure, irregular heartbeat, or a history of heart attack), glaucoma, an enlarged prostate, urinary retention, kidney problems, liver problems, diabetes (as it can raise blood glucose levels), seizure disorders, or an overactive thyroid (thyrotoxicosis).
• Do not use this medicine if you are allergic to formoterol, tiotropium, or milk proteins.
• This medication may cause dizziness or blurred vision; avoid driving or operating heavy machinery if you experience these side effects.
• If using a capsule-based inhaler, do not swallow the capsule; it is for inhalation only.
• Avoid smoking, as it can worsen your lung condition.
• Do not exceed the recommended dosage.

What happens if a dose of TIOMATE INH is missed?

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the missed one.

How should TIOMATE INH be stored?

Store TIOMATE INH at room temperature, away from excess heat, moisture, and direct sunlight. It should be kept below 30°C. Always ensure the cap is on the inhaler when not in use to prevent dust and keep it out of the sight and reach of children.