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Duova Rotacaps

✅ Asthma symptom management
✅ Convenient rotacap format
✅ Easy inhalation method
✅ Enhanced respiratory comfort

Contains Tiotropium Bromide and Formoterol Fumarate

Medicinsk gennemgået af Morgan Ellis — Apoteksforsker · 8 års erfaring  · Sidst gennemgået: maj 2026

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⚡ Quick Answer — What is Duova Rotacaps?

Duova Rotacaps er en dual bronchodilator combination inhaler for COPD, containing tiotropium (a long-acting muscarinic antagonist, LAMA) and formoterol (a long-acting β2 agonist, LABA). The two molecules attack airflow obstruction through complementary pathways — anticholinergic + β2 — giving deeper bronchodilation than either alone. Used as twice-daily maintenance for moderate-to-severe COPD. Each rotacaps delivers tiotropium 18 mcg + formoterol 12 mcg per rotacap, fremstillet af Cipla at WHO-GMP certified facilities. International equivalent: No exact equivalent.

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What Is Duova Rotacaps?

Duova Rotacaps combines a LAMA (tiotropium) and a LABA (formoterol) in a single inhaler. Dual bronchodilator therapy is the cornerstone of moderate-to-severe COPD management — landmark trials (FLAME, IMPACT, ETHOS) consistently show LAMA-LABA combinations reduce exacerbations and improve lung function more than LAMA alone or ICS-LABA alone in patients without elevated eosinophils.

How Does Duova Rotacaps Work?

  • Tiotropium blocks M3 muscarinic receptors on bronchial smooth muscle, relaxing parasympathetic tone for 24 hours.
  • Formoterol activates β2-adrenergic receptors, raising cyclic AMP and producing rapid bronchodilation lasting 12 hours, with onset in 1–3 minutes.
  • Synergy: the two pathways act in parallel — together they deliver greater bronchodilation than either alone, and reduce exacerbations more than monotherapy.

— det forstærker den normale fysiologiske respons snarere end at udløse en kunstigt.

  • Moderate-to-severe COPD maintenance — first-line dual bronchodilation at GOLD groups B and E
  • COPD exacerbation prevention
  • Frequent rescue-inhaler use on LAMA or LABA monotherapy
  • Step-up from ICS-LABA in COPD without elevated eosinophils

Duova Rotacaps Dosage

PatientDosisHyppighed
Adults — COPD maintenance1 rotacapTwice daily

How to Use Duova Rotacaps Properly

  • Insert one rotacap into the Rotahaler with the coloured end down.
  • Twist sharply — listen for the click.
  • Breathe out fully away from device.
  • Seal lips around mouthpiece.
  • Inhale forcefully and deeply; you should hear the rotacap whir.
  • Hold breath 10 seconds, then breathe out slowly.
  • Check rotacap is empty; repeat if powder remains.
  • For ICS-containing combinations: rinse mouth, gargle, and spit out.

Side Effects of Duova Rotacaps

Almindelige:

  • Dry mouth (anticholinergic — usually mild)
  • Mild tremor or palpitations (LABA effect)
  • Throat irritation, mild cough on inhalation
  • Headache, mild sinusitis

Mindre almindelige:

  • Forstoppelse
  • Urinary hesitancy (men with prostatic enlargement)
  • Acute angle-closure glaucoma (rare; care with mist near eyes)
  • Hypokalaemia at high doses (with diuretics, theophylline, oral steroids)
  • Atrial fibrillation in susceptible patients

Serious — stop and seek help:

  • Severe allergic reaction / anaphylaxis
  • Paradoxical bronchospasm
  • Acute eye pain, red eye, halos (suspected glaucoma — emergency)
  • Acute urinary retention

Advarsler og forholdsregler

  • {$brand} is a controller, not a reliever. Keep a SABA (Asthalin, Levolin) for acute attacks.
  • Use twice daily, every day.
  • Avoid mist near eyes — risk of acute glaucoma in predisposed patients.
  • Cardiovascular disease: use cautiously in arrhythmias, severe coronary disease.
  • Prostatic obstruction: caution; risk of urinary retention.
  • Hypersensitivity to milk protein — DPI formulations contain lactose.

Kontraindikationer

  • Known hypersensitivity to tiotropium, formoterol, atropine derivatives, or excipients
  • Severe lactose / milk-protein hypersensitivity (DPI)
  • Acute glaucoma — relative
  • Severe symptomatic prostatic obstruction — relative

Lægemiddelinteraktioner

Interacting drugEffektHvad skal der gøres
Other anticholinergics (oral, ophthalmic)Additive dry mouth, urinary retention, glaucoma riskUse with caution; monitor symptoms
Non-selective beta-blockers (propranolol, timolol)Block formoterol — risk of severe bronchospasmAvoid; switch to cardioselective if essential
Loop or thiazide diureticsAdditive hypokalaemia from formoterolMonitor potassium with high doses
Theophylline / aminophyllineAdditive hypokalaemia, tachycardiaMonitor heart rate and potassium
MAOIs and tricyclic antidepressantsPotentiate β-agonist cardiovascular effectsCaution — monitor BP/HR

Opbevaring

  • Store below 25°C in a dry place. Keep desiccant in the bottle.
  • Do not store in the bathroom — humidity makes the powder clump and reduces dose delivery.
  • Once the strip/blister is opened, use within the period stated on the leaflet (typically 2–3 months).
  • Keep out of reach of children.

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Why is Duova Rotacaps twice daily?

The formoterol LABA component lasts ~12 hours and requires twice-daily dosing. Although tiotropium alone is once-daily, the combination follows the LABA dose schedule.

How does Duova Rotacaps differ from the inhaler?

Same molecules, different device. Inhaler = pressurised aerosol with spacer compatibility. Rotacaps = dry powder via Rotahaler — needs fast forceful inhalation. Choice depends on inspiratory ability and coordination.

Is Duova Rotacaps a rescue inhaler?

No — controller only. Keep a SABA (Asthalin, Levolin) for acute attacks.

Why dry mouth?

Anticholinergic effect from tiotropium. Usually mild.

Can I open a Duova rotacap and take it orally?

No — the powder is formulated for inhalation; oral absorption is poor and dose is inappropriate. Use only via Rotahaler.

Is Duova safe long-term?

Yes, with annual review. Watch for dry mouth, urinary symptoms, eye symptoms.

Can children use Duova?

No — LAMA-LABA combinations are for adult COPD. Paediatric severe asthma uses ICS-LABA ± tiotropium add-on.

Can I co-prescribe Duova with an ICS?

Yes — for COPD with frequent exacerbations or eosinophilic phenotype, an ICS can be added alongside Duova (or use the triple inhaler Triohale instead).

Is Duova safe in pregnancy?

Limited data; not first-line. Discuss with prescriber.

Medical disclaimer: This page is educational and does not replace professional medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any inhaler or respiratory medication, especially if you have other medical conditions, take other prescriptions, are pregnant or breastfeeding, or are over 65.

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Styrke

12 + 18 mcg

Antal

30 Rotacap/s, 60 Rotacap/s, 90 Rotacap/s

Farmaceutisk form

Rotacaps

Producent

Cipla Inc

Behandling

Asthma, Chronic obstructive pulmonary disorder (COPD)

Generisk mærke

Tiotropium Bromide + Formoterol

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