{"id":54375,"date":"2023-09-20T09:58:09","date_gmt":"2023-09-20T09:58:09","guid":{"rendered":"https:\/\/medsname.com\/triohale-rotacaps\/"},"modified":"2026-04-30T10:24:58","modified_gmt":"2026-04-30T10:24:58","slug":"triohale-rotacaps","status":"publish","type":"product","link":"https:\/\/medsbase.com\/el\/triohale-rotacaps\/","title":{"rendered":"Triohale Rotacaps"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 28px 0;border-radius:4px;\">\n<h3 style=\"margin:0 0 10px 0;font-size:18px;color:#1a1a1a;\">\u26a1 Quick Answer \u2014 What is Triohale Rotacaps?<\/h3>\n<p><strong>Triohale Rotacaps<\/strong> \u03b5\u03af\u03bd\u03b1\u03b9 <strong>triple-therapy inhaler<\/strong> for severe COPD and difficult asthma, combining three molecules in one device: <strong>tiotropium<\/strong> (LAMA), <strong>formoterol<\/strong> (LABA), and <strong>ciclesonide<\/strong> (ICS). Triple therapy targets all three modifiable mechanisms of obstructive airways disease: parasympathetic tone, smooth-muscle \u03b22 deficiency, and airway inflammation. Used as <strong>twice-daily maintenance<\/strong> in COPD with frequent exacerbations. Each rotacaps delivers <strong>tiotropium 18 mcg + formoterol 12 mcg + ciclesonide 200 mcg per rotacap<\/strong>, \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03bc\u03ad\u03bd\u03b7 \u03b1\u03c0\u03cc <strong>Cipla<\/strong> \u03c3\u03b5 \u03b5\u03b3\u03ba\u03b1\u03c4\u03b1\u03c3\u03c4\u03ac\u03c3\u03b5\u03b9\u03c2 \u03c0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03b7\u03bc\u03ad\u03bd\u03b5\u03c2 \u03b1\u03c0\u03cc WHO-GMP.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>\u0391\u03c5\u03c4\u03cc \u03c0\u03bf\u03c5 \u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03c4\u03b5 \u03bc\u03b5 \u03c4\u03b7\u03bd MedsBase:<\/strong> \u03a0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03b7\u03bc\u03ad\u03bd\u03bf\u03c2 \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ae\u03c2 WHO-GMP \u00b7 \u0394\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u00b7 \u03a0\u03b1\u03b3\u03ba\u03cc\u03c3\u03bc\u03b9\u03b1 \u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae \u00b7 1,400+ \u03b5\u03c0\u03b1\u03bb\u03b7\u03b8\u03b5\u03c5\u03bc\u03ad\u03bd\u03b5\u03c2 <a href=\"https:\/\/medsbase.com\/el\/reviews\/\">\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ad\u03c2 \u03c0\u03b5\u03bb\u03b1\u03c4\u03ce\u03bd<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd <a href=\"https:\/\/medsbase.com\/el\/medsbase-re-shipment-assurance-policy\/\"><strong>\u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03b3\u03b3\u03cd\u03b7\u03c3\u03b7\u03c2 \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2<\/strong><\/a> \u2014 \u03b5\u03ac\u03bd \u03c4\u03bf \u03b4\u03ad\u03bc\u03b1 \u03c3\u03b1\u03c2 \u03b4\u03b5\u03bd \u03c6\u03c4\u03ac\u03c3\u03b5\u03b9 \u03b5\u03bd\u03c4\u03cc\u03c2 20 \u03b5\u03c1\u03b3\u03ac\u03c3\u03b9\u03bc\u03c9\u03bd \u03b7\u03bc\u03b5\u03c1\u03ce\u03bd, \u03c4\u03bf \u03b5\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03c5\u03bc\u03b5.<\/p>\n<h3>\u0393\u03b9\u03b1\u03c4\u03af \u03bd\u03b1 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03af\u03bb\u03b5\u03c4\u03b5 \u03b1\u03c0\u03cc \u03c4\u03b7 MedsBase<\/h3>\n<p>\u03a4\u03b1 \u03b3\u03b5\u03bd\u03cc\u03c3\u03b7\u03bc\u03b1 \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03ac \u03bc\u03b1\u03c2 \u03c0\u03c1\u03bf\u03ad\u03c1\u03c7\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ad\u03c2 \u03c0\u03bf\u03c5 \u03c0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd WHO-GMP \u03ba\u03b1\u03b9 \u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03bd\u03c4\u03b1\u03b9 \u03c0\u03b1\u03b3\u03ba\u03bf\u03c3\u03bc\u03af\u03c9\u03c2 \u03c3\u03b5 \u03b4\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae, \u03b1\u03c0\u03bb\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u2014 \u03c7\u03c9\u03c1\u03af\u03c2 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5 \u03c3\u03c4\u03bf \u03b5\u03be\u03c9\u03c4\u03b5\u03c1\u03b9\u03ba\u03cc \u03c4\u03bf\u03c5 \u03b4\u03ad\u03bc\u03b1\u03c4\u03bf\u03c2. \u039f\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u03b4\u03c1\u03bf\u03bc\u03bf\u03bb\u03bf\u03b3\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03bc\u03ad\u03c3\u03c9 \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf\u03c5 \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae (\u03bf\u03b9 \u03c0\u03b5\u03c1\u03b9\u03b3\u03c1\u03b1\u03c6\u03ad\u03c2 \u03b5\u03ba\u03ba\u03b1\u03b8\u03ac\u03c1\u03b9\u03c3\u03b7\u03c2 \u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03bf\u03c5\u03bd \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ce\u03bd \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u2014 \u03c0\u03bf\u03c4\u03ad \u201cMedsBase\u201d \u03ae \u03bf\u03c0\u03bf\u03b9\u03bf\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5). \u0393\u03af\u03bd\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b4\u03b5\u03ba\u03c4\u03ad\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03c1\u03c5\u03c0\u03c4\u03bf\u03bd\u03bf\u03bc\u03af\u03c3\u03bc\u03b1\u03c4\u03b1 \u03ba\u03b1\u03b9 \u03c4\u03c1\u03b1\u03c0\u03b5\u03b6\u03b9\u03ba\u03ae \u03bc\u03b5\u03c4\u03b1\u03c6\u03bf\u03c1\u03ac SEPA. \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2 \u0395\u03be\u03b1\u03c3\u03c6\u03b1\u03bb\u03af\u03c3\u03b5\u03ce\u03c2 \u03bc\u03b1\u03c2.<\/p>\n<div style=\"background:#f4f8fb;border:1px solid #e0e0e0;padding:12px 18px;margin:0 0 24px 0;border-radius:4px;font-size:14px;text-align:center;\">\n<strong>\ud83d\udd12 \u039a\u03c1\u03c5\u03c0\u03c4\u03bf\u03b3\u03c1\u03b1\u03c6\u03b7\u03bc\u03ad\u03bd\u03b7 \u039f\u03bb\u03bf\u03ba\u03bb\u03ae\u03c1\u03c9\u03c3\u03b7 \u0391\u03b3\u03bf\u03c1\u03ac\u03c2<\/strong> \u00b7 <strong>\ud83d\udcb3 \u0395\u03c0\u03b1\u03bb\u03b7\u03b8\u03b5\u03c5\u03bc\u03ad\u03bd\u03bf\u03c2 \u0395\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae\u03c2<\/strong> \u00b7 <strong>\ud83d\ude9a \u03a0\u03b1\u03b3\u03ba\u03cc\u03c3\u03bc\u03b9\u03b1 \u0391\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae<\/strong> \u00b7 <strong>\u2b50 4.9\/5 \u03b1\u03c0\u03cc 1,400+ \u03c0\u03b5\u03bb\u03ac\u03c4\u03b5\u03c2<\/strong>\n<\/div>\n<h2>What Is Triohale Rotacaps?<\/h2>\n<p>Triohale Rotacaps is one of the few <strong>three-in-one fixed-dose triple-therapy inhalers<\/strong> available in India. Major international triple combinations include Trelegy Ellipta (fluticasone furoate + umeclidinium + vilanterol; GSK), Trimbow (beclomethasone + formoterol + glycopyrronium; Chiesi), and Breztri Aerosphere (budesonide + glycopyrrolate + formoterol; AstraZeneca). Triohale Rotacaps is conceptually similar \u2014 a single twice-daily inhaler delivering all three mechanism classes.<\/p>\n<h2>How Does Triohale Rotacaps Work?<\/h2>\n<ul>\n<li><strong>Tiotropium (LAMA)<\/strong> \u2014 blocks M3 muscarinic receptors, relaxing parasympathetic airway tone for 24 hours.<\/li>\n<li><strong>Formoterol (LABA)<\/strong> \u2014 activates \u03b22 receptors for rapid (1\u20133 min) and sustained (12 h) bronchodilation.<\/li>\n<li><strong>Ciclesonide (ICS)<\/strong> \u2014 a prodrug activated by lung esterases; suppresses airway inflammation. The prodrug design minimises oropharyngeal candidiasis seen with older ICS.<\/li>\n<li><strong>Combined:<\/strong> reduces exacerbations more than dual therapy in COPD with frequent exacerbations and elevated blood eosinophils (\u2265100\u2013300\/\u00b5L), per IMPACT, ETHOS, KRONOS, TRIBUTE landmark trials.<\/li>\n<\/ul>\n<h2>\u03a7\u03c1\u03ae\u03c3\u03b5\u03b9\u03c2 \u03ba\u03b1\u03b9 \u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2<\/h2>\n<ul>\n<li><strong>Severe COPD with frequent exacerbations<\/strong> on LAMA-LABA dual therapy (GOLD group E)<\/li>\n<li><strong>COPD with elevated blood eosinophils<\/strong> (\u2265100\/\u00b5L) \u2014 eosinophilic COPD<\/li>\n<li><strong>Severe asthma (Step 5 GINA)<\/strong> not controlled by ICS-LABA at high dose<\/li>\n<li><strong>Asthma-COPD overlap (ACOS)<\/strong> with frequent exacerbations<\/li>\n<\/ul>\n<h2>Triohale Rotacaps Dosage<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u0391\u03c3\u03b8\u03b5\u03bd\u03ae\u03c2<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u0394\u03cc\u03c3\u03b7<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u03a3\u03c5\u03c7\u03bd\u03cc\u03c4\u03b7\u03c4\u03b1<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Adults \u2014 severe COPD<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>1 rotacap<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Twice daily<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Adults \u2014 severe asthma (Step 5 GINA)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>1 rotacap<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Twice daily<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>How to Use Triohale Rotacaps Properly<\/h3>\n<ul>\n<li>Insert one rotacap into the Rotahaler with the coloured end down.<\/li>\n<li>Twist sharply \u2014 listen for the click.<\/li>\n<li>Breathe out fully away from device.<\/li>\n<li>Seal lips around mouthpiece.<\/li>\n<li><strong>\u0395\u03b9\u03c3\u03c0\u03bd\u03b5\u03cd\u03c3\u03c4\u03b5 \u03b4\u03c5\u03bd\u03b1\u03c4\u03ac \u03ba\u03b1\u03b9 \u03b2\u03b1\u03b8\u03b9\u03ac<\/strong>; you should hear the rotacap whir.<\/li>\n<li>\u039a\u03c1\u03b1\u03c4\u03ae\u03c3\u03c4\u03b5 \u03c4\u03b7\u03bd \u03b1\u03bd\u03b1\u03c0\u03bd\u03bf\u03ae \u03b3\u03b9\u03b1 10 \u03b4\u03b5\u03c5\u03c4\u03b5\u03c1\u03cc\u03bb\u03b5\u03c0\u03c4\u03b1, \u03bc\u03b5\u03c4\u03ac \u03b5\u03ba\u03c0\u03bd\u03b5\u03cd\u03c3\u03c4\u03b5 \u03b1\u03c1\u03b3\u03ac.<\/li>\n<li>Check rotacap is empty; repeat if powder remains.<\/li>\n<li>\u0393\u03b9\u03b1 \u03c3\u03c5\u03bd\u03b4\u03c5\u03b1\u03c3\u03bc\u03bf\u03cd\u03c2 \u03c0\u03bf\u03c5 \u03c0\u03b5\u03c1\u03b9\u03ad\u03c7\u03bf\u03c5\u03bd ICS: <strong>\u03be\u03b5\u03c0\u03bb\u03cd\u03bd\u03b5\u03c4\u03b5 \u03c4\u03bf \u03c3\u03c4\u03cc\u03bc\u03b1, \u03b3\u03b1\u03c1\u03b3\u03b1\u03c1\u03af\u03c3\u03c4\u03b5 \u03ba\u03b1\u03b9 \u03c6\u03c4\u03cd\u03c3\u03c4\u03b5<\/strong>.<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\"><strong>Rinse mouth after every dose.<\/strong> The ciclesonide ICS component still warrants oral rinsing despite its prodrug design. Rinse, gargle, and spit.<\/div>\n<h2>Side Effects of Triohale Rotacaps<\/h2>\n<p><strong>\u03a3\u03c5\u03c7\u03bd\u03ad\u03c2:<\/strong><\/p>\n<ul>\n<li>Dry mouth (anticholinergic)<\/li>\n<li>Mild tremor or palpitations (\u03b22)<\/li>\n<li>Mild oral thrush, hoarseness (ICS \u2014 minimised by ciclesonide prodrug design and oral rinsing)<\/li>\n<li>Throat irritation, mild cough on inhalation<\/li>\n<li>Headache, sinusitis<\/li>\n<\/ul>\n<p><strong>\u039b\u03b9\u03b3\u03cc\u03c4\u03b5\u03c1\u03bf \u03c3\u03c5\u03c7\u03bd\u03ad\u03c2:<\/strong><\/p>\n<ul>\n<li>Constipation, urinary hesitancy<\/li>\n<li>Acute angle-closure glaucoma (rare; care with mist near eyes)<\/li>\n<li>Hypokalaemia at high doses (with diuretics, theophylline, oral steroids)<\/li>\n<li>Pneumonia (slight ICS-related increase in COPD)<\/li>\n<li>Atrial fibrillation in susceptible older patients<\/li>\n<\/ul>\n<p><strong>\u03a3\u03bf\u03b2\u03b1\u03c1\u03cc \u2014 \u03b4\u03b9\u03b1\u03ba\u03cc\u03c8\u03c4\u03b5 \u03ba\u03b1\u03b9 \u03b6\u03b7\u03c4\u03ae\u03c3\u03c4\u03b5 \u03b2\u03bf\u03ae\u03b8\u03b5\u03b9\u03b1:<\/strong><\/p>\n<ul>\n<li>Severe allergic reaction \/ anaphylaxis<\/li>\n<li>\u03a0\u03b1\u03c1\u03b1\u03b4\u03bf\u03be\u03b9\u03ba\u03cc\u03c2 \u03b2\u03c1\u03bf\u03b3\u03c7\u03cc\u03c3\u03c0\u03b1\u03c3\u03bc\u03bf\u03c2<\/li>\n<li>Acute eye pain, red eye, halos (glaucoma \u2014 emergency)<\/li>\n<li>\u039f\u03be\u03b5\u03af\u03b1 \u03bf\u03c5\u03c1\u03bf\u03ba\u03b1\u03b8\u03b5\u03c4\u03b7\u03c1\u03b9\u03b1\u03ba\u03ae \u03ba\u03b1\u03c4\u03b1\u03ba\u03c1\u03ac\u03c4\u03b7\u03c3\u03b7<\/li>\n<li>Pneumonia signs in COPD users (fever, productive cough, breathlessness change)<\/li>\n<\/ul>\n<h2>\u03a0\u03c1\u03bf\u03b5\u03b9\u03b4\u03bf\u03c0\u03bf\u03b9\u03ae\u03c3\u03b5\u03b9\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03c1\u03bf\u03c6\u03c5\u03bb\u03ac\u03be\u03b5\u03b9\u03c2<\/h2>\n<ul>\n<li><strong>{$brand} is a controller, not a reliever.<\/strong> Keep a SABA (Asthalin, Levolin) for acute attacks.<\/li>\n<li><strong>Triple therapy is for selected COPD patients<\/strong> \u2014 those with frequent exacerbations on LAMA-LABA, especially with elevated blood eosinophils. Not first-line for newly diagnosed COPD.<\/li>\n<li><strong>Pneumonia risk:<\/strong> ICS in COPD slightly raises pneumonia risk \u2014 ensure ICS adds value (eosinophilic phenotype, frequent exacerbations).<\/li>\n<li><strong>Glaucoma &#038; prostatism:<\/strong> caution with anticholinergic component.<\/li>\n<li><strong>\u039a\u03b1\u03c1\u03b4\u03b9\u03b1\u03b3\u03b3\u03b5\u03b9\u03b1\u03ba\u03ae \u03bd\u03cc\u03c3\u03bf\u03c2:<\/strong> use cautiously with arrhythmias, severe coronary disease.<\/li>\n<li><strong>Rinse mouth after every dose<\/strong> to minimise oral thrush and hoarseness.<\/li>\n<li><strong>\u0395\u03b3\u03ba\u03c5\u03bc\u03bf\u03c3\u03cd\u03bd\u03b7:<\/strong> limited data on triple therapy \u2014 discuss benefit\/risk with prescriber.<\/li>\n<\/ul>\n<h2>\u0391\u03bd\u03c4\u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2<\/h2>\n<ul>\n<li>Hypersensitivity to tiotropium, formoterol, ciclesonide, atropine derivatives, or excipients<\/li>\n<li>Severe lactose \/ milk-protein hypersensitivity (DPI)<\/li>\n<li>Untreated active fungal, bacterial, mycobacterial, or viral respiratory infection<\/li>\n<li>Acute glaucoma \u2014 relative<\/li>\n<li>Severe prostatic obstruction \u2014 relative<\/li>\n<\/ul>\n<h2>\u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03b9\u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2 \u03a6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u03a6\u03ac\u03c1\u03bc\u03b1\u03ba\u03bf \u03b1\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03af\u03b4\u03c1\u03b1\u03c3\u03b7\u03c2<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u0391\u03c0\u03bf\u03c4\u03ad\u03bb\u03b5\u03c3\u03bc\u03b1<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u03a4\u03b9 \u03bd\u03b1 \u03ba\u03ac\u03bd\u03b5\u03c4\u03b5<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Strong CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole, clarithromycin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Increase systemic ICS exposure \u2192 adrenal suppression \/ Cushing risk<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Avoid prolonged co-use; monitor cortisol if essential<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Other inhaled or systemic corticosteroids<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Additive HPA-axis suppression<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Use lowest effective dose; monitor for systemic steroid effects<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u0396\u03c9\u03bd\u03c4\u03b1\u03bd\u03ac \u03b5\u03bc\u03b2\u03cc\u03bb\u03b9\u03b1<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Reduced immune response if high-dose ICS<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Inactivated vaccines preferred during high-dose use<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>\u0391\u03c0\u03bf\u03b8\u03ae\u03ba\u03b5\u03c5\u03c3\u03b7<\/h2>\n<ul>\n<li>\u0391\u03c0\u03bf\u03b8\u03ae\u03ba\u03b5\u03c5\u03c3\u03b7 \u03ba\u03ac\u03c4\u03c9 \u03b1\u03c0\u03cc <strong>25\u00b0C<\/strong> in a dry place. Keep desiccant in the bottle.<\/li>\n<li>Do not store in the bathroom \u2014 humidity makes the powder clump and reduces dose delivery.<\/li>\n<li>Once the strip\/blister is opened, use within the period stated on the leaflet (typically 2\u20133 months).<\/li>\n<li>\u039c\u03b7\u03bd \u03b1\u03c6\u03ae\u03bd\u03b5\u03c4\u03b5 \u03c3\u03b5 \u03bc\u03ad\u03c1\u03b7 \u03c0\u03c1\u03bf\u03c3\u03b2\u03ac\u03c3\u03b9\u03bc\u03b1 \u03b1\u03c0\u03cc \u03c0\u03b1\u03b9\u03b4\u03b9\u03ac.<\/li>\n<\/ul>\n<h2>\u03a3\u03c7\u03b5\u03c4\u03b9\u03ba\u03ad\u03c2 \u0395\u03bd\u03b1\u03bb\u03bb\u03b1\u03ba\u03c4\u03b9\u03ba\u03ad\u03c2 \u039b\u03cd\u03c3\u03b5\u03b9\u03c2 \u03c3\u03c4\u03bf MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/el\/foracort-inhaler\/\"><strong>Foracort Inhaler \u2014 \u03b2\u03bf\u03c5\u03b4\u03b5\u03c3\u03bf\u03bd\u03bf\u03af\u03b4\u03b7 + \u03c6\u03bf\u03c1\u03bc\u03bf\u03c4\u03b5\u03c1\u03cc\u03bb\u03b7 ICS-LABA<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/seretide-accuhaler\/\"><strong>Seretide Accuhaler \u2014 fluticasone + salmeterol ICS-LABA<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/budecort-inhaler\/\"><strong>Budecort Inhaler \u2014 \u03b2\u03bf\u03c5\u03b4\u03b5\u03c3\u03bf\u03bd\u03bf\u03af\u03b4\u03b7 ICS \u03b3\u03b9\u03b1 \u03c0\u03c1\u03cc\u03bb\u03b7\u03c8\u03b7<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/duova-inhaler\/\"><strong>Duova Inhaler \u2014 tiotropium + formoterol LAMA-LABA combo<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/triohale-inhaler\/\"><strong>Triohale Inhaler \u2014 tiotropium + formoterol + ciclesonide triple<\/strong><\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">\u03a3\u03c5\u03c7\u03bd\u03ad\u03c2 \u0395\u03c1\u03c9\u03c4\u03ae\u03c3\u03b5\u03b9\u03c2<\/h2>\n<h3>When is triple therapy indicated?<\/h3>\n<p>For COPD with frequent exacerbations on LAMA-LABA (especially with elevated blood eosinophils), or for severe asthma uncontrolled on high-dose ICS-LABA. Not first-line in newly diagnosed COPD or mild asthma.<\/p>\n<h3>How is Triohale different from Foracort plus Tiova?<\/h3>\n<p>Triohale combines all three molecules in one device \u2014 single inhaler, twice daily. Taking Foracort + Tiova achieves a similar pharmacological effect but requires two inhalers (and more compliance burden). Single-device triple has been shown in trials to improve adherence.<\/p>\n<h3>How fast does Triohale work?<\/h3>\n<p>Formoterol = 1\u20133 min onset (rapid). Tiotropium and ciclesonide build over hours-to-days. Full benefit at 2\u20134 weeks.<\/p>\n<h3>Is Triohale a reliever?<\/h3>\n<p>No \u2014 controller only. Keep a SABA (Asthalin, Levolin) for acute attacks.<\/p>\n<h3>Why must I rinse my mouth?<\/h3>\n<p>Ciclesonide ICS component still warrants oral rinsing to prevent thrush, although ciclesonide produces less oropharyngeal candidiasis than older ICS due to its prodrug design.<\/p>\n<h3>Is Triohale safe long-term?<\/h3>\n<p>Yes, with regular review. Annual checks for glaucoma, cataracts, urinary symptoms, oral thrush, pneumonia in COPD users.<\/p>\n<h3>Pneumonia risk?<\/h3>\n<p>ICS in COPD slightly raises pneumonia risk (~1\u20132% absolute increase in trials). Ensure ICS is needed (eosinophilic phenotype, frequent exacerbations).<\/p>\n<h3>Can I take Triohale during pregnancy?<\/h3>\n<p>Limited data on triple therapy in pregnancy. Discuss with prescriber; budesonide-based ICS-LABA is preferred where the LAMA can be omitted.<\/p>\n<h3>How does Triohale compare to Trimbow or Trelegy?<\/h3>\n<p>Trimbow (beclomethasone + formoterol + glycopyrronium, Chiesi) and Trelegy Ellipta (fluticasone furoate + umeclidinium + vilanterol, GSK) are international triple inhalers. Triohale (tiotropium + formoterol + ciclesonide) is the Indian-market triple. Pharmacological class equivalent; molecule choice varies.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:24px 0;border-radius:4px;font-size:13px;\"><strong>\u0399\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03b1\u03c0\u03bf\u03c0\u03bf\u03af\u03b7\u03c3\u03b7 \u03b5\u03c5\u03b8\u03cd\u03bd\u03b7\u03c2:<\/strong> \u0391\u03c5\u03c4\u03ae \u03b7 \u03c3\u03b5\u03bb\u03af\u03b4\u03b1 \u03b5\u03af\u03bd\u03b1\u03b9 \u03b5\u03ba\u03c0\u03b1\u03b9\u03b4\u03b5\u03c5\u03c4\u03b9\u03ba\u03ae \u03ba\u03b1\u03b9 \u03b4\u03b5\u03bd \u03b1\u03bd\u03c4\u03b9\u03ba\u03b1\u03b8\u03b9\u03c3\u03c4\u03ac \u03c4\u03b7\u03bd \u03b5\u03c0\u03b1\u03b3\u03b3\u03b5\u03bb\u03bc\u03b1\u03c4\u03b9\u03ba\u03ae \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03c3\u03c5\u03bc\u03b2\u03bf\u03c5\u03bb\u03ae. \u03a3\u03c5\u03bc\u03b2\u03bf\u03c5\u03bb\u03b5\u03c5\u03c4\u03b5\u03af\u03c4\u03b5 \u03c0\u03ac\u03bd\u03c4\u03b1 \u03ad\u03bd\u03b1\u03bd \u03ba\u03b1\u03c4\u03b1\u03bb\u03bb\u03ae\u03bb\u03c9\u03c2 \u03b5\u03be\u03bf\u03c0\u03bb\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf \u03b5\u03c0\u03b1\u03b3\u03b3\u03b5\u03bb\u03bc\u03b1\u03c4\u03af\u03b1 \u03c5\u03b3\u03b5\u03af\u03b1\u03c2 \u03c0\u03c1\u03b9\u03bd \u03be\u03b5\u03ba\u03b9\u03bd\u03ae\u03c3\u03b5\u03c4\u03b5, \u03c3\u03c4\u03b1\u03bc\u03b1\u03c4\u03ae\u03c3\u03b5\u03c4\u03b5 \u03ae \u03b1\u03bb\u03bb\u03ac\u03be\u03b5\u03c4\u03b5 \u03bf\u03c0\u03bf\u03b9\u03bf\u03bd\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03b5\u03b9\u03c3\u03c0\u03bd\u03b5\u03c5\u03c3\u03c4\u03ae\u03c1\u03b1 \u03ae \u03b1\u03bd\u03b1\u03c0\u03bd\u03b5\u03c5\u03c3\u03c4\u03b9\u03ba\u03ae \u03c6\u03b1\u03c1\u03bc\u03b1\u03ba\u03b5\u03c5\u03c4\u03b9\u03ba\u03ae \u03b1\u03b3\u03c9\u03b3\u03ae, \u03b5\u03b9\u03b4\u03b9\u03ba\u03ac \u03b1\u03bd \u03ad\u03c7\u03b5\u03c4\u03b5 \u03ac\u03bb\u03bb\u03b5\u03c2 \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ad\u03c2 \u03c0\u03b1\u03b8\u03ae\u03c3\u03b5\u03b9\u03c2, \u03c0\u03b1\u03af\u03c1\u03bd\u03b5\u03c4\u03b5 \u03ac\u03bb\u03bb\u03b5\u03c2 \u03c3\u03c5\u03bd\u03c4\u03b1\u03b3\u03ad\u03c2, \u03b5\u03af\u03c3\u03c4\u03b5 \u03ad\u03b3\u03ba\u03c5\u03bf\u03c2 \u03ae \u03b8\u03b7\u03bb\u03ac\u03b6\u03b5\u03c4\u03b5, \u03ae \u03b5\u03af\u03c3\u03c4\u03b5 \u03ac\u03bd\u03c9 \u03c4\u03c9\u03bd 65 \u03b5\u03c4\u03ce\u03bd.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">\u03a3\u03c7\u03b5\u03c4\u03b9\u03ba\u03ad\u03c2 \u0395\u03bd\u03b1\u03bb\u03bb\u03b1\u03ba\u03c4\u03b9\u03ba\u03ad\u03c2<\/h3>\n<p>\u0386\u03bb\u03bb\u03b1 \u03c0\u03c1\u03bf\u03ca\u03cc\u03bd\u03c4\u03b1 \u03c3\u03b5 <strong>\u03a7\u03c1\u03cc\u03bd\u03b9\u03b5\u03c2 \u03a0\u03b1\u03b8\u03ae\u03c3\u03b5\u03b9\u03c2<\/strong> \u03c0\u03bf\u03c5 \u03bf\u03b9 \u03c0\u03b5\u03bb\u03ac\u03c4\u03b5\u03c2 \u03b5\u03be\u03b5\u03c4\u03ac\u03b6\u03bf\u03c5\u03bd \u03b5\u03c0\u03af\u03c3\u03b7\u03c2:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/el\/bonair-inhaler\/\">Bonair Inhaler<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/reactin\/\">Reactin<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/clodict\/\">Clodict<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/leptomate\/\">Leptomate<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/simlo-5\/\">Simlo 5<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<h5>\u2705 Comprehensive symptom control<br \/>\n\u2705 Enhanced lung function<br \/>\n\u2705 Reduced exacerbation risk<br \/>\n\u2705 \u0392\u03b5\u03bb\u03c4\u03b9\u03c9\u03bc\u03ad\u03bd\u03b7 \u03c0\u03bf\u03b9\u03cc\u03c4\u03b7\u03c4\u03b1 \u03b6\u03c9\u03ae\u03c2<\/h5>\n<p><span style=\"color: #999999;\">Contains Tiotropium Bromide, Formoterol Fumarate, and Ciclesonide<\/span><\/p>","protected":false},"featured_media":54376,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3681,3141,3223],"product_tag":[3722,3723,3724,3725],"class_list":{"0":"post-54375","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-asthma-copd-treatment","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","9":"product_tag-ciclesonide","10":"product_tag-formoterol-fumarate","11":"product_tag-tiotropium-bromide","12":"product_tag-triohale-rotacaps","14":"first","15":"instock","16":"shipping-taxable","17":"purchasable","18":"product-type-variable","19":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product\/54375","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/comments?post=54375"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media\/54376"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media?parent=54375"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_brand?post=54375"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_cat?post=54375"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_tag?post=54375"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}