Triohale Inhaler
✅ Comprehensive symptom control
✅ Enhanced lung function
✅ Reduced exacerbation risk
✅ Verbeterde levenskwaliteit
Contains Tiotropium Bromide, Formoterol Fumarate, and Ciclesonide
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer — What is Triohale Inhaler?
Triohale Inhaler is een triple-therapy inhaler for severe COPD and difficult asthma, combining three molecules in one device: tiotropium (LAMA), formoterol (LABA), and ciclesonide (ICS). Triple therapy targets all three modifiable mechanisms of obstructive airways disease: parasympathetic tone, smooth-muscle β2 deficiency, and airway inflammation. Used as twice-daily maintenance in COPD with frequent exacerbations. Each inhaler delivers tiotropium 9 mcg + formoterol 6 mcg + ciclesonide 200 mcg per actuation, geproduceerd door Cipla at WHO-GMP certified facilities.
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Waarom bestellen bij MedsBase
Onze generieke medicijnen zijn afkomstig van WHO-GMP gecertificeerde fabrikanten en worden wereldwijd verzonden in discrete, eenvoudige verpakkingen — geen medicijnnaam op de buitenkant van het pakket. Betalingen met kaart worden verwerkt via een gereguleerde processor (betalingsoverzichten vermelden een gereguleerde kaartbetalingprocessor — nooit “MedsBase” of een medicijnnaam). Crypto en SEPA bankoverschrijvingen worden ook geaccepteerd. Elke bestelling wordt ondersteund door ons Reshipment Assurance Policy.
What Is Triohale Inhaler?
Triohale Inhaler is one of the few three-in-one fixed-dose triple-therapy inhalers 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 Inhaler is conceptually similar — a single twice-daily inhaler delivering all three mechanism classes.
How Does Triohale Inhaler Work?
- Tiotropium (LAMA) — blocks M3 muscarinic receptors, relaxing parasympathetic airway tone for 24 hours.
- Formoterol (LABA) — activates β2 receptors for rapid (1–3 min) and sustained (12 h) bronchodilation.
- Ciclesonide (ICS) — a prodrug activated by lung esterases; suppresses airway inflammation. The prodrug design minimises oropharyngeal candidiasis seen with older ICS.
- Combined: reduces exacerbations more than dual therapy in COPD with frequent exacerbations and elevated blood eosinophils (≥100–300/µL), per IMPACT, ETHOS, KRONOS, TRIBUTE landmark trials.
Toepassingen en Indicaties
- Severe COPD with frequent exacerbations on LAMA-LABA dual therapy (GOLD group E)
- COPD with elevated blood eosinophils (≥100/µL) — eosinophilic COPD
- Severe asthma (Step 5 GINA) not controlled by ICS-LABA at high dose
- Asthma-COPD overlap (ACOS) with frequent exacerbations
Triohale Inhaler Dosage
| Patient | Dosering | Frequentie |
|---|---|---|
| Adults — severe COPD | 2 inhalations | Twice daily |
| Adults — severe asthma | 2 inhalations | Twice daily |
How to Use Triohale Inhaler Properly
- Shake the inhaler well; remove the cap.
- Adem volledig uit, weg van het apparaat.
- Seal lips around the mouthpiece.
- Press the canister at the start of a slow deep breath (3–5 seconds).
- Hold breath 10 seconds, then breathe out gently.
- Wait 30 seconds before second puff if needed.
- For ICS-containing combinations: rinse mouth, gargle, and spit out.
- Use a spacer for children, the elderly, and during acute illness.
Side Effects of Triohale Inhaler
Vaak voorkomend:
- Dry mouth (anticholinergic)
- Mild tremor or palpitations (β2)
- Mild oral thrush, hoarseness (ICS — minimised by ciclesonide prodrug design and oral rinsing)
- Throat irritation, mild cough on inhalation
- Headache, sinusitis
Minder vaak:
- Constipation, urinary hesitancy
- Acute angle-closure glaucoma (rare; care with mist near eyes)
- Hypokalaemia at high doses (with diuretics, theophylline, oral steroids)
- Pneumonia (slight ICS-related increase in COPD)
- Atrial fibrillation in susceptible older patients
Serious — stop and seek help:
- Severe allergic reaction / anaphylaxis
- Paradoxical bronchospasm
- Acute eye pain, red eye, halos (glaucoma — emergency)
- Acute urineretentie
- Pneumonia signs in COPD users (fever, productive cough, breathlessness change)
Waarschuwingen en voorzorgsmaatregelen
- {$brand} is a controller, not a reliever. Keep a SABA (Asthalin, Levolin) for acute attacks.
- Triple therapy is for selected COPD patients — those with frequent exacerbations on LAMA-LABA, especially with elevated blood eosinophils. Not first-line for newly diagnosed COPD.
- Pneumonia risk: ICS in COPD slightly raises pneumonia risk — ensure ICS adds value (eosinophilic phenotype, frequent exacerbations).
- Glaucoma & prostatism: caution with anticholinergic component.
- Cardiovascular disease: use cautiously with arrhythmias, severe coronary disease.
- Rinse mouth after every dose to minimise oral thrush and hoarseness.
- Zwangerschap: limited data on triple therapy — discuss benefit/risk with prescriber.
Contra-indicaties
- Hypersensitivity to tiotropium, formoterol, ciclesonide, atropine derivatives, or excipients
- Severe lactose / milk-protein hypersensitivity (DPI)
- Untreated active fungal, bacterial, mycobacterial, or viral respiratory infection
- Acute glaucoma — relative
- Severe prostatic obstruction — relative
Geneesmiddelinteracties
| Interacting drug | Effect | Wat te doen |
|---|---|---|
| Strong CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole, clarithromycin) | Increase systemic ICS exposure → adrenal suppression / Cushing risk | Avoid prolonged co-use; monitor cortisol if essential |
| Other inhaled or systemic corticosteroids | Additive HPA-axis suppression | Use lowest effective dose; monitor for systemic steroid effects |
| Live vaccines | Reduced immune response if high-dose ICS | Inactivated vaccines preferred during high-dose use |
Opslag
- Store below 25°C, protected from direct sunlight and heat.
- Do not refrigerate. Do not freeze.
- Do not puncture the canister; even an empty canister can explode if heated.
- Keep out of reach of children. Use within the expiry date printed on the canister.
Gerelateerde alternatieven op MedsBase
- Foracort Inhaler — budesonide + formoterol ICS-LABA
- Seretide Accuhaler — fluticasone + salmeterol ICS-LABA
- Budecort Inhaler — budesonide ICS-preventer
- Duova Inhaler — tiotropium + formoterol LAMA-LABA combo
- Triohale Inhaler — tiotropium + formoterol + ciclesonide triple
Veelgestelde vragen
How is Triohale Inhaler different from Triohale Rotacaps?
Same three molecules, different device. Inhaler = pressurised aerosol with spacer compatibility. Rotacaps = dry powder, needs fast forceful inhalation. Choose based on inspiratory ability.
Is the inhaler version stronger than rotacaps?
No — total daily dose is similar. The inhaler delivers half the per-dose strength but is taken as 2 puffs vs 1 capsule.
Can I use a spacer with Triohale Inhaler?
Yes — strongly recommended, especially for ICS-containing inhalers. A spacer increases lung delivery and reduces oropharyngeal deposition.
When should I switch from ICS-LABA to triple?
For COPD: frequent exacerbations on LAMA-LABA dual therapy, especially with blood eosinophils ≥100/µL. For severe asthma: uncontrolled on high-dose ICS-LABA at Step 5 GINA.
How fast does Triohale work?
Formoterol begins in 1–3 min. Tiotropium peaks at 1–3 h. Ciclesonide preventer effect builds over 1–2 weeks.
Is Triohale safe in pregnancy?
Limited data. Budesonide-based ICS-LABA (Foracort) is the better-studied alternative if a switch is feasible.
Why dry mouth?
Anticholinergic effect from tiotropium.
How long does an inhaler canister last?
120 actuations = 30 days at 2 puffs twice daily. Track usage.
Should I rinse my mouth after Triohale?
Yes — even though ciclesonide is a prodrug with lower thrush risk, oral rinsing is still recommended after ICS-containing inhalers.
Gerelateerde alternatieven
Andere producten in Chronische aandoeningen die klanten ook bekijken:
- Raloxiheal
- Etoford
- Neurobion Forte RF Injection (Methylcobalamin + B6 + B3) — Nerve Repair
- Arkamin-H
- Trajenta Duo
Meer opties in Astma/COPD-behandeling
Gerangschikt op recente bestelvolumes van MedsBase — wat andere klanten in deze categorie kiezen.
| Sterkte | 200 + 6 + 9 mcg |
|---|---|
| Hoeveelheid | 1 Inhaler/s, 2 Inhaler/s, 3 Inhaler/s |
| Farmaceutische vorm | Inhaler/s |
| Fabrikant | Cipla Inc |
| Behandeling | Asthma, Chronic obstructive pulmonary disorder (COPD) |
| Generiek merk | Tiotropium + Formoterol + Ciclesonide |
Triohale Inhaler
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