{"id":25678,"date":"2022-09-24T12:11:47","date_gmt":"2022-09-24T12:11:47","guid":{"rendered":"https:\/\/zeepedia.com\/?p=25678"},"modified":"2022-09-26T07:29:58","modified_gmt":"2022-09-26T07:29:58","slug":"trimbow","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/trimbow\/","title":{"rendered":"Trimbow uses, dose and side effects"},"content":{"rendered":"\n<p>88 micrograms\/5 micrograms\/9 micrograms&nbsp;Inhalation powder<br>beclometasone dipropionate\/formoterol fumarate dihydrate\/glycopyrronium (beclometasone dipropionase\/formoterol fumarase dihydricus\/glycopyrronium)<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Trimbow is and what it is used for<\/h2>\n\n\n\n<p>Tombow is a medicine to make breathing easier that contains three active substances:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>beclomethasone dipropionate<\/li><li>formoterol fumarate dihydrate and<\/li><li>glycopyrronium.<\/li><\/ul>\n\n\n\n<p>Beclomethasone dipropionate belongs to a group of medicines called&nbsp;corticosteroids&nbsp;that work by reducing swelling and irritation in the lungs.<\/p>\n\n\n\n<p>Formoterol and glycopyrronium are medicines called long-acting\u00a0bronchodilators.\u00a0They work in different ways to relax the muscles in the airways, helping to widen the airways so you can breathe more easily.<\/p>\n\n\n\n<p>Regular treatment with these three active substances helps relieve and prevent symptoms such as shortness of breath, wheezing, and <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/cough-in-children\/\">cough<\/a> in adult patients with chronic\u00a0obstructive pulmonary disease\u00a0(COPD).\u00a0Tombow can reduce\u00a0exacerbations\u00a0(flare-ups) of COPD symptoms.\u00a0COPD is a serious, long-term disease that means that the airways are blocked and the alveoli in the lungs are damaged, leading to breathing difficulties.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What you need to know before using Trimbow<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not use Trimbow<\/h2>\n\n\n\n<p>If you are allergic to beclomethasone dipropionate, formoterol fumarate dihydrate, and\/or glycopyrronium, or any of the other ingredients of this medicine (listed in section 6).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and precautions<\/h2>\n\n\n\n<p>Tombow is used as a maintenance treatment for\u00a0obstructive lung disease.\u00a0Do not use this medicine to treat a sudden attack of shortness of breath or wheezing.<\/p>\n\n\n\n<p>If your breathing worsens<\/p>\n\n\n\n<p>If your shortness of breath or wheezing (breathing with a whistling sound) worsens immediately after inhaling the medicine, stop using the Trimbow inhaler and use your rapid-acting emergency inhaler immediately.&nbsp;You should contact a doctor immediately.&nbsp;The doctor will evaluate your symptoms and can start another treatment for you if necessary.<\/p>\n\n\n\n<p>See also section 4, &#8220;Possible side effects&#8221;.<\/p>\n\n\n\n<p>If your lung disease worsens<\/p>\n\n\n\n<p>See your doctor immediately if your symptoms get worse or are difficult to manage (eg if you use a separate as-needed inhaler more often) or if your as-needed inhaler does not improve your symptoms.&nbsp;Your lung disease may have worsened and the doctor may need to&nbsp;prescribe&nbsp;another treatment.<\/p>\n\n\n\n<p>Talk to your doctor or pharmacist before using Trimbow:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you have heart problems, e.g.\u00a0angina (pain in the heart or chest), recently had a heart attack (myocardial infarction),\u00a0heart failure, narrowing of the\u00a0arteries around the heart (coronary artery disease), heart valve disease, or another heart defect, or a condition called hypertrophic obstructive\u00a0cardiomyopathy\u00a0(\u00a0a condition where the heart muscle is abnormal).<\/li><li>if you have heart rhythm disturbances such as irregular heartbeats, high\u00a0pulse\u00a0or palpitations, or if you have found out that you have an abnormal heart rhythm (\u00a0ECG\u00a0).<\/li><li>if you have narrowing of the\u00a0arteries\u00a0(&#8220;arteriosclerosis&#8221;,\u00a0high\u00a0blood pressure,\u00a0or if you know you have an\u00a0aneurysm\u00a0(an abnormal bulge in the vessel wall).<\/li><li>if you have an overactive\u00a0thyroid gland.<\/li><li>if you have a low level of potassium in your blood (\u00a0hypokalaemia\u00a0).\u00a0Tombow in combination with certain other medicines for the lungs or medicines such as\u00a0diuretics\u00a0(water-reducing medicines to treat heart disease or high\u00a0blood pressure\u00a0) can cause a rapid drop in potassium levels in the blood.\u00a0Therefore, the doctor may need to measure the potassium level in your blood from time to time.<\/li><li>if you have liver or kidney disease.<\/li><li>if you have\u00a0diabetes.\u00a0High\u00a0doses\u00a0of formoterol can raise your blood sugar and therefore you may need to take extra blood sugar measurements when you start using this medicine and also from time to time during treatment.<\/li><li>if you have a\u00a0tumor\u00a0in the adrenal gland (so-called\u00a0pheochromocytoma\u00a0).<\/li><li>if you are going to have anesthesia.\u00a0Depending on the type of anesthetic, it may be necessary to stop treatment with Trimbow at least 12 hours before the anesthetic.<\/li><li>if you are being treated or have ever been treated for\u00a0tuberculosis\u00a0(TB) or if you have a respiratory\u00a0infection.<\/li><li>if you have an eye disease called\u00a0narrow-angle glaucoma.<\/li><li>if you have difficulty urinating.<\/li><li>if you have an\u00a0infection\u00a0in your mouth or throat.<\/li><\/ul>\n\n\n\n<p>If any of the above apply to you, talk to your doctor before using Trimbow.\u00a0If you have or have had any medical problems or\u00a0allergies, or if you are not sure if you can use Trimbow, you should contact your doctor or pharmacist before using the inhaler.<\/p>\n\n\n\n<p><br>If you already use Trimbow<\/p>\n\n\n\n<p>If you use Trimbow or high\u00a0doses\u00a0of other inhaled cortisone preparations for long periods and in case of stress (eg hospitalization after an accident, after a serious injury, or before surgery) you may need more of this medicine.\u00a0In such a\u00a0situation, the doctor can increase the\u00a0dose of\u00a0cortisone\u00a0to overcome the stress and can\u00a0prescribe\u00a0these in the form of tablets or\u00a0injections.<\/p>\n\n\n\n<p>Contact a doctor if you experience blurred vision or other visual disturbances.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Children and young people<\/h2>\n\n\n\n<p>This medicine should not be given to children under the age of 18.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Trimbow<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you are using, have recently used, or might be using other medicines.\u00a0This includes medicines that, like Trimbow, are used for lung disease.<\/p>\n\n\n\n<p>Some medicines can increase the effects of Trimbow and your doctor may want to monitor you closely if you are taking these medicines (eg some anti-HIV medicines: ritonavir, cobicistat).<\/p>\n\n\n\n<p><strong>Do not use this medicine together with a\u00a0beta-blocker<\/strong>\u00a0(used to treat certain heart problems such as angina pectoris or to lower\u00a0blood pressure, etc.) unless your doctor has chosen a\u00a0beta blocker\u00a0that does not affect your breathing.\u00a0Beta-blockers\u00a0(including\u00a0beta-blocker\u00a0eye drops\u00a0) can reduce the effect of formoterol or cancel it completely.\u00a0On the other hand, the use of other beta2-agonists\u00a0(\u00a0medicines that act in the same way as formoterol) may increase the effect of formoterol.<\/p>\n\n\n\n<p>Use of Trimbow together with:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>drugs for the treatment of<ul><li>abnormal heart rhythm (\u00a0quinidine,\u00a0disopyramide,\u00a0procainamide\u00a0)<\/li><li>allergic reactions (\u00a0antihistamines\u00a0)<\/li><li>symptoms of depression or mental disorders such as\u00a0MAOIs\u00a0(eg phenelzine and isocarboxazid),\u00a0tricyclic antidepressants\u00a0(eg amitriptyline and imipramine), or phenothiazines<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>can cause changes in the\u00a0ECG\u00a0(\u00a0electrocardiogram\u00a0).\u00a0They can also increase the risk of heart rhythm disturbances (\u00a0ventricular arrhythmias\u00a0).<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>drugs for the treatment of\u00a0Parkinson&#8217;s disease\u00a0(\u00a0levodopa\u00a0), for the treatment of underactive\u00a0thyroid gland\u00a0(levothyroxine), drugs containing\u00a0oxytocin\u00a0(which causes uterine contraction), and alcohol may increase the risk of cardiac side effects of formoterol.<\/li><li>MAO inhibitors, including drugs with a similar effect such as furazolidone and procarbazine (in mental disorders), can cause increased\u00a0blood pressure.<\/li><li>medicines for the treatment of heart disease (\u00a0digoxin\u00a0) can cause a lowered level of\u00a0potassium\u00a0in the blood.\u00a0This can increase the risk of abnormal heart rhythms.<\/li><li>other drugs for the treatment of\u00a0obstructive pulmonary disease\u00a0(theophylline, aminophylline, or\u00a0corticosteroids\u00a0) and\u00a0diuretics\u00a0can also cause a decrease in potassium levels in the blood.<\/li><li>some anesthetics can increase the risk of abnormal heart rhythms.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy and breastfeeding<\/h2>\n\n\n\n<p>If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.<\/p>\n\n\n\n<p>You should only use Trimbow during pregnancy if your doctor advises you to do so.&nbsp;Use of Trimbow during labor should preferably be avoided due to formoterol&#8217;s inhibitory effects on uterine contractions.<\/p>\n\n\n\n<p>You should not use Trimbow while breastfeeding.\u00a0You and the doctor must decide whether to stop breastfeeding or to stop\/abstain from treatment with Trimbow, taking into account the benefit of breastfeeding for the baby and the benefit of treatment for you.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving ability and use of machinery<\/h2>\n\n\n\n<p>Tombow is unlikely to affect the ability to drive or use machines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Trimbow contains lactose<\/h2>\n\n\n\n<p>Lactose&nbsp;contains small amounts of milk protein, which can cause allergic reactions.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to use Trimbow<\/h2>\n\n\n\n<p>Always use this medicine as directed by your doctor or pharmacist.&nbsp;Ask your doctor or pharmacist if you are unsure.<\/p>\n\n\n\n<p>The recommended&nbsp;dose&nbsp;is two&nbsp;inhalations&nbsp;in the morning and two&nbsp;inhalations&nbsp;in the evening.<\/p>\n\n\n\n<p>If you feel that the medicine is not having a sufficient effect, you should contact the doctor.<\/p>\n\n\n\n<p>If you have previously used another\u00a0inhaler\u00a0containing beclomethasone dipropionate, consult your doctor, as the effective\u00a0dose\u00a0of beclomethasone dipropionate in Trimbow to treat your obstructive pulmonary disease may be lower than for some other\u00a0inhalers.<\/p>\n\n\n\n<p><strong>Mode of administration<\/strong><\/p>\n\n\n\n<p>Tombow is intended for\u00a0inhalation.<\/p>\n\n\n\n<p>You must inhale the medicine through the mouth so that the medicine is taken directly into the lungs.<\/p>\n\n\n\n<p><strong><u>Instructions for use<\/u><\/strong><\/p>\n\n\n\n<p>Information about the contents of the package can be found in section 6.<\/p>\n\n\n\n<p><strong>If the contents of the package do not match what is described in section 6, return the inhaler to the person who supplied it and exchange it for a new one.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do&nbsp;<strong>not<\/strong>&nbsp;remove the inhaler from the protective bag unless you intend to use it immediately.<\/li><li>Only use the inhaler as directed.<\/li><li>Keep the protective cap closed until you need to take a&nbsp;dose&nbsp;from the inhaler.<\/li><li>Store the inhaler in a clean, dry place when not in use.<\/li><li><strong>Never<\/strong>&nbsp;attempt&nbsp;to disassemble the inhaler.<\/li><\/ul>\n\n\n\n<p><strong>A. The main parts of the inhaler<\/strong><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20200228000071#\" rel=\"noopener\"><\/a><\/p>\n\n\n\n<p>It takes three steps to take a\u00a0dose\u00a0from the inhaler: open, inhale, and close.<\/p>\n\n\n\n<p><strong>B. Before using a new&nbsp;inhaler<\/strong><\/p>\n\n\n\n<p><strong>1. Open the protective bag and take out the inhaler.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do&nbsp;<strong>not use the<\/strong>&nbsp;inhaler if the protective bag seal is broken or if the protective bag is damaged &#8211; return it to the person who supplied it and exchange it for a new one.<\/li><li>Use the label on the carton to record the date you opened the protective bag.<\/li><\/ul>\n\n\n\n<p><strong>2. Examine the inhaler.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>If the inhaler shows signs of damage or is broken, return it to the person who provided it and exchange it for a new one.<\/li><\/ul>\n\n\n\n<p><strong>3. Check the dose counter.&nbsp;If the inhaler is new, the dose counter will show &#8220;120&#8221;.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do&nbsp;<strong>not use<\/strong>&nbsp;a new&nbsp;inhaler&nbsp;that shows a number below &#8216;120&#8217; &#8211; return it to the person who supplied it and exchange it for a new one.<a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20200228000071#\" rel=\"noopener\"><\/a><\/li><\/ul>\n\n\n\n<p><strong>C. How to use the inhaler<\/strong><\/p>\n\n\n\n<p><strong>C.1.&nbsp;Open<\/strong><\/p>\n\n\n\n<p><strong>1. Hold the inhaler firmly and hold it upright.<\/strong><\/p>\n\n\n\n<p><strong>2. Check the number of remaining doses: a number between &#8220;1&#8221; and &#8220;120&#8221; indicates that there are&nbsp;doses&nbsp;left.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>If the dose counter shows &#8220;0&#8221;, there are no&nbsp;doses&nbsp;left.&nbsp;Throw away the inhaler and get a new one.<\/li><\/ul>\n\n\n\n<p><strong>3. Open the protective cover completely.<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20200228000071#\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.fass.se\/imaging\/resources\/203ab821-31f8-4ffe-83af-36e394914188\" alt=\"Image 7\" title=\"Image 7\"\/><\/a><\/figure>\n\n\n\n<p><strong>4. Exhale as much as feels comfortable before inhaling.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do&nbsp;<strong>not<\/strong>&nbsp;exhale through the inhaler.<\/li><\/ul>\n\n\n\n<p><strong>C.2.&nbsp;Inhale<\/strong><\/p>\n\n\n\n<p><strong>If possible, stand or sit upright when inhaling.<\/strong><\/p>\n\n\n\n<p><strong>1. Pick up the inhaler, bring it to your mouth and close your lips around the mouthpiece.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do&nbsp;<strong>not<\/strong>&nbsp;cover the air hole when holding the inhaler.<\/li><li>Do&nbsp;<strong>not<\/strong>&nbsp;inhale through the vent.<\/li><\/ul>\n\n\n\n<p><strong>2. Inhale forcefully and deeply through the mouth.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>You may feel a certain taste when you take&nbsp;dose&nbsp;one.<\/li><li>You may hear or feel a click when you take&nbsp;dose&nbsp;one.<\/li><li>Do&nbsp;<strong>not<\/strong>&nbsp;inhale through the nose.<\/li><li>Keep your lips around the inhaler during&nbsp;inhalation&nbsp;a.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20200228000071#\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.fass.se\/imaging\/resources\/7cc79c23-fa64-4e3c-855e-3db406a82b02\" alt=\"Picture 8\" title=\"Picture 8\"\/><\/a><\/figure>\n\n\n\n<p><strong>3. Remove the inhaler from the mouth.<\/strong><\/p>\n\n\n\n<p><strong>4. Hold your breath for 5 to 10 seconds or as long as feels good.<\/strong><\/p>\n\n\n\n<p><strong>5. Exhale slowly.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Do\u00a0<strong>not<\/strong>\u00a0exhale through the inhaler.<\/li><li>If you are unsure that you are taking the correct\u00a0dose, contact a pharmacist or doctor.<\/li><\/ul>\n\n\n\n<p><strong>D.3.&nbsp;Close<\/strong><\/p>\n\n\n\n<p><strong>1. Turn the inhaler back to the upright position and close the protective cap completely.<\/strong><\/p>\n\n\n\n<p><strong>2. Check that the dose counter has counted down by one\u00a0dose.<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=20200228000071#\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/www.fass.se\/imaging\/resources\/40f53fae-d5d4-405f-b41e-ae056f1e16d5\" alt=\"Picture 9\" title=\"Picture 9\"\/><\/a><\/figure>\n\n\n\n<ul class=\"wp-block-list\"><li>If you are unsure whether the dose counter has counted down by a\u00a0dose\u00a0after an\u00a0inhalation, wait until the next dosing occasion and take\u00a0dose\u00a0one as usual.\u00a0Do not take an extra\u00a0dose.<\/li><\/ul>\n\n\n\n<p><strong>3. If you need to take another\u00a0dose, repeat steps C.1 to C.3.<\/strong><\/p>\n\n\n\n<p><strong>D. Cleaning<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The inhaler usually does not need to be cleaned.<\/li><li>If necessary, the inhaler can be wiped with a dry cloth or paper towel.<ul><li>Do&nbsp;<strong>not use<\/strong>&nbsp;water or other liquids to clean the inhaler.&nbsp;Keep it dry.<\/li><\/ul><\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">If you have used too much Trimbow&nbsp;<\/h2>\n\n\n\n<p>You must take the\u00a0dose\u00a0as directed by your doctor.\u00a0Do not exceed the prescribed\u00a0dose\u00a0without talking to a doctor.<\/p>\n\n\n\n<p>If you take too much Trimbow,\u00a0side effects, as described in section 4, may occur.<\/p>\n\n\n\n<p>Tell your doctor if you have used too much Trimbow and if you get any of these symptoms.&nbsp;Your doctor may want to do some blood tests.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to use Trimbow<\/h2>\n\n\n\n<p>Take the next\u00a0dose\u00a0as soon as you remember.\u00a0If it is almost time for the next\u00a0dose, skip the missed\u00a0dose\u00a0and instead just take the next\u00a0dose\u00a0at the correct time.\u00a0Do not take a double\u00a0dose\u00a0to make up for a missed\u00a0dose.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop using Trimbow<\/h2>\n\n\n\n<p>You must use Trimbow every day.\u00a0Do not stop using Trimbow or reduce the\u00a0dose, even if you feel better or are symptom-free.\u00a0If you want to do that, you should contact a doctor.<\/p>\n\n\n\n<p>If you have any further questions about this medicine, ask your doctor or pharmacist.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n<p>There is a risk of worsening shortness of breath or wheezing immediately after using Trimbow and this is called paradoxical\u00a0bronchospasm\u00a0(which may affect up to 1 in 1,000 people).\u00a0If this happens, you should stop using Trimbow and instead immediately use your rapid-acting as-needed inhaler to treat shortness of breath and wheezing.\u00a0Contact a doctor immediately.<\/p>\n\n\n\n<p>Tell a doctor immediately<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you get allergic reactions such as skin <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/insect-allergy\/\">allergy<\/a>, hives,\u00a0itching, rash (may affect up to 1 in 100 users), redness of the skin, swelling of the skin or mucous membranes, especially the eyes, face, lips, and throat (may affect up to 1 in 1 000 users).<\/li><li>if you experience pain or discomfort in the eyes, temporary blurred vision, light rings, or color impressions in the\u00a0field\u00a0of vision together with red eyes.\u00a0These may be signs of an\u00a0acute\u00a0attack of\u00a0narrow-angle glaucoma\u00a0(which may affect up to 1 in 10,000 users).<\/li><\/ul>\n\n\n\n<p>Tell your doctor if you have any of the following symptoms while using Trimbow as they may be symptoms of\u00a0pneumonia\u00a0(which may affect up to 1 in 10 people):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>fever or chills<\/li><li>increased mucus production changed the color of the mucus<\/li><li>increased coughing or increased breathing difficulties.<\/li><\/ul>\n\n\n\n<p><strong>Possible&nbsp;side effects&nbsp;are<\/strong>&nbsp;listed below according to frequency.<\/p>\n\n\n\n<p><strong>Common<\/strong>&nbsp;(may affect up to 1 in 10 users)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/sore-throat\/\">sore throat<\/a><\/li><li>runny or stuffy nose and sneezing<\/li><li>fungal infections in the mouth.\u00a0Reduce the risk of these\u00a0side effects\u00a0by rinsing your mouth, gargling with water, or brushing your teeth immediately after\u00a0inhalation<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/huskiness\/\">huskiness<\/a><\/li><li>headache<\/li><li>urinary tract infection.<\/li><\/ul>\n\n\n\n<p><strong>Uncommon<\/strong>\u00a0(may affect up to 1 in 100 users)<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>flu-like symptomssinusitisitchy, runny or stuffy nosefungal infections of the throat or gullet (esophagus)vaginal\u00a0yeast infectionrestlessnesstremorsdizzinesstaste changes or reduced tastenumbnessotitisirregular heartbeats changes on\u00a0electrocardiogram\u00a0(\u00a0ECG\u00a0)unusually fast heartbeats and heart rhythm disturbancespalpitations (abnormal heartbeats)facial flushing increased blood flow to certain\u00a0tissues\u00a0in the body asthma attack cough and phlegm<\/td><td>throat irritationnosebleedredness\u00a0in the throat dry mouthdiarrheadifficulty swallowing malaise upset stomach discomfort in the stomach after a meal burning sensation in the lipscariesskin rash, hives,\u00a0itching inflammation\u00a0of the oral mucosa, with or without ulcers increased sweating muscle cramps and muscle pain pain in arms or legs pain in muscles, bones or joints in the chestfatiguehigh\u00a0blood pressure reduction of levels of certain substances in the blood: of certain\u00a0white blood cells\u00a0called\u00a0granulocytes, of\u00a0potassium\u00a0or cortisol increase in certain components of the blood:\u00a0glucose, C-reactive\u00a0protein, the number of\u00a0blood platelets,\u00a0insulin, free fatty acids or ketones.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Rare<\/strong>\u00a0(may affect up to 1 in 1,000 users)<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>fungal infections in the chest decreased appetite sleep disorders (too little or too much sleep)feeling of tightness over the chest feeling of skipped heartbeats or extra heartbeats, usually slow heartbeatsworsening of\u00a0asthma<\/td><td>leakage of blood from a\u00a0vessel\u00a0into surrounding\u00a0tissuelowered\u00a0blood pressureweaknesspain in the back of the mouth and throat inflammation\u00a0of the throat dryness throw frequent and painful urination difficulty and pain when urinatingkidney inflammation.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Very rare<\/strong>&nbsp;(may affect up to 1 in 10,000 users)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>low level of certain&nbsp;blood cells&nbsp;called&nbsp;platelets<\/li><li>respiratory distress<\/li><li>swollen hands and feet<\/li><li>growth retardation in children and adolescents.<\/li><\/ul>\n\n\n\n<p><strong>Has been reported<\/strong>&nbsp;(occurring in an unknown number of users)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>blurred vision<\/li><\/ul>\n\n\n\n<p><strong>Use of high&nbsp;doses&nbsp;of inhaled cortisone preparations for a long time can in very rare cases cause effects in the body:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>impaired functioning of the adrenal glands (adrenal suppression)<\/li><li>decreased bone density<\/li><li>clouding of the lens of the eye (cataract or&nbsp;cataract&nbsp;).<\/li><\/ul>\n\n\n\n<p>Tombow does not contain a high\u00a0dose\u00a0of inhaled\u00a0corticosteroid\u00a0but the doctor may want to measure cortisol levels in the blood from time to time.<\/p>\n\n\n\n<p>The following&nbsp;side effects&nbsp;may also occur with long-term use of high&nbsp;doses&nbsp;of inhaled cortisone preparations but the frequency is currently unknown (cannot be estimated from available data):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Depression<\/li><li>worries, nervousness, feeling rushed or irritable.<\/li><\/ul>\n\n\n\n<p>It is more likely that these&nbsp;side effects&nbsp;occur in children.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How Trimbow should be stored<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Use before the expiry date which is stated on the label and carton after EXP.&nbsp;The expiration date is the last day of the specified month.<\/p>\n\n\n\n<p>Store at a maximum of 25 \u00b0C.<\/p>\n\n\n\n<p>Store the inhaler in the original packaging.&nbsp;Moisture sensitive.&nbsp;Do not remove the inhaler from the protective bag until just before the first use.<\/p>\n\n\n\n<p>After opening the protective bag, the medicine must be stored dry and used within 6 weeks.&nbsp;Use the self-adhesive label on the outer carton to record the date you opened the protective pouch and attach the label to the underside of the inhaler.<\/p>\n\n\n\n<p>Medicines must not be thrown into the drain or among the household waste.\u00a0Ask the pharmacist how to dispose of medicines that are no longer used.\u00a0These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Contents declaration<\/h2>\n\n\n\n<p>The active substances are beclomethasone dipropionate, formoterol fumarate dihydrate, and glycopyrronium.<\/p>\n\n\n\n<p>Each delivered\u00a0dose\u00a0(\u00a0dose\u00a0one leaving the mouthpiece) contains 88 micrograms of beclomethasone dipropionate, 5 micrograms of formoterol fumarate dihydrate, and 9 micrograms of glycopyrronium (as 11 micrograms of glycopyrronium bromide).<\/p>\n\n\n\n<p>Each metered\u00a0dose\u00a0contains 100 micrograms of beclomethasone dipropionate, 6 micrograms of formoterol fumarate dihydrate, and 10 micrograms of glycopyrronium (as 12.5 micrograms of glycopyrronium bromide).<\/p>\n\n\n\n<p>Other ingredients are\u00a0<a href=\"https:\/\/zeepedia.com\/medical\/diseases\/lactose-intolerance\/\">lactose<\/a> monohydrate\u00a0(see section 2) and magnesium stearate.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Appearance and package sizes of the medicine<\/h2>\n\n\n\n<p>Tombow is a white to almost white\u00a0inhalation powder.<\/p>\n\n\n\n<p>It is supplied in a white plastic\u00a0inhaler\u00a0called NEXThaler fitted with a gray protective cap over the mouthpiece and a counter for the\u00a0inhalations.<\/p>\n\n\n\n<p>Each&nbsp;inhaler&nbsp;is packed in a sealed protective bag.<\/p>\n\n\n\n<p>Tombow is supplied in packs containing one\u00a0inhaler\u00a0and in multipacks of two or three\u00a0inhalers, which provide 120\u00a0inhalations\u00a0each (120, 240, or 360 inhalations).<\/p>\n\n\n\n<p>Not all pack sizes may be marketed.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder<\/h2>\n\n\n\n<p>Chiesi Farmaceutici SpA<\/p>\n\n\n\n<p>Via Palermo 26\/A<\/p>\n\n\n\n<p>43122 Parma<\/p>\n\n\n\n<p>Italy<\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>Chiesi Farmaceutici SpA<\/p>\n\n\n\n<p>Via San Leonardo 96<\/p>\n\n\n\n<p>43122 Parma<\/p>\n\n\n\n<p>Italy<\/p>\n\n\n\n<p>Contact the representative of the Marketing Authorization Holder if you would like to know more about this medicine:<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Belgi\u00eb\/Belgique\/Belgien<\/strong>Chiesi said\/nvTel\/Tel: + 32 (0)2 788 42 00<\/td><td><strong>Lithuania<\/strong>Chiesi Pharmaceuticals GmbHPhone: + 43 1 4073919<\/td><\/tr><tr><td><strong>Bulgaria<\/strong>Chiesi Bulgaria EOODTel.: + 359 29201205<\/td><td><strong>Luxembourg\/Luxembourg<\/strong>Chiesi said\/nvTel\/Tel: + 32 (0)2 788 42 00<\/td><\/tr><tr><td><strong>Czech Republic<\/strong>Chiesi CZ Serophene: + 420 261221745<\/td><td><strong>Magyarorsz\u00e1g<\/strong>Chiesi Hungary Kft.Tel.: + 36-1-429 1060<\/td><\/tr><tr><td><strong>Denmark<\/strong>Chiesi Pharma ABPhone: + 46 8 753 35 20<\/td><td><strong>Malta<\/strong>Chiesi Farmaceutici SpAPhone: + 39 0521 2791<\/td><\/tr><tr><td><strong>Deutschland<\/strong>Chiesi GmbHPhone: + 49 40 89724-0<\/td><td><strong>The Netherlands<\/strong>Chiesi Pharmaceuticals BVPhone: + 31 88 501 64 00<\/td><\/tr><tr><td><strong>Estonia<\/strong>Chiesi Pharmaceuticals GmbHPhone: + 43 1 4073919<\/td><td><strong>Norway<\/strong>Chiesi Pharma phone: + 46 8 753 35 20<\/td><\/tr><tr><td><strong>Greece<\/strong>Chiesi Hellas AEBETel: + 30 210 6179763<\/td><td><strong>Austria<\/strong>Chiesi Pharmaceuticals GmbHPhone: + 43 1 4073919<\/td><\/tr><tr><td><strong>Spain<\/strong>Chiesi Espa\u00f1a, SAUPhone: + 34 93 494 8000<\/td><td><strong>Polish<\/strong>Chiesi Poland Sp.&nbsp;ZooTel.: + 48 22 620 1421<\/td><\/tr><tr><td><strong>France<\/strong>Chiesi SASTel: + 33 1 47688899<\/td><td><strong>Portugal<\/strong>Chiesi Farmaceutici SpAPhone: + 39 0521 2791<\/td><\/tr><tr><td><strong>Hrvatska<\/strong>Chiesi Pharmaceuticals GmbHPhone: + 43 1 4073919<\/td><td><strong>Romania<\/strong>Chiesi Romania SRLPhone: + 40 212023642<\/td><\/tr><tr><td><strong>Ireland<\/strong>Chiesi Farmaceutici SpAPhone: + 39 0521 2791<\/td><td><strong>Slovenija<\/strong>Chiesi Slovenija dooPhone: + 386-1-43 00 901<\/td><\/tr><tr><td><strong>Iceland<\/strong>Chiesi Pharma ABTelephone: +46 8 753 35 20<\/td><td><strong>Slovenian Republic<\/strong>Chiesi Slovakia s.r.oPhone: + 421 259300060<\/td><\/tr><tr><td><strong>Italy<\/strong>Chiesi Italia SpAPhone: + 39 0521 2791<\/td><td><strong>Finland\/Finland<\/strong>Chiesi Pharma ABPhone\/Tel: +46 8 753 35 20<\/td><\/tr><tr><td><strong>Cyprus<\/strong>Chiesi Farmaceutici SpATel: + 39 0521 2791<\/td><td><strong>Sweden<\/strong>Chiesi Pharma ABPhone: +46 8 753 35 20<\/td><\/tr><tr><td><strong>Latvia<\/strong>Chiesi Pharmaceuticals GmbHPhone: + 43 1 4073919<\/td><td><strong>United Kingdom (Northern Ireland)<\/strong>Chiesi Farmaceutici SpAPhone: + 39 0521 2791<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>88 micrograms\/5 micrograms\/9 micrograms\u00a0Inhalation powder<br \/>\nbeclometasone dipropionate\/formoterol fumarate dihydrate\/glycopyrronium (beclometasone dipropionase\/formoterol fumarase dihydricus\/glycopyrronium)<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,22500],"tags":[26513,26521,26514,2476,26516,26515,26520,26518,26519,26517],"class_list":["post-25678","post","type-post","status-publish","format-standard","hentry","category-medicines","category-t","tag-beclometasone-dipropionate","tag-benefits-of-trimbow","tag-formoterol-fumarase-dihydricus","tag-formoterol-fumarate-dihydrate","tag-glycopyrronium-beclometasone-dipropionase","tag-glycopyrronium-2","tag-trimbow","tag-trimbow-side-effects","tag-what-is-trimbow","tag-what-trimbow-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25678","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=25678"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25678\/revisions"}],"predecessor-version":[{"id":25754,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25678\/revisions\/25754"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=25678"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=25678"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=25678"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}