Oxis Turbuhaler
Oxis Turbuhaler: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Oxis Turbuhaler
ATX code: R03AC13
Active ingredient: formoterol (Formoterol)
Manufacturer: AstraZeneca, AB (AstraZeneca, AB) (Sweden)
Description and photo update: 2019-04-10
Prices in pharmacies: from 499 rubles.
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Oxis Turbuhaler is a bronchodilator drug, selective beta 2 -adrenomimetic.
Release form and composition
The drug is available in the form of a metered dose powder for inhalation, which is in plastic inhalers with a rotating disc of greenish-blue color, which has a light (for Oxis Turbuhaler 4.5 μg) or dark (for Oxis Turbuhaler 9 μg) shade. The contents of the inhaler are a powdery fraction or rounded granules from almost white to white, which disintegrate into a fine powder with little exposure. Plastic inhalers with first opening control contain 60 doses, 1 inhaler is placed in a carton box together with instructions for use Oxis Turbuhaler.
1 dose (1 inhalation) contains:
- active substance: formoterol fumarate dihydrate - 4.5 or 9 μg;
- auxiliary component: lactose monohydrate - about 450 mcg.
Pharmacological properties
Pharmacodynamics
Oxis Turbuhaler is a bronchodilator drug. Its active substance - formoterol, being a selective beta 2 -adrenomimetic, has a bronchodilator effect in reversible airway obstruction. The clinical effect occurs within 1-3 minutes after applying a single dose and lasts for 12 hours.
Pharmacokinetics
After inhalation, formoterol is rapidly absorbed and reaches its maximum plasma concentration after 1/6 hour.
By inhalation, the lungs receive 28–49% of the delivered dose (corresponds to 21–37% of the administered dose). The total systemic bioavailability depends on the level of concentration of the drug in the lungs and can reach 61% of the delivered dose (corresponds to 46% of the administered dose).
Plasma protein binding is approximately 50%.
It is metabolized by direct addition of the glucuronic acid residue and O-demethylation. The enzyme involved in the O-demethylation reaction has not been identified.
Through the kidneys, 6-10% of the inhaled dose is excreted unchanged, the remaining part of formoterol is excreted as a result of metabolism. The half-life is an average of 17 hours.
With severe cirrhosis of the liver, it is possible to slow down the elimination of the drug.
Indications for use
The use of the drug Oxis Turbuhaler is indicated in combination with corticosteroids as a regular maintenance therapy of bronchial asthma, for relief of attacks of bronchospasm and prevention of attacks caused by physical activity.
In addition, in chronic obstructive pulmonary disease, Oxis Turbuhaler is used for the prevention and treatment of broncho-obstructive symptoms.
Contraindications
Absolute contraindications for the use of the drug are children under 6 years of age and the presence of hypersensitivity to the components of the drug.
Oksis Turbuhaler should be used with caution in exacerbation of severe bronchial asthma, thyrotoxicosis, pheochromocytoma, diabetes, hypertrophic obstructive cardiomyopathy, idiopathic subvalvular aortic stenosis, severe hypertension, aneurysm, ischemic disease, tachyarrhythmias, or other severe cardiac arrhythmias. or concomitant therapy with drugs that can affect the duration of the QTc interval.
The decision to prescribe the drug during pregnancy or lactation is made by the doctor individually. It is considered justified when the expected benefit to the mother outweighs the possible risks to the fetus or child.
Oxis Turbuhaler, instructions for use: method and dosage
Oxis Turbuhaler is used by inhalation, inhaling the powder through the mouthpiece of the inhaler.
To take one dose of the drug, you must strictly adhere to the following sequence of actions. First of all, unscrew and remove the cover. Holding the inhaler in an upright position with the dispenser down (without touching the mouthpiece), measure the dose of the drug by turning the dispenser clockwise or counterclockwise (the direction of rotation is unimportant) until it stops, and then also until it stops in the opposite direction. When the dispenser rotates, a click should sound (when opening a new package and preparing Turbuhaler for the first procedure, the described actions with the dispenser are performed twice).
First you need to exhale, but you should not exhale through the mouthpiece. After exhaling, the mouthpiece is carefully placed between the teeth, clasping it tightly with your lips, and a strong deep breath is taken through the inhaler.
Taking the inhaler out of your mouth, exhale.
Do not squeeze or chew the mouthpiece with your teeth.
If inhalation of several doses is required, the steps should be repeated in the same sequence. It should be borne in mind that strict adherence to the rules for using the inhaler is a guarantee of taking the required dose of the drug, even if the taste of the powder is not felt after inhalation.
Do not rotate the mouthpiece unnecessarily or try to remove it.
Once a week, the outside of the mouthpiece is cleaned with a dry cloth; water or other liquids cannot be used.
When approximately 20 doses remain in the inhaler, a red mark appears in the dose indicator window. Its position in the lower edge of the dose indicator window means that the inhaler is empty.
The dispenser of the empty inhaler continues to rotate, and the shaking sound is produced by the desiccant, not the powder.
The recommended dosage for inhalers Oxis Turbuhaler 4.5 mcg (containing 4.5 mcg of active substance in 1 dose):
- maintenance therapy of bronchial asthma: the usual dosage in adults is 1 or 2 inhalations 1-2 times a day, in the morning and / or in the evening. In some cases, 4 inhalations may be required 1-2 times a day. The maximum daily dose of maintenance therapy is 8 inhalations. If additional inhalations are required to relieve attacks of bronchospasm, 12 inhalations per day are allowed. You cannot take more than 6 doses of the drug to stop one attack. If more often 2 times within 7 days there is a need to use higher single doses of Oxis Turbuhaler and / or to increase the frequency more than 2 times a day, this is the basis for revising the treatment regimen. When selecting an individual dose, it is recommended to strive for the use of the minimum effective dose. With nighttime symptoms of bronchial asthma, the dose of the drug can be taken 1 time before bedtime. The duration of action of the drug is about 12 hours. The usual dosage for children 6 years of age and older: 2 inhalations 1-2 times a day. The maximum daily dose for children is 4 inhalations;
- prevention of bronchial asthma attacks caused by physical activity in adults and children 6 years of age and older: 2 inhalations before the expected physical activity. Do not exceed the maximum daily dose;
- chronic obstructive pulmonary disease: the usual dosage for adults is 2 inhalations 1-2 times a day. The maximum daily dose is 4 inhalations. If necessary, to alleviate broncho-obstructive symptoms, additional use of no more than 4 inhalations is allowed. It is not recommended to inhale more than 4 doses at a time. The criterion for insufficient control of the disease is the occurrence of the need to use Oxis Turbuhaler more than 2 times a day more often 2 times within 7 days and / or an increase in the recommended doses as normal maintenance therapy. In this case, a revision of the treatment regimen is required.
The recommended dosage for Oksis Turbuhaler inhalers is 9 μg (containing 9 μg of active substance in 1 dose):
- maintenance therapy of bronchial asthma: the usual dosage in adults is 1 inhalation 1-2 times a day, in the morning and / or in the evening. In some cases, 2 inhalations 1–2 times a day may be required. The maximum daily dose for systematic maintenance therapy is 4 inhalations. If additional inhalations are needed to relieve attacks of bronchospasm, 6 inhalations per day are allowed. Do not take more than 3 doses of the drug to stop one attack. If more often 2 times within 7 days there is a need to use higher single doses of Oxis Turbuhaler and / or to increase the frequency more than 2 times a day, this is the basis for revising the treatment regimen. When selecting an individual dose, it is recommended to prescribe the minimum effective dose. With nighttime symptoms of bronchial asthma, the dose of the drug can be taken 1 time before bedtime. The usual dosage for children 6 years of age and older: 1 inhalation 1-2 times a day. The maximum daily dose is 2 inhalations. The duration of action of Oxis Turbuhaler is about 12 hours;
- prevention of bronchial asthma attacks caused by physical activity in adults and children 6 years of age and older: 1 inhalation of the drug before the expected physical activity. Do not exceed the maximum daily dose;
- chronic obstructive pulmonary disease: the usual dosage for adults is 1 inhalation 1-2 times a day. The maximum daily dose is 2 inhalations. If necessary, to alleviate broncho-obstructive symptoms, additional use of no more than 2 inhalations is allowed. It is not recommended to inhale more than 2 doses at a time. The criterion for insufficient control of the disease is the occurrence of the need to use Oxis Turbuhaler more than 2 times a day more often 2 times within 7 days and / or an increase in the recommended doses as normal maintenance therapy. In this case, a revision of the treatment regimen is required.
In case of impaired liver or kidney function, as well as elderly patients, special dose selection is not required.
Side effects
- from the central nervous system: often (from ≥ 1/100 to <1/10) - headache; rarely (from ≥ 1/10 000 to <1/1000) - agitation, sleep disturbance, anxiety; isolated cases - dizziness;
- on the part of the cardiovascular system: often - transient rapid heartbeat; rarely - changes in blood pressure, tachycardia; very rarely (<1/10 000) - supraventricular tachycardia, atrial fibrillation, extrasystoles; isolated cases - lengthening of the QTc interval, angina pectoris;
- on the part of the musculoskeletal system: often - tremor (it is temporary, goes away on its own in the course of treatment); rarely - muscle cramps;
- from the immune system: isolated cases - hypersensitivity reactions;
- from the respiratory tract: very rarely - bronchospasm; possibly paradoxical bronchospasm;
- dermatological reactions: very rarely - itching, rash, urticaria;
- laboratory parameters: very rarely - hypokalemia, hyperkalemia; possibly - an increase in the concentration of free fatty acids, ketone, glycerol, insulin in the blood;
- others: isolated cases - taste disturbance, nausea, hyperglycemia.
Overdose
In case of an overdose of Oxis Turbuhaler, symptoms typical of beta 2 -adrenomimetics may appear, such as headache, tremor, nausea, vomiting, heart palpitations, tachycardia, prolongation of the QTc interval, arrhythmia, hypokalemia, hyperglycemia.
In case of overdose, supportive and symptomatic treatment is recommended. When prescribing cardioselective beta-blockers, caution should be exercised due to the increased risk of bronchospasm in the presence of beta 2 -adrenergic receptor blockers. Serum potassium levels should be monitored.
special instructions
The doctor must clearly instruct the patient that a strong and deep breath through the mouthpiece of the inhaler is a guarantee that the most complete dose of Oxis Turbuhaler will enter the respiratory tract with an air stream.
Do not use Turbuhaler if the mouthpiece is damaged or disconnected from its body.
It is not recommended to increase the dose of Oxis Turbuhaler in case of severe exacerbation of bronchial asthma.
Regular use of beta 2 -adrenomimetics in patients with bronchial asthma should be accompanied by optimal anti-inflammatory corticosteroid therapy, even in cases of improvement.
The safety of long-term use of Oxis Turbuhaler in doses exceeding the maximum daily dose has not been established, therefore, the recommended dosing regimen should not be violated.
If, against the background of maintenance therapy with long-acting beta 2 -adrenomimetics and glucocorticosteroids, it becomes necessary to use Oxis Turbuhaler several times within 7 days to prevent symptoms of bronchial asthma caused by exercise, then a revision of the current treatment regimen is required.
Due to the hyperglycemic effect of beta 2 -adrenomimetics, patients with diabetes mellitus require more frequent monitoring of blood glucose levels at the beginning of therapy with Oxis Turbuhaler.
The use of beta 2 -adrenomimetics can potentiate the development of severe hypokalemia. In this regard, with an exacerbation of severe bronchial asthma, Oxis Turbuhaler should be taken with extreme caution, since hypoxia aggravates the risk of hypokalemia.
The amount of lactose in the delivered dose of the drug does not cause problems in patients with lactose intolerance.
Influence on the ability to drive vehicles and complex mechanisms
The use of the drug Oxis Turbuhaler does not negatively affect the ability of patients to drive vehicles or complex mechanisms.
Application during pregnancy and lactation
Due to the limited clinical experience of using Oxis Turbuhaler during gestation, the decision to prescribe it at all stages of pregnancy should be made only in exceptional cases when the expected effect of therapy for the mother is higher than the potential risk to the fetus.
It should be borne in mind that the degree of penetration of formoterol into the breast milk of women has not been established. In this regard, the decision to use Oxis Turbuhaler during lactation is made by the doctor, provided that the expected benefit to the mother exceeds the potential risk to the child.
Pediatric use
The use of Oksis Turbuhaler for the treatment of children under the age of 6 is contraindicated.
With impaired renal function
A special dose selection associated with impaired renal function is not required.
For violations of liver function
No special dose selection associated with liver dysfunction is required.
Use in the elderly
Elderly patients do not need a special selection of the dose of Oxis Turbuhaler.
Drug interactions
There are no research results on the interaction of the drug Oxis Turbuhaler, therefore, when it is used simultaneously with other drugs, it is recommended to take into account the compatibility characteristic of sympathomimetics.
When combined with other beta 2 -adrenomimetics or ephedrine, individual dose selection may be required due to the risk of side effects of formoterol.
The combined use of beta 2 -adrenomimetics with thiazide and loop diuretics, xanthine derivatives or steroids potentiates the development of hypokalemia, which in patients receiving cardiac glycosides increases the predisposition to arrhythmias. In cases of need for concomitant therapy with diuretics, xanthine derivatives or steroids, regular monitoring of the serum potassium level is required.
It should be borne in mind that against the background of concomitant therapy with antihistamines (including terfenadine, mizolastine, astemizole), erythromycin, tricyclic antidepressants, some antiarrhythmic drugs such as quinidine, procainamide or disopyramide, the risk of ventricular arrhythmia increases. When carrying out anesthesia with halogenated hydrocarbons in patients taking formoterol, the likelihood of developing arrhythmias increases significantly.
Due to the fact that adrenergic receptor blockers can decrease or inhibit the pharmacological action of formoterol, the combined use of Oxis Turbuhaler with beta-blockers (including eye drops) is allowed only in cases of extreme necessity.
Analogs
Oksis Turbuhaler analogs are Formoterol, Formoterol Easyhaler, Formoterol-native, Atimos, Astmanon, Foradil, etc.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 30 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Oxis Turbuhaler
Reviews about Oxis Turbuhaler are positive. Experts point to the sufficient efficacy and safety of the drug.
Price for Oxis Turbuhaler in pharmacies
The price for Oxis Turbuhaler for a package containing 1 inhaler can be: 4.5 μg / dose - from 610 rubles, 9 μg / dose - from 759 rubles.
Oxis Turbuhaler: prices in online pharmacies
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Drug name Price Pharmacy |
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Oxis Turbuhaler 9 mcg / dose 60 doses powder for inhalation dosed 1 pc. RUB 499 Buy |
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Oxis Turbuhaler 4.5 mcg / dose 60 doses powder for inhalation dosed 1 pc. 559 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
