DuoResp Spiromax

DuoResp Spiromax is a combination inhaler containing budesonide and formoterol – the same active ingredients as in Symbicort. It is used to treat asthma and COPD and offers an alternative to the Symbicort Turbuhaler with the same active ingredients.

The special Spiromax inhaler is a breath-actuated powder inhaler that is particularly easy to use: open the cap, inhale, close the cap. It looks similar to a metered-dose inhaler, but it is a dry powder inhaler.

Like Symbicort, DuoResp Spiromax can be used in the MART approach as both maintenance and as-needed therapy.

DuoResp works through the proven budesonide/formoterol combination:

Budesonide (ICS):

• Anti-inflammatory effect in the airways
• Reduces swelling and mucus production
• Lowers bronchial hyperresponsiveness
• Long-term protection against asthma attacks

Formoterol (LABA):

• Rapid onset of action (1-3 minutes)
• Long-lasting bronchodilation (12 hours)
• Enables MART use
• Relaxes the bronchial muscles

Same active ingredients as Symbicort.

DuoResp Spiromax is suitable for:

• Asthma in adults aged 18 and over
• COPD in adults
• As MART therapy
• Alternative to Symbicort

Advantages of the Spiromax:

• Particularly easy to use
• Looks like a spray but is a powder inhaler
• Integrated dose counter
• Breath-actuated

Not suitable:

• For children and adolescents under 18 years of age
• As the only measure during an acute severe asthma attack

DuoResp Spiromax:

• 160/4.5 µg (budesonide/formoterol) per single dose
• 320/9 µg per single dose

Dosage for asthma (160/4.5 µg):

• Maintenance therapy: 1-2 inhalations 2 times daily
• MART: 1 inhalation 2 times daily + as needed
• Maximum with MART: 6 inhalations per occasion and normally 8 inhalations/day, up to 12 inhalations/day for a limited period
• If you need more than 8 inhalations a day, you are strongly advised to seek medical advice

For COPD (160/4.5 µg):

• 2 inhalations 2 times daily

Dosage with 320/9 µg:

• Asthma: 1 inhalation 2 times daily, in some patients up to 2 inhalations 2 times daily
• Only as maintenance therapy, not for MART
• COPD: 1 inhalation 2 times daily

Spiromax inhaler: 1. Fold the cap down (the dose is loaded automatically) 2. Breathe out deeply (not into the inhaler) 3. Close your lips firmly around the mouthpiece 4. Breathe in forcefully and deeply 5. Hold your breath for 5-10 seconds 6. Close the cap again 7. Rinse your mouth and spit out

Important notes:

• Hold upright when opening
• Do not shake
• Use regularly
• Rinse your mouth after inhalation

Do not use in case of:

• Hypersensitivity to budesonide, formoterol or lactose

Use with caution in case of:

• Severe cardiovascular diseases
• QT prolongation
• Hyperthyroidism
• Diabetes mellitus
• Hypokalemia
• Pulmonary tuberculosis

Pregnancy: Only if clearly indicated.

Breastfeeding: Benefit-risk assessment.

Common (1-10%):

• Oral thrush
• Hoarseness
• Headache
• Tremor
• Palpitations

Uncommon:

• Muscle cramps
• Restlessness
• Sleep disorders
• Nausea

Rare:

• Paradoxical bronchospasm
• Hypokalemia

Very rare:

• Systemic corticosteroid effects

Prevention: Rinse your mouth after each inhalation.

Interactions:

• CYP3A4 inhibitors (ketoconazole, ritonavir) – increased budesonide levels
• Beta blockers – can cancel out the effect of formoterol
• QT-prolonging medications
• Potassium-lowering medications

Not recommended:

• Other LABAs at the same time