What Enerzair Breezhaler is and how it works

Enerzair Breezhaler contains three active substances:

-                 indacaterol

-                 glycopyrronium

-                 mometasone furoate

Indacaterol and glycopyrronium belong to a group of medicines called bronchodilators. They work in different ways to relax the muscles of the small airways in the lungs. This helps to open the airways and makes it easier for air to get in and out of the lungs. When they are taken regularly, they help the small airways to remain open.

Mometasone furoate belongs to a group of medicines called corticosteroids (or steroids). Corticosteroids reduce the swelling and irritation (inflammation) in the small airways in the lungs and so gradually ease breathing problems. Corticosteroids also help to prevent attacks of asthma.

What Enerzair Breezhaler is used for

Enerzair Breezhaler is used regularly as treatment for asthma in adults.

Asthma is a serious, long‑term lung disease where the muscles around the smaller airways become tight (bronchoconstriction) and inflamed. Symptoms come and go and include shortness of breath, wheezing, chest tightness and cough.

You should use Enerzair Breezhaler every day and not only when you have breathing problems or other symptoms of asthma. This will ensure that it controls your asthma properly. Do not use this medicine to relieve a sudden attack of breathlessness or wheezing.

If you have any questions about how Enerzair Breezhaler works or why this medicine has been prescribed for you, ask your doctor.

Follow all the doctor’s instructions carefully.

a.       Do not use Enerzair Breezhaler

-                 if you are allergic to indacaterol, glycopyrronium, mometasone furoate, or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, ask your doctor for advice.

b.      Take special care with Enerzair Breezhaler

Talk to your doctor, pharmacist or nurse before using Enerzair Breezhaler if any of the following applies to you:

-                 if you have heart problems, including an irregular or fast heartbeat.

-                 if you have thyroid gland problems.

-                 if you have ever been told you have diabetes or high blood sugar.

-                 if you suffer from seizures or fits.

-                 if you have severe kidney problems.

-                 if you have severe liver problems.

-                 if you have a low level of potassium in your blood.

-                 if you have an eye problem called angle‑closure glaucoma.

-                 if you have difficulty passing urine.

-           if you have tuberculosis (TB) of the lung, or any long standing or untreated infections.

During treatment with Enerzair Breezhaler

Stop using this medicine and get medical help immediately if you have any of the following:

-                 tightness of the chest, coughing, wheezing or breathlessness immediately after using Enerzair Breezhaler (signs the medicine is unexpectedly tightening the airways, known as paradoxical bronchospasm).

-                 difficulty breathing or swallowing, swelling of the tongue, lips or face, skin rash, itching and hives (signs of allergic reaction).

-                 eye pain or discomfort, temporary blurring of vision, visual haloes (seeing bright circles around lights) or coloured images in association with red eyes (signs of an attack of angle‑closure glaucoma).

Children and adolescents

Do not give this medicine to children or adolescents (below the age of 18 years) because it has not been studied in this age group.

c.       Using Other medicines, herbal or dietary supplements

Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines. In particular, tell your doctor or pharmacist if you are using:

-                 medicines that decrease the level of potassium in your blood. These include diuretics (which increase urine production and can be used to treat high blood pressure, e.g. hydrochlorothiazide), other bronchodilators such as methylxanthines used for breathing problems (e.g. theophylline) or corticosteroids (e.g. prednisolone).

-                 tricyclic antidepressants or monoamine oxidase inhibitors (medicines used in the treatment of depression).

-                 any medicines that may be similar to Enerzair Breezhaler (contain similar active substances); using them together may increase the risk of possible side effects.

-                 medicines called beta blockers used to treat high blood pressure or other heart problems (e.g. propranolol) or to treat glaucoma (e.g. timolol).

-                 ketoconazole or itraconazole (medicines used to treat fungal infections).

-                 ritonavir, nelfinavir or cobicistat (medicines used to treat HIV infection).

d.      Pregnancy and breast‑feeding

If you are pregnant or breast‑feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. Your doctor will discuss with you whether you can use Enerzair Breezhaler.

e.       Driving and using machines

It is unlikely that this medicine will affect your ability to drive and use machines.

f.        Important information about some of the ingredients of Enerzair Breezhaler

Enerzair Breezhaler contains lactose

This medicine contains about 25 mg of lactose per capsule. If you have been told by your doctor that you have an intolerance to some sugars, speak with your doctor before taking this medicine.

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

How much Enerzair Breezhaler to inhale

The usual dose is to inhale the content of one capsule each day. You only need to use the medicine once a day. Do not use more than your doctor tells you to use.

You should use Enerzair Breezhaler every day, even when your asthma is not troubling you.

When to inhale Enerzair Breezhaler

Inhale Enerzair Breezhaler at the same time each day. This will help control your symptoms throughout the day and night. It will also help you to remember to use it.

How to inhale Enerzair Breezhaler

-                 Enerzair Breezhaler is for inhalation use.

-                 In this pack, you will find an inhaler and capsules that contain the medicine. The inhaler enables you to inhale the medicine in the capsule. Only use the capsules with the inhaler provided in this pack. The capsules should remain in the blister until you need to use them.

-                 Peel the backing away from the blister to open it, do not push the capsule through the foil.

-                 When you start a new pack, use the new inhaler supplied in this new pack.

-                 Dispose of the inhaler in each pack after all capsules in that pack have been used.

-                 Do not swallow the capsules.

-                 Please read the instructions for use on the other side of this leaflet for more information on how to use the inhaler.

If your symptoms do not improve

If your asthma is not getting better or if it gets worse after you have started using Enerzair Breezhaler, talk to your doctor.

a.       If you use more Enerzair Breezhaler than you should

If you accidently inhale too much of this medicine, contact your doctor or hospital for advice immediately. You may need medical attention.

b.      If you forget to use Enerzair Breezhaler

If you forget to inhale a dose at the usual time, inhale one as soon as possible on that day. Then inhale the next dose at the usual time on the next day. Do not inhale two doses on the same day.

c.       If you stop using Enerzair Breezhaler

Do not stop using Enerzair Breezhaler unless your doctor tells you to. Your asthma symptoms may come back if you stop using it.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some side effects could be serious

Stop using Enerzair Breezhaler and get medical help immediately if you have any of the following:

Common: may affect up to 1 in every 10 people

-                 difficulty breathing or swallowing, swelling of the tongue, lips or face, skin rash, itching and hives (signs of allergic reaction).

Other side effects

Other side effects include the following listed below. If these side effects become severe, please tell your doctor, pharmacist or nurse.

Very common: may affect more than 1 in 10 people

-                 sore throat

-                 runny nose

-                 sudden difficulty breathing and feeling of tightness in chest with wheezing or coughing

Common: may affect up to 1 in every 10 people

-                 oral thrush (sign of candidiasis). After you have finished taking your dose, rinse your mouth with water or a mouthwash solution and then spit this out. This will help to prevent thrush.

-                 a frequent urge to urinate and pain or burning when urinating (signs of urinary tract infection)

-                 headache

-                 fast heart beat

-                 cough

-                 voice alteration (hoarseness)

-                 diarrhoea, abdominal cramps, nausea, and vomiting (gastroenteritis)

-                 pain in muscles, bones or joints (signs of musculoskeletal pain)

-                 muscle spasm

-                 fever

Uncommon: may affect up to 1 in every 100 people

-                 dry mouth

-                 rash

-                 high level of sugar in the blood

-           skin itching

-           difficulty and pain when passing urine (signs of dysuria)

-                 clouding of the lens of your eyes (signs of cataract)

-                 Keep this medicine out of the sight and reach of children.

-                 Do not use this medicine after the expiry date which is stated on the carton and blister after “EXP”. The expiry date refers to the last day of that month.

-                 Do not store above 30°C.

-                 Store the capsules in the original blister, in order to protect from light and moisture, and do not remove until immediately before use.

-                 Do not throw away any medicines via wastewater. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.