Duaklir Genuair 340 micrograms /12 micrograms inhalation powder

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor, pharmacist or nurse.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1. What Duaklir Genuair is and what it is used for
2. What you need to know before you use Duaklir Genuair
3. How to use Duaklir Genuair
4. Possible side effects
5. How to store Duaklir Genuair
6. Contents of the pack and other information
Instructions for Use

What Duaklir Genuair is

This medicine contains two active ingredients called aclidinium and formoterol fumarate dihydrate. Both belong to a group of medicines called bronchodilators. Bronchodilators relax the muscles in your airways, which allows the airways to open more widely and helps you to breathe more easily. The Genuair inhaler delivers the active ingredients directly into your lungs as you breathe in.

What Duaklir Genuair is used for

Duaklir Genuair is used for adult patients who have breathing difficulties due to a lung disease called chronic obstructive pulmonary disease (COPD), in which the airways and air sacs in the lungs become damaged or blocked. By opening the airways, the medicine helps relieve symptoms such as shortness of breath. Taking Duaklir Genuair regularly will reduce the effects of COPD on your everyday life.

Do not use Duaklir Genuair:

• if you are allergic to aclidinium, formoterol fumarate dihydrate or to the other ingredient of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor, pharmacist or nurse before using Duaklir Genuair, if you have any of the following conditions/symptoms:

• If you have asthma. This medicine should not be used for the treatment of asthma.
• If you have heart problems.
• If you have epilepsy.
• If you have thyroid gland problems (thyrotoxicosis).
• If you have a tumour in one of your adrenal glands (phaeochromocytoma).
• If you have difficulty passing urine or problems due to an enlarged prostate.
• If you have an eye condition called narrow angle glaucoma, which results in high pressure in the eye.

Stop taking Duaklir Genuair and seek medical help immediately if you experience any of the following:

• If you get sudden tightness of the chest, coughing, wheezing or breathlessness immediately after using the medicine. See section 4.

Duaklir Genuair is used as a maintenance (long-term) treatment for COPD. You should not use this medicine to treat a sudden attack of breathlessness or wheezing.

If your usual COPD symptoms (breathlessness, wheezing, cough) do not improve or get worse while you are using Duaklir Genuair you should continue to use it, but go to see your doctor as soon as possible because you may need another medicine.

If you see halos around lights or coloured images, have eye pain or discomfort or suffer temporary blurring of vision, go to see your doctor for advice as soon as possible.

Dry mouth has been observed with medicines like Duaklir Genuair. In the long-term, dry mouth can be associated with tooth decay, so it is important to pay attention to oral hygiene.

Children and adolescents

Duaklir Genuair is not for use in children or adolescents below 18 years of age.

Other medicines and Duaklir Genuair

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. If you use Duaklir Genuair with some other medicines, the effect of Duaklir Genuair or the other medicines may be altered.

Tell your doctor or pharmacist if you are taking:

• Any medicines that may be similar to Duaklir Genuair to treat breathing difficulties.
• Medicines that lower the amount of potassium in your blood. These include:
  • corticosteroids that you take by mouth (such as prednisolone),
  • diuretics (such as furosemide or hydrochlorothiazide),
  • certain medicines used to treat breathing conditions (such as theophylline).
• Medicines called beta blockers that may be used to treat high blood pressure or other heart problems (such as atenolol or propranolol) or to treat glaucoma (such as timolol).
• Medicines which can cause a type of change in the electrical activity of the heart known as QT interval prolongation (observed in an electrocardiogram). These include medicines for the treatment of:
  • depression (such as monoamine oxidase inhibitors or tricyclic antidepressants),
  • bacterial infections (such as erythromycin, clarithromycin, telithromycin),
  • allergic reactions (anti-histamines).

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, nurse or pharmacist for advice before using this medicine. You should not use Duaklir Genuair if you are pregnant or are breast-feeding unless your doctor tells you to do so.

Driving and using machines

Duaklir Genuair is unlikely to affect your ability to drive or use machines. In some patients, this medicine may cause blurred vision or dizziness. If you are affected by either of these side effects, do not drive or use machines until the dizziness has cleared or your vision has returned to normal.

Duaklir Genuair contains lactose

This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

If you use more Duaklir Genuair than you should

If you think you may have used more Duaklir Genuair than you should, you are more likely to experience some of its side effects, such as blurred vision, dry mouth, feeling sick, shaking/tremor, headache, palpitations or an increase in blood pressure, therefore you must immediately contact your doctor or go to the nearest emergency unit. Show the packaging of Duaklir Genuair. Medical attention may be needed.

If you forget to use Duaklir Genuair

If you forget a dose of Duaklir Genuair, just take it as soon as possible and take your next dose at the usual time. Do not take a double dose to make up for a forgotten dose.

If you stop using Duaklir Genuair

This medicine is for long-term use. If you want to stop treatment, first talk to your doctor, as your symptoms may worsen.

Other side effects which may occur while using Duaklir Genuair:

Common (may affect up to 1 in 10 people)

• Combination of sore throat and runny nose – these may be signs of nasopharyngitis
• Headache
• Painful and/or frequent urination – these may be signs of a urinary tract infection
• Cough
• Diarrhoea
• A blocked, runny or stuffy nose and/or pain or a feeling of pressure in the cheeks or forehead – these may be symptoms of sinusitis
• Dizziness
• Muscle cramps
• Nausea (feeling sick)
• Difficulty sleeping
• Dry mouth
• Muscle pain
• Abscess (infection) in the tissues at the base of a tooth
• Increased blood levels of a protein found in muscle called creatine phosphokinase
• Shaking/tremor
• Anxiety

Uncommon

• Fast heart beat (tachycardia)
• Chest pain or tightness in the chest (angina pectoris)
• Blurred vision
• Changes in the sound of the voice (dysphonia)
• Difficulty passing urine or a feeling that your bladder has not completely emptied (urinary retention)
• An abnormal heart trace (QT interval prolongation) potentially leading to an abnormal heart rhythm
• Distorted sense of taste (dysgeusia)
• Throat irritation
• Inflammation of the mouth (stomatitis)
• Increased blood pressure
• Agitation
• Rash
• Itching of the skin

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

What Duaklir Genuair contains

• The active substances are aclidinium and formoterol fumarate dihydrate. Each delivered dose (the dose leaving the mouthpiece) contains 396 micrograms aclidinium bromide equivalent to 340 micrograms of aclidinium and 11.8 micrograms of formoterol fumarate dihydrate.
• The other ingredient is lactose monohydrate (see end of section 2 under ‘Duaklir Genuair contains lactose’ for more information).

What Duaklir Genuair looks like and contents of the pack

Duaklir Genuair is a white or almost white inhalation powder.

The Genuair inhaler is a white device fitted with an integral dose indicator and an orange dosage button. The mouthpiece is covered with a removable orange protective cap. It is supplied in a sealed protective aluminium bag containing a desiccant sachet. After removing the inhaler from the bag, the bag and desiccant sachet should be thrown away.

Pack sizes supplied:

Carton containing 1 inhaler with 30 doses.

Carton containing 1 inhaler with 60 doses.

Carton containing 3 inhalers each with 60 doses.

Not all pack sizes may be marketed.

Marketing Authorisation Holder:

Manufacturer:

Getting Started

Read these Instructions for Use before you start using the medicine.

Become familiar with the parts of your Genuair inhaler.

Before use:

a) Before first use, tear open the sealed bag and remove the inhaler. Throw away the bag and the desiccant.

b) Do not press the orange button until you are ready to take a dose.

c) Pull off the cap by lightly squeezing the arrows marked on each side (Figure B).

STEP 1: Prepare your dose

1.1 Look in the opening of the mouthpiece and make sure nothing is blocking it (Figure C).

1.2 Look at the control window (should be red, Figure C).

1.3 Hold the inhaler horizontally with the mouthpiece facing you and the orange button on top (Figure D).

1.4 Press the orange button all the way down to load your dose (Figure E).

When you press the button all the way down, the control window changes from red to green.

Make sure the orange button is on top. Do not tilt.

1.5 Release the orange button (Figure F).

Make sure you release the button so the inhaler can work correctly.

Stop and Check:

1.6 Make sure the control window is now green (Figure G).

Your medicine is ready to be inhaled.

Go to ‘STEP 2: Inhale your medicine’.

What to do if the control window is still red after pressing the button (Figure H).

The dose is not prepared. Go back to ‘STEP 1 Prepare your dose’ and repeat steps 1.1 to 1.6.

STEP 2: Inhale your medicine

Read steps 2.1 to 2.7 fully before use. Do not tilt.

2.1 Hold the inhaler away from your mouth, and breathe out completely. Never breathe out into the inhaler (Figure I).

2.2 Hold your head upright, put the mouthpiece between your lips, and close your lips tightly around it (Figure J).

Do not hold the orange button down while inhaling.

2.3 Take a strong, deep breath through your mouth. Keep breathing in for as long as possible.

A ‘click’ will let you know that you are inhaling correctly. Keep breathing in as long as possible after you hear the ‘click’. Some patients may not hear the ‘click’. Use the control window to ensure you have inhaled correctly.

2.4 Take the inhaler out of your mouth.

2.5 Hold your breath for as long as possible.

2.6 Slowly breathe out away from the inhaler.

Some patients may experience a grainy sensation in their mouth, or a slightly sweet or bitter taste. Do not take an extra dose even if you do not taste or feel anything after inhaling.

Stop and Check:

2.7 Make sure the control window is now red (Figure K). This means you have inhaled your medicine correctly.

What to do if the control window is still green after inhalation (Figure L).

This means you have not inhaled your medicine correctly. Go back to ‘STEP 2 Inhale your medicine’ and repeat steps 2.1 to 2.7.

If the control window still does not change to red, you may have forgotten to release the orange button before inhaling, or you may not have inhaled strongly enough. If this happens, try again. Make sure you have released the orange button, and you have breathed out completely. Then take a strong, deep breath through the mouthpiece.

Please contact your doctor if the control window is still green after repeated attempts.

Push the protective cap back onto the mouthpiece after each use (Figure M), to prevent contamination of the inhaler with dust or other materials. You should discard your inhaler if you lose the cap.

Additional information

What should you do if you accidently prepare a dose?

Store your inhaler with the protective cap in place until it is time to inhale your medicine, then remove the cap and start at Step 1.6.

How does the dose indicator work?

• The dose indicator shows the total number of doses left in the inhaler (Figure N).
• On first use, every inhaler contains at least 60 doses, or at least 30 doses, depending on the pack size.
• Each time you load a dose by pressing the orange button, the dose indicator moves by a small amount towards the next number (50, 40, 30, 20, 10, or 0).

When should you get a new inhaler?

You should get a new inhaler:

• If your inhaler appears to be damaged or if you lose the cap, or
• When a red band appears in the dose indicator, this means you are nearing your last dose (Figure N), or
• If your inhaler is empty (Figure O).

Dose indicator moves slowly from 60 to 0: 60, 50, 40, 30, 20, 10, 0.

How do you know that your inhaler is empty?

When the orange button will not return to its full upper position and is locked in a middle position, you have reached the last dose (Figure O). Even though the orange button is locked, your last dose may still be inhaled. After that, the inhaler cannot be used again and you should start using a new inhaler.

How should you clean the inhaler?

NEVER use water to clean the inhaler, as this may damage your medicine.

If you wish to clean your inhaler, just wipe the outside of the mouthpiece with a dry tissue or paper towel.