Oxis Turbohaler 6, inhalation powder

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• 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 or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

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

Oxis Turbohaler is used to treat asthma in adults, adolescents and children 6 years and older.

For asthma, your doctor will prescribe two asthma inhalers: Oxis Turbohaler and a separate ‘corticosteroid’ inhaler. These should be used together.

• Oxis Turbohaler is used to help prevent asthma symptoms from happening.
• Some people also use Oxis Turbohaler when they need extra doses for relief of asthma symptoms, to make it easier to breathe again.
• Oxis Turbohaler can also be used before exercise to prevent asthma symptoms caused by exercise.

Oxis Turbohaler can also be used to treat the symptoms of COPD in adults. COPD is a long-term disease of the airways in the lungs, which is often caused by cigarette smoking.

• If you are allergic (hypersensitive) to formoterol, or any of the other ingredients of this medicine (listed in section 6).

Talk to your doctor or pharmacist before using Oxis Turbohaler if

• You are diabetic. You may need some additional blood sugar tests while you are using Oxis Turbohaler.
• You have high blood pressure or you have ever had a heart problem.
• You have problems with your thyroid gland.
• You have low levels of potassium in your blood. Your doctor may take blood samples to check the levels of potassium in your blood.
• You have severe liver problems such as liver cirrhosis.

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before using Oxis Turbohaler.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription and herbal medicines.

This is because Oxis Turbohaler can affect the way some medicines work and some medicines can have an effect on Oxis Turbohaler.

In particular, tell your doctor or pharmacist if you are taking any of the following medicines:

• Beta-blocker medicines (such as atenolol or propranolol for high blood pressure), including eyedrops (such as timolol for glaucoma).
• Medicines for a fast or uneven heart beat (such as quinidine).
• Medicines like digoxin, often used to treat heart failure.
• Diuretics, also known as ‘water tablets’ (such as furosemide). These are used to treat high blood pressure.
• Steroid medicines that you take by mouth (such as prednisolone).
• Xanthine medicines (such as theophylline or aminophylline). These are often used to treat asthma.
• Erythromycin (used to treat infections).
• Anti-histamines (such as terfenadine).
• Other substances that dilate the airways (bronchodilators, such as salbutamol).
• Ephedrine (used to treat asthma or as a decongestant).
• Tricyclic anti-depressants (such as amitriptyline).

If any of the above applies to you, or if you are not sure, talk to your doctor or pharmacist before using Oxis Turbohaler.

Also tell your doctor or pharmacist if you are going to have a general anaesthetic for an operation or for dental work.

The addition of anticholinergics (such as tiotropium or ipratropium bromide) to the treatment with Oxis Turbohaler, can help to open your airways even more.

• If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor for advice before taking this medicine - do not use Oxis Turbohaler unless your doctor tells you to.
• If you get pregnant while using Oxis Turbohaler, do not stop using Oxis Turbohaler but talk to your doctor immediately.

Oxis Turbohaler is not likely to affect you being able to drive or use any tools or machines.

Oxis Turbohaler contains lactose, which is a type of sugar. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. The amount of lactose in this medicine does not normally cause problems in people who are lactose intolerant.

The excipient lactose contains small amounts of milk proteins, which may cause allergic reactions.

If you feel you are getting breathless or wheezy while using Oxis Turbohaler, you should continue to use Oxis Turbohaler but go to see your doctor as soon as possible, as you may need additional treatment.

Contact your doctor immediately if:

• Your breathing is getting worse or you often wake up at night with asthma.
• You start getting chest tightness.
• You are not getting relief from your current dose.
• You need to take more than your usual dose for more than two days in a week.
• You need to use your Turbohaler more often than usual before exercise.

These signs could mean that your asthma or COPD is not being properly controlled and you may need different or additional treatment immediately.

Oxis Turbohaler should not be used in children under 6 years of age.

Adults (18 years and above)

• The recommended dose is 1 or 2 inhalations, once or twice a day.
• Your doctor may increase this to 4 inhalations, once or twice a day.
• Some people also use Oxis Turbohaler as a ‘reliever inhaler’. If you get asthma symptoms, the usual dose is 1 or 2 inhalations when they happen.
• A total daily dose of more than 8 inhalations is not normally needed. This includes the inhalations that you take every day, when you get asthma symptoms and before exercise. However, your doctor may allow you to take up to 12 inhalations a day. Do not use more than 12 inhalations in total in 24 hours.
• Do not take more than 6 inhalations at any one time.

Children and adolescents (6 to 17 years)

• The recommended dose is 2 inhalations, once or twice a day.
• Some children also use Oxis Turbohaler as a ‘reliever inhaler’. If your child gets asthma symptoms, the usual dose is 1 or 2 inhalations when they happen.
• A total daily dose of more than 4 inhalations is not normally needed. This includes the inhalations that your child takes every day, when they get asthma symptoms and before exercise. However, your doctor may allow your child to take up to 8 inhalations a day. Your child should not use more than 8 inhalations in total in 24 hours.
• Your child should not have more than 2 inhalations at any one time.

Your doctor (or asthma nurse) will help you to manage your asthma. Once your asthma is well controlled your doctor may consider it appropriate to gradually reduce the dose of Oxis Turbohaler.

If you or your child have asthma symptoms caused by exercise, your doctor may advise you or your child to use Oxis Turbohaler before exercise as well. Oxis Turbohaler should not be used in children under 6 years of age.

Adults (18 years and above)

• The recommended dose is 2 inhalations before exercise.
• A total daily dose of more than 8 inhalations is not normally needed. This includes the inhalations that you take every day, when you get asthma symptoms and before exercise. However, your doctor may allow you to take up to 12 inhalations a day. Do not use more than 12 inhalations in total in 24 hours.
• Do not take more than 6 inhalations at any one time.

Children and adolescents (6 to 17 years)

• The recommended dose is 1 or 2 inhalations before exercise.
• A total daily dose of more than 4 inhalations is not normally needed. This includes the inhalations that your child takes every day, when they get asthma symptoms and before exercise. However, your doctor may allow your child to take up to 8 inhalations a day. Your child should not use more than 8 inhalations in total in 24 hours.
• Your child should not have more than 2 inhalations at any one time.

• Only to be used by adults (aged 18 years and above).
• The recommended dose is 2 inhalations once or twice a day.
• Your doctor may advise you to take extra doses for relief of your COPD symptoms.
• You should not have more than 8 inhalations a day.
• Do not take more than 4 inhalations at any one time.

Before using your new Oxis Turbohaler for the first time, you need to prepare it for use as follows.

• Unscrew the white cover and lift it off. You may hear a rattling sound.
• Hold your Oxis Turbohaler upright with the turquoise grip at the bottom.
• Turn the turquoise grip as far as it will go in one direction. Then turn it as far as it will go in the other direction (it does not matter which way you turn it first).
• You should hear a click sound.
• Do this again, turning the turquoise grip in both directions.
• Your Oxis Turbohaler is now ready for use.

Every time you need to take an inhalation, follow the instructions below.

1. Unscrew the white cover and lift it off. You may hear a rattling sound.

2. Hold your Turbohaler upright with the turquoise grip at the bottom.

3. Do not hold the mouthpiece when you load your Turbohaler. To load your Turbohaler with a dose, turn the turquoise grip as far as it will go in one direction. Then turn it as far as it will go in the other direction (it does not matter which way you turn it first). You should hear a click sound. Your Turbohaler is now loaded and ready to use. Only load your Turbohaler when you need to use it.

4. Hold your Turbohaler away from your mouth. Breathe out gently (as far as is comfortable). Do not breathe out through your Turbohaler.

5. Place the mouthpiece gently between your teeth. Close your lips. Breathe in as deeply and as hard as you can through your mouth. Do not chew or bite on the mouthpiece.

6. Remove your Turbohaler from your mouth. Then breathe out gently. The amount of medicine that is inhaled is very small. This means you may not be able to taste it after inhalation. If you have followed the instructions, you can be confident that you have inhaled the dose and the medicine is now in your lungs.

7. If you are to take a second inhalation, repeat steps 2 to 6.

8. Replace the cover tightly after use.

Do not try to remove the mouthpiece since it is fixed to your Turbohaler and must not be taken off. The mouthpiece can be rotated but do not twist it unnecessarily. Do not use your Turbohaler if it has been damaged or if the mouthpiece has come apart from your Turbohaler.

As with all inhalers, caregivers should ensure that children prescribed Oxis Turbohaler use correct inhalation technique, as described above.

Wipe the outside of the mouthpiece once a week with a dry tissue. Do not use water or liquids.

• The dose indicator tells you how many doses are left in the Turbohaler, starting with 60 doses when it is full.

• The dose indicator is marked in intervals of 10 doses. Therefore, it does not show every dose. When you first see a red mark at the edge of the indicator window, there are approximately 20 doses left. For the last 10 doses, the background of the dose indicator is red. When the ‘0’ on the red background has reached the middle of the window, you must start using a new Turbohaler.

Note:

• The grip will still twist and ‘click’ even when your Turbohaler is empty.
• The sound that you hear as you shake your Turbohaler is produced by a drying agent and not the medicine. Therefore, the sound does not tell you how much medicine is left in your Turbohaler.
• If you load your Oxis Turbohaler more than once by mistake before taking your dose, you will still only receive one dose. However, the dose indicator will register all the loaded doses.

If you use more Oxis Turbohaler than you should, contact your doctor or pharmacist for advice immediately. The following effects may happen: trembling, headache or a rapid heartbeat.

If you forget to take a dose, take it as soon as you remember. However, if it is nearly time for your next dose, skip the missed dose.

Do not take a double dose to make up for a forgotten dose.

Do not stop using Oxis Turbohaler without talking to your doctor.

• Bronchospasm (tightening of the muscles in the airways which causes sudden wheezing) after inhaling your medicine. This happens very rarely, may affect up to 1 in 10,000 people.

Common (may affect up to 1 in 10 people)

• Trembling or shaking. If these effects occur, they are usually mild and usually disappear as you continue to use Oxis Turbohaler.
• Headache.
• Feeling dizzy.
• Nausea (feeling sick).
• Muscle cramps.

Uncommon (may affect up to 1 in 100 people)

• Palpitations (awareness of your heart beating). If this effect occurs, it is usually mild and usually disappear as you continue to use Oxis Turbohaler.
• Disturbed sleep.
• Fast heart beat.
• Allergic reactions such as rash, itching and bronchospasm.
• Low level of potassium in your blood.
• An increase in the amount of sugar (glucose) in your blood.
• Taste changes, such as an unpleasant taste in the mouth.
• Changes in your blood pressure.
• Uneven heart beat.
• Chest pain or tightness in the chest (angina pectoris).

Rare (may affect up to 1 in 1,000 people)

• Feeling restless or agitated.

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly (see details below).

By reporting side effects you can help provide more information on the safety of this medicine.

United Kingdom

or search for MHRA Yellow Card in the Google Play or Apple App Store.

The active substance is formoterol fumarate dihydrate. Each dose contains 6 micrograms of formoterol fumarate dihydrate of which you can inhale 4.5 micrograms.

The other ingredient is lactose monohydrate (which contains milk proteins). See section 2 Oxis Turbohaler contains lactose.

Oxis Turbohaler 6 is an inhaler containing your medicine. The inhalation powder is white in colour. Each Turbohaler contains 60 doses and has a white body with a turquoise turning grip.

Oxis Turbohaler 6 is available in the following pack sizes: 60 doses (1 inhaler), 3x60 doses (3 inhalers), 10x60 doses (10 inhalers), 18x60 doses (18 inhalers) or 20x60 doses (20 Inhalers).

Not all pack sizes may be marketed.

The Marketing Authorisation for Oxis Turbohaler 6 in the United Kingdom is held by

Oxis Turbohaler 6 is manufactured by