Oxima Plus Acucap | 110mcg+50mcg | 10'S

✔️ Dosage & Administration:

Adults (≥18 years): 1 inhalation once daily at the same time each day.

Not for: Children, adolescents (≤17 years), acute COPD episodes, or asthma.

Geriatric use: Safe at recommended dose.

Renal impairment: Mild to moderate – standard dose; severe impairment – use only if benefits outweigh risks.

Hepatic impairment: Mild to moderate – standard dose; severe – use with caution.

✔️ How to Use the Turbohaler:

• Remove the protective cap.
• Open the mouthpiece by turning it in the direction of the arrow.
• Insert a capsule into the chamber.
• Close the mouthpiece.
• Hold upright, press both push buttons firmly once to pierce the capsule.
• Exhale fully (not into the device), place mouthpiece in mouth, and inhale deeply and steadily. A whirring sound indicates proper operation.
• Remove inhaler, hold breath for 5–10 seconds.
• Rinse mouth with water after use.
• Clean the mouthpiece with water and dry; brush capsule chamber; press the perforation needles several times. Replace cap.

✔️ Overdose:

May cause β2-agonist effects: tachycardia, tremor, palpitations, headache, nausea, vomiting, hypokalemia, hyperglycemia.

May cause anticholinergic effects: increased eye pressure, constipation, difficulty urinating.

Treatment is supportive and symptomatic; hospitalization may be required for severe cases.

✔️ Side Effects:

• Muscarinic effects: Dry mouth, urinary retention, blurred vision, GI disturbances, cardiovascular effects (tachycardia, arrhythmias)
• β2-agonist effects: Tremor, headache, insomnia, nervousness, palpitations, hypokalemia, hyperglycemia
• Most common (>3% vs. placebo): cough and throat irritation

✔️ Pregnancy & Lactation

Category C – use only if benefits outweigh fetal risk.

Unknown if drug is excreted in breast milk; use with caution.

✔️ Interaction

No formal interaction studies, but use caution with:

• β-adrenergic blockers, anticholinergics, sympathomimetics
• Hypokalemic treatments (risk of low potassium)
• Sympathomimetic agents may increase the adverse effects of Indacaterol.

✔️ Contraindications:

Known hypersensitivity to Indacaterol, Glycopyrronium, or device components

• Severe milk protein allergy
• Patients with asthma without long-term asthma control therapy

✔️ Precautions & Warnings

• Not for acute COPD or asthma attacks.
• Avoid use with additional LABA-containing products.
• Monitor for paradoxical bronchospasm; discontinue if it occurs.
• Use with caution in: cardiovascular disease, convulsive disorders, thyrotoxicosis, diabetes, ketoacidosis, narrow-angle glaucoma, urinary retention.
• Monitor potassium and blood sugar levels.

✔️ Storage:

Store in a cool, dry place away from sunlight and heat.

Keep out of reach of children.