Divitrop F 6mcg/9mcg Inhaler: Complete Guide to Uses, Side Effects, and Safety
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Sudden worsening of breathing or wheezing immediately after using the inhaler
- Severe chest pain or palpitations
- Signs of a severe allergic reaction: rash, swelling of face, lips, or throat, difficulty breathing
- Fever, chills, increased cough, or difficulty breathing (possible pneumonia)
- Difficulty urinating or severe eye pain (anticholinergic effects)
- Irregular heartbeat or fainting
- Yellowing of skin or eyes (jaundice)
If experiencing severe symptoms, call emergency services immediately.
What is ibitrop nexhaler used for?
This medicine is a combination inhaler containing formoterol (a LABA) and tiotropium (a LAMA). It is used for maintenance treatment of COPD and severe asthma. It works by relaxing airway muscles to make breathing easier. It is not a rescue inhaler.
- Generic Name: Formoterol (6mcg) + Tiotropium (9mcg)
- Manufacturer: Indiabulls pharmaceutical ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 ibitrop nexhaler के बारे में (Hindi Summary)
उपयोग: यह दवा फोर्मोटेरोल और टायोट्रोपियम का संयोजन है, जिसका उपयोग क्रोनिक ऑब्सट्रक्टिव पल्मोनरी डिजीज (सीओपीडी) और गंभीर अस्थमा के रखरखाव उपचार के लिए किया जाता है। यह सांस की नली की मांसपेशियों को आराम देकर सांस लेना आसान बनाती है। यह दवा तुरंत सांस की तकलीफ के लिए नहीं है, बल्कि नियमित उपयोग के लिए है। इसे डॉक्टर के निर्देशानुसार ही लें।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में गले में खराश, सिरदर्द, पीठ दर्द, खांसी और मुंह सूखना शामिल हैं। ये आमतौर पर हल्के होते हैं और कुछ समय में ठीक हो जाते हैं। गंभीर दुष्प्रभावों में दिल की धड़कन तेज होना, सीने में दर्द, एलर्जी की प्रतिक्रिया, और सांस लेने में कठिनाई शामिल हैं। अगर ऐसा कुछ हो, तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा का उपयोग डॉक्टर के बताए अनुसार ही करें। इसे तुरंत सांस की तकलीफ के लिए रेस्क्यू इनहेलर की तरह न लें। हर बार इनहेलर लेने के बाद मुंह को पानी से धोएं। दवा की खुराक न बढ़ाएं। अगर आपको दिल, किडनी, लिवर या डायबिटीज की समस्या है, तो डॉक्टर को बताएं। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें।
💊 ibitrop nexhaler Uses & Benefits
- [{"condition":"Chronic Obstructive Pulmonary Disease (COPD)","description":"This medicine is used for long-term maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and emphysema.
- It helps improve lung function and reduces symptoms such as shortness of breath and wheezing.","evidence":"Well-established"},{"condition":"Asthma (maintenance therapy)","description":"This medicine may be prescribed as part of a combination regimen with an inhaled corticosteroid for patients with severe asthma whose symptoms are not controlled by other treatments.
- It is not for acute asthma attacks.","evidence":"Established for use with inhaled corticosteroids"}]
Off-label uses: [{"condition":"Bronchiectasis","description":"Sometimes prescribed off-label to help with airway obstruction in bronchiectasis, though evidence is limited.","evidence":"Limited"}]
Primary treatment for: Chronic Obstructive Pulmonary Disease (COPD)
Also treats: Asthma (severe, as add-on therapy)
📋 Drug Information
| Generic Name(s) | Formoterol (6mcg) + Tiotropium (9mcg) |
| Brand Name | ibitrop nexhaler |
| Manufacturer | Indiabulls pharmaceutical ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | RESPIRATORY |
| Action Class | |
| Route of Administration | Inhalation |
| Storage | Store at room temperature (15-30°C) in a dry place, away from direct sunlight and heat. Do not refrigerate or freeze. Keep the inhaler in its original packaging to protect from moisture. Do not puncture or incinerate the canister. |
| Shelf Life | 24 months from the date of manufacture, or as printed on the packaging. |
| WHO Guideline | Not established from the available information. Guidelines recommend LABA/LAMA combinations for COPD patients with persistent symptoms. Consult current guidelines. |
| ICMR Guideline | Not established from the available information. ICMR guidelines for COPD management may include LABA/LAMA combinations. Consult current guidelines. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two bronchodilators with different mechanisms of action. Formoterol, a long-acting beta-2 agonist, selectively stimulates beta-2 adrenergic receptors on airway smooth muscle cells, leading to relaxation and widening of the airways. Tiotropium, a long-acting muscarinic antagonist, blocks muscarinic receptors in the airways, preventing acetylcholine from causing bronchoconstriction and mucus secretion. Together, they provide sustained bronchodilation through complementary pathways, improving airflow and reducing symptoms in obstructive lung diseases.
Mechanism Steps
💡 How to Take ibitrop nexhaler
Strength: Inhaler containing formoterol 6 mcg and tiotropium 9 mcg per actuation.
Dosage Information
| Adult Dosage | The usual adult dose of this medicine is one inhalation once daily, preferably at the same time each day. The dose may be adjusted by your doctor based on your condition and response to treatment. Do not exceed the prescribed dose. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | No specific dose adjustment is required for elderly patients based on age alone. However, elderly patients may be more sensitive to the effects of this medicine, especially cardiac effects. Use with caution and monitor closely. |
| Renal Impairment | Tiotropium is primarily excreted by the kidneys. In patients with moderate to severe renal impairment, systemic exposure may increase. Use with caution and monitor renal function. Dose adjustment may be necessary as per clinician's judgment. |
| Hepatic Impairment | Formoterol is metabolized in the liver. In patients with severe hepatic impairment, systemic exposure may increase. Use with caution and monitor for side effects. Dose adjustment may be necessary as per clinician's judgment. |
| Maximum Daily Dose | The maximum recommended daily dose is one inhalation of the 6 mcg/9 mcg strength. Do not exceed this dose unless specifically instructed by your doctor. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of ibitrop nexhaler
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Salbutamol | Major | |
| Furosemide | Major | |
| Propranolol | Major | |
| Prednisolone | Moderate | |
| Theophylline | Moderate | |
| Ipratropium | Moderate | |
| Cimetidine | Minor | |
| Ketoconazole | Minor | |
| Alcohol | Moderate | |
| Grapefruit juice | Minor |
🚨 Major Interactions
- Other beta-agonists (e.g., salbutamol)
- Non-potassium-sparing diuretics (e.g., furosemide)
- MAO inhibitors and tricyclic antidepressants
- Beta-blockers (e.g., propranolol)
⚡ Moderate Interactions
- Corticosteroids (oral or inhaled)
- Xanthine derivatives (e.g., theophylline)
- Anticholinergics (e.g., ipratropium)
🍷 Alcohol Interaction
Alcohol may increase the risk of dizziness, drowsiness, and changes in heart rate when used with this medicine. It is advisable to limit or avoid alcohol while using this inhaler.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Hypersensitivity to formoterol, tiotropium, or any component of the inhaler","Severe milk-protein allergy (if applicable to the specific product)","Acute bronchospasm requiring immediate rescue therapy","Children under 18 years for COPD indication"]
⚠️ Warnings & Precautions
["Do not use as a rescue inhaler for acute breathing attacks.","Rinse mouth after inhalation to prevent oral thrush.","Use with caution in patients with cardiovascular disease, especially arrhythmias.","Monitor potassium levels if using diuretics or corticosteroids.","May cause paradoxical bronchospasm; stop use and seek help if breathing worsens.","Not recommended for patients with severe renal impairment without dose adjustment.","Use with caution in patients with narrow-angle glaucoma or urinary retention.","Do not exceed prescribed dose; higher doses may cause serious cardiac effects.","Inform your doctor if you are pregnant, planning pregnancy, or breastfeeding.","Keep out of reach of children."]
🤱 Lactation Safety
It is not known whether formoterol or tiotropium pass into breast milk. Because many drugs do, caution is advised when using this medicine during breastfeeding. Consult your doctor to weigh the benefits and risks.
💊 Overdose Management
Overdose with this inhaler may cause severe tachycardia, palpitations, tremor, headache, and hypokalemia. If you suspect an overdose, seek emergency medical attention immediately. Treatment is supportive and symptomatic, including monitoring of vital signs and electrolytes. There is no specific antidote.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Additional Safety Advice
Always use this medicine exactly as prescribed by your doctor. Do not use it as a rescue inhaler for sudden breathing problems; keep a separate fast-acting rescue inhaler available at all times. Rinse your mouth with water after each inhalation to reduce the risk of oral thrush and throat irritation. Do not exceed the prescribed dose, as higher doses can increase the risk of serious heart-related side effects. Inform your doctor if you have heart disease, high blood pressure, irregular heartbeat, thyroid problems, diabetes, or kidney or liver disease. Do not stop using this medicine suddenly without talking to your doctor, as your breathing may worsen. Keep this medicine away from children and store it as directed on the packaging. If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor before using this medicine.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients may be more sensitive to the cardiac effects of formoterol, such as increased heart rate and palpitations. Monitor heart rate and blood pressure regularly. Renal function should be assessed before starting tiotropium, as it is excreted by the kidneys. No dose adjustment is required based on age alone, but individualization is important.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before using this medicine. The safety of this combination during pregnancy is not well established. Your doctor will weigh the benefits and risks and may adjust your treatment.
🏥 Post-Surgery Considerations
Inform your surgeon and anesthesiologist that you are using this inhaler before any surgery. It may interact with certain anesthetic agents. Continue using it as prescribed unless told otherwise. Monitor for respiratory complications after surgery.
🦷 Dental Procedures
Inform your dentist that you are using this inhaler, as it may cause dry mouth, which can increase the risk of dental problems. Rinsing your mouth after inhalation can help. No specific precautions are needed for dental procedures, but maintain good oral hygiene.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Exercise can be beneficial, but avoid strenuous activity in extreme weather or high pollution. Use your rescue inhaler if you experience shortness of breath during exercise. Consult your doctor before starting a new exercise regimen.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause dizziness or blurred vision in some people. Avoid driving or operating heavy machinery until you know how it affects you. It should not interfere with most work activities, but if your job involves exposure to respiratory irritants, take precautions.
🛑 When to Stop This Medicine
Do not stop using this medicine without consulting your doctor. If you experience severe side effects or your condition worsens, contact your doctor immediately. Your doctor may adjust the dose or switch to a different treatment.
📅 Long-Term Use Effects
Long-term use of this medicine is generally safe for managing COPD and asthma. However, regular monitoring of lung function, heart rate, and potassium levels is advised. Some patients may develop tolerance to the bronchodilator effects, and the risk of pneumonia may be slightly increased in COPD patients. Periodic review with your doctor is necessary to assess the continued benefit and adjust treatment as needed.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
A structured program of exercise, education, and support that can improve breathing and quality of life.
Evidence: Well-establishedTechniques like pursed-lip breathing and diaphragmatic breathing can help manage shortness of breath.
Evidence: EstablishedFor patients with severe COPD and low blood oxygen levels, supplemental oxygen may be prescribed.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
Patients with COPD should receive annual influenza vaccination and pneumococcal vaccination as per guidelines. These vaccines can reduce the risk of respiratory infections that may exacerbate COPD symptoms. Consult your doctor for appropriate timing.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate or freeze
✅ DO
Keep in original container
❌ DON'T
Do not puncture or incinerate the canister
✅ DO
Keep away from direct sunlight and heat
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
Carry your inhaler in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid temperature extremes in checked baggage. If traveling across time zones, continue taking your dose at the same interval as prescribed; consult your doctor for specific advice. Ensure you have enough supply for your trip and a backup rescue inhaler. Check customs regulations for carrying prescription inhalers.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: Formoterol starts working within 5-15 minutes, but the full benefits of the combination may take a few days to weeks of regular use.
A: No, this is a maintenance inhaler and should not be used for sudden breathing attacks. Always use a rescue inhaler for acute symptoms.
A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
A: Avoid grapefruit juice as it may increase drug levels. Limit caffeine as it may increase heart rate.
A: No, do not stop without consulting your doctor. This medicine controls symptoms but does not cure the condition. Stopping suddenly can worsen your breathing.
🤔 Common Patient Concerns
🔄 Substitutes for ibitrop nexhaler
View AllAlternative brands with exact same active ingredient:
-
divitrop f 6mcg/9mcg inhalerDivine Savior Pvt Ltd ₹442.50 15.7% CHEAPER
-
tioform hfa 6mcg/9mcg inhalerZydus Cadila ₹478.13 8.9% CHEAPER
-
airtio-f 6mcg/9mcg inhalerGlenmark Pharmaceuticals Ltd ₹545.00 3.8% COSTLIER
-
aerotrop-f inhalerMacleods Pharmaceuticals Pvt Ltd ₹679.43 29.4% COSTLIER
-
duova 6mcg/9mcg inhalerCipla Ltd ₹697.01 32.8% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine can be used as a rescue inhaler.
Fact: This medicine is a maintenance inhaler and should not be used for sudden breathing attacks. Always keep a rescue inhaler available. - Myth: Once you feel better, you can stop using this medicine.
Fact: This medicine controls symptoms but does not cure the disease. Stopping suddenly can worsen your condition. Consult your doctor before stopping. - Myth: This medicine is addictive.
Fact: This medicine is not addictive. It is a bronchodilator that helps manage chronic lung conditions.