Medicine Information

Dilbro-Unicap

Name: Dilbro-Unicap
Brand: Dilbro-Unicap
Rating: 4.5 (117 reviews)

Inhalation Capsule (for use with inhaler device)Tiotropium Bromide 18 mcg + Olodaterol Hydrochloride 5 mcgBronchodilators (Long-acting Muscarinic Antagonist + Long-acting Beta-2 Adrenergic Agonist)ATC: R03AL06

Generic Name

dilbro-unicap-110-mcg-inhalation-capsule

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
dilbro unicap 110 mcg inhalation capsule	৳ 70.00	৳ 700.00

Description

Overview of the medicine

Dilbro-Unicap 110 mcg is an inhalation capsule containing a combination of Tiotropium Bromide (a long-acting muscarinic antagonist) and Olodaterol Hydrochloride (a long-acting beta-2 adrenergic agonist). It is used for the long-term, once-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It helps to relax the muscles around the airways, making it easier to breathe.

Uses & Indications

Long-term, once-daily maintenance bronchodilator treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

Reduction of COPD exacerbations.

Dosage

Adults

The recommended dosage is the inhalation of the contents of one capsule once daily, using the appropriate inhalation device. It should be used at the same time each day.

Elderly

No dosage adjustment is required for elderly patients.

Renal_impairment

No dosage adjustment is required for patients with mild to moderate renal impairment. For severe renal impairment, use with caution and monitor for potential side effects.

How to Take

For oral inhalation only, using the accompanying inhaler device. Do not swallow the capsule. The capsule should be placed in the device, and the patient should inhale the medicine through the mouthpiece as directed by a healthcare professional. Ensure proper inhalation technique.

Mechanism of Action

Tiotropium is a long-acting muscarinic antagonist (LAMA) that inhibits M1, M2, and M3 muscarinic receptors in the airways, primarily blocking M3 receptors which leads to bronchial smooth muscle relaxation. Olodaterol is a long-acting beta-2 adrenergic agonist (LABA) that selectively stimulates beta-2 receptors in the bronchial smooth muscle, causing bronchodilation.

Pharmacokinetics

Onset

Within 5 minutes (for olodaterol component, tiotropium also has a rapid onset).

Excretion

Tiotropium: Primarily unchanged in urine (renal clearance 74%). Olodaterol: Primarily via feces (58%), with renal excretion (17%).

Half life

Tiotropium: 25-30 hours (terminal). Olodaterol: Approximately 45 hours (terminal).

Absorption

Tiotropium: Low systemic absorption after inhalation, absolute bioavailability 19.5%. Olodaterol: High systemic exposure after inhalation, absolute bioavailability 30%. Both reach peak plasma concentrations within 5-10 minutes post-inhalation.

Metabolism

Tiotropium: Minor metabolism via ester cleavage. Olodaterol: Primarily by direct glucuronidation and O-demethylation followed by conjugation.

Side Effects

Contraindications

Hypersensitivity to tiotropium, olodaterol, or any excipients.
Patients with a history of severe hypersensitivity to milk proteins (if capsules contain lactose).
Not for initial treatment of acute episodes of bronchospasm or for relief of acute symptoms (rescue therapy).

Drug Interactions

Beta-blockers

May weaken or antagonize the effect of olodaterol. Cardioselective beta-blockers may be used with caution, but non-selective beta-blockers should generally be avoided.

Other Anticholinergics

Concurrent administration of other anticholinergic-containing drugs may potentiate anticholinergic adverse effects. Avoid co-administration.

Diuretics (non-potassium sparing)

May exacerbate hypokalemia when co-administered with LABAs, increasing the risk of arrhythmias.

MAOIs, Tricyclic Antidepressants, QT-prolonging drugs

May potentiate the effect of olodaterol on the cardiovascular system. Use with extreme caution.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Overdose may lead to exaggerated anticholinergic effects (e.g., dry mouth, blurred vision, increased heart rate, urinary retention) from tiotropium, and exaggerated beta-adrenergic effects (e.g., tachycardia, palpitations, arrhythmia, tremor, headache, nausea, hypokalemia, hyperglycemia) from olodaterol. Treatment is symptomatic and supportive.

Pregnancy & Lactation

Pregnancy Category C. Use only if the potential benefit outweighs the potential risk to the fetus. It is not known whether tiotropium or olodaterol are excreted in human milk. Exercise caution when administered to a nursing woman.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

30 inhalation capsules with a reusable inhaler device30 inhalation capsules (refill pack)

Shelf Life

Typically 24-36 months, refer to product packaging for exact date.

Availability

Available in pharmacies nationwide

Approval Status

Approved (e.g., by DGDA)

Patent Status

Patent expired for active ingredients, product patent might exist for specific formulation

Clinical Trials

Extensive clinical trials (e.g., OTEMTO and TONADO programs) have demonstrated the efficacy and safety of tiotropium/olodaterol combination in improving lung function and health-related quality of life in COPD patients.

Lab Monitoring

Routine monitoring of pulmonary function (FEV1) and COPD symptoms. No specific lab tests are generally required for routine monitoring beyond clinical assessment. Monitor potassium levels in patients predisposed to hypokalemia.

Doctor Notes

Emphasize correct inhaler technique for optimal drug delivery.
Monitor patients for signs of paradoxical bronchospasm.
Caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction.

Patient Guidelines

Use exactly as prescribed by your doctor.
Do not use for sudden breathing problems; use your rescue inhaler for acute symptoms.
Always use the designated inhaler device for the capsules. Do not swallow the capsules.
Rinse your mouth after use to reduce the risk of oral thrush (though less common with LAMA/LABA than ICS).

Missed Dose Advice

If a dose is missed, skip the missed dose and take the next dose at the regularly scheduled time. Do not take two doses at once to make up for a missed dose.

Driving Precautions

This medicine is unlikely to affect the ability to drive or operate machinery. However, if you experience side effects like dizziness or blurred vision, avoid driving or operating heavy machinery.

Lifestyle Advice

Quit smoking to slow the progression of COPD.
Avoid exposure to air pollutants, dust, and allergens.
Regular exercise (as tolerated) and a healthy diet can improve overall lung health.
Stay hydrated.