Last updated on 19/01/2023

 

Asthma Australia would like to update you on a new listing on the Pharmaceutical Benefits Scheme (PBS), so you know your options when talking about your asthma with your doctor.  

People with severe asthma usually need to use regular inhaled medicines to keep their symptoms under control. This helps to maintain their quality of life and reduces their risk of having an asthma flare-up.  

The Australian Pharmaceutical Benefits Scheme (PBS) has recently listed a new combination preventer inhaler for use by people with severe asthma.  

It’s a new puffer called Trimbow and contains 3 medicines in the one puffer (inhaler). 

TRIMBOW is used to prevent symptoms such as shortness of breath, wheezing and cough in adults with severe asthma. 

WHAT HAS CHANGED? 

Trimbow is a new addition to the list of combination preventer medicines available for those with severe asthma.   

  • It will be prescribed for use twice a day.  
  • It is inhaled through the mouth by a puffer device which may be familiar for people with asthma. (See below for device use instructions.) 
  • The puffer device of Trimbow has been designed to get extra-fine particles to the smaller airways of the lungs.  

HOW WILL THIS CHANGE IMPACT ME? 

For people with severe asthma and their treating health care team, it offers another option for your doctor to consider as part of your medical treatment based on your needs. 

As with everything in asthma, not every medicine and device will work for everybody. 

With any asthma medicine, it is important that: 

  • you can use your device correctly,  
  • you take it regularly and  
  • you have your instructions for use in place with an Asthma Action Plan. 

If you haven’t spoken to your doctor recently about your asthma control, this might be a good time to do so. Together, you should aim for fewer and less severe symptoms and prevention or fewer asthma attacks (flare-ups). Aiming for better asthma control helps you towards achieving your activity and lifestyle goals.  

WHAT IS TRIMBOW pMDI 

Trimbow pMDI (pressurised metered dose inhaler) is a combination preventer puffer. 

Trimbow pMDI: 

  • Trimbow is the brand name which contains the three medicines listed below 
  • pMDI is the device or puffer which you use to deliver the medicines to your lungs. We explain how to use the puffer device below. 

It contains the medicines: 

  • beclometasone dipropionate  
  • formoterol fumarate   
  • glycopyrronium bromide  

Trimbow may also be called a triple therapy combination preventer. 

Trimbow works in two ways due to the action of its three medicines: 

  1. One preventer medicine (Beclometasone): reduces the swelling and irritation in the lungs and helps to ease breathing problems over time 
  2. Two long-acting reliever medicines (Formoterol and glycopyrronium): both relax the muscles in the airways in your lungs. This helps to open the airways and make it easier for you to breathe.  

Strength available for people with Severe Asthma:  

  • TRIMBOW 200/6/10 

WHO CAN USE TRIMBOW? 

Trimbow is available by prescription only. It is for adults 18 years and over with severe asthma. 

Trimbow may be prescribed to people who:  

  • Have experienced a serious flareup in the past 12 months  
  • Have been using a high strength combination preventer  
  • Demonstrate correct inhaler technique with this preventer, and 
  • Have been using that preventer regularly, as prescribed. 

HOW OFTEN IS IT USED? 

Trimbow is usually prescribed as 2 puffs in the morning and 2 puffs in the evening, every day. 

It needs to be taken every day to be effective. It should not be used to relieve a sudden episode of breathlessness or wheezing.  

The recommended dose for you will be: 

  • 2 puffs in the morning and  
  • 2 puffs in the evening, every day.  

Each container provides 120 puffs. Using 2 puffs morning and night, will give you one month of treatment. 

HOW TO USE YOUR TRIMBOW INHALER 

It is important to use your puffer device correctly to get the most benefit from the medicine. Watch this puffer instruction video and be sure to ask your doctor or pharmacist to check that you are using your puffer correctly.  

This medicine is contained in a pressurised container enclosed in a plastic inhaler with a mouthpiece. 

You do not need to shake this inhaler as the medicine is in a solution. 

Remember to wash your hands before using your inhaler device

1. Open device

    1. Remove dust cap

2. With each dose:

  1. Breathe out gently away from puffer 
  2. Put mouthpiece of puffer between teeth without biting and close lips to form a good seal 
  3. Breathe in slowly and deeply 
  4. Just after starting your breath in, press down on the top of the puffer’s pressurised container firmly to release one puff 
  5. Continue to breathe in until your lungs are full and hold your breath for up to 4-5 seconds or as long as is comfortable 
  6. Remove puffer from your mouth and breathe out gently away from the device

3. Repeat for second dose

4. Check that the dose counter has moved down by two

5. Replace the dust cap

6. Rinse your mouth out with water after use, or gargle without swallowing.

You can use Trimbow puffer with a spacer. 

Spacers are used with puffers to help get more medicine into your lungs. See our Spacer page for more help using spacers.  

Other important points: 

  • Test your puffer when first removed from the pack by firmly pressing the pressurised container whilst holding the device upright and pointing it away from you. Check the dose counter has moved after doing so 
  • Take care not to drop the puffer as this may cause the counter to count down. 
  • Ensure your device is always clean 
  • Take your medicine at the same time each day 
  • As with all medicines, some side effects may occur. Most commonly this might be sore, raised patches in the mouth and throat, caused by a fungal infection. You can prevent or lower your chance of this side effect by using a spacer with your puffer and rinsing your mouth with a water. Rinse, gargle and spit after use. 
  • Report all side effects to your doctor. Make an urgent appointment with your doctor if you feel like your asthma is worsening.   

CLEANING YOUR TRIMBOW INHALER 

You should clean your inhaler once a week. 

  • Do not remove the pressurised container from the inhaler and do not use water or other liquids to clean your inhaler. 
  • Remove the protective cap from the mouthpiece by pulling it away from your inhaler. 
  • Wipe inside and outside of the mouthpiece and the inhaler with a clean, dry cloth or tissue. 
  • Replace the mouthpiece cap. 

IN SUMMARY 

  • Trimbow is a new medicine available in Australia for people with asthma, available by prescription only for people aged 18 years and over 
  • It is a triple therapy combination preventer medicine. It is prescribed for daily use to prevent symptoms and asthma attacks (flare-ups) for people with severe asthma 
  • The list of asthma medicines available in Australia is growing. This is good news for you and your treating health professional as there are now more options to get the right treatment for your individual needs 
  • Regular preventer use is important to help you control your asthma, prevent flare ups and improve your quality of life 
  • To get the most benefit from your asthma preventer, make sure you use it regularly as prescribed 
  • When starting a new puffer, it’s a good time to review your puffer techniques. Ask your doctor to check your puffer technique and update your Asthma Action Plan which clearly describes how to use your asthma medicines and what to do in case of worsening asthma 
  • If symptoms are still not controlled while using Trimbow it is important to review your asthma urgently. 

Want to know more? For more information about Trimbow or to speak with an Asthma Educator about your asthma, call 1800 ASTHMA (1800 278 462).