Trimbow (beclomethasone dipropionate/formoterol fumarate/glycopyrrolate) is a prescription inhaler used for the maintenance treatment of asthma. It combines three medicines in a single inhaler to help control asthma symptoms.
While Trimbow can be a helpful treatment, it can also cause side effects and may interact with other medicines.
Keep reading to learn about possible Trimbow side effects, how to manage them, and which medicines may interact with Trimbow. This article does not include all possible side effects or interactions. Tell your health care provider about any symptoms that concern you or do not improve.
Trimbow Side Effects
Common side effects
The most common side effects reported with Trimbow include:
- Bronchitis
- High or increased blood pressure
- Back pain
- Hoarseness or laryngitis
- Infection in the nose or throat, sore throat, or common cold symptoms
- Flu
- Muscle spasms
- Mouth pain or sore throat
- Sinusitis
Serious side effects
While less common, potentially serious side effects of Trimbow may include:
- Fungal infection in the mouth or throat (oral thrush)
- Sudden breathing problems (paradoxical bronchospasm) or worsening of asthma
- Eye problems (glaucoma, cataracts)
- Trouble emptying your bladder (urinary retention)
- Adrenal gland problems
- Increased risk of infections
- Heart problems
- Weakened bones
- Shaking or nervousness
- Slow growth (in children)
- Serious allergic reactions
If you have symptoms that feel serious or life-threatening, seek medical care right away.
How to Manage Trimbow Side Effects
While not a complete guide, the following tips can help you prevent or manage common side effects of Trimbow.
1. Oral thrush
Trimbow contains beclomethasone dipropionate, an inhaled corticosteroid. Like other inhaled corticosteroids, it can increase the risk of a fungal (yeast) infection in the mouth or throat called oral thrush.
Possible symptoms include:
- White patches in the mouth or throat
- Mouth soreness
- Pain when swallowing
- A cotton-like feeling in the mouth
To help prevent oral thrush:
- Rinse your mouth with water after each dose.
- Spit out the water after rinsing.
- Do not swallow the water.
Tell your health care provider if you have symptoms of oral thrush. They may prescribe an antifungal medicine. Typically, it is OK to continue using Trimbow while treating oral thrush, but your health care provider will let you know if you should temporarily stop using it.
2. Respiratory infections
Because Trimbow contains a corticosteroid, it may make it harder for your immune system to fight infections. Infections of the airways or lungs, such as upper respiratory tract infections, bronchitis, flu, and sinusitis, were among the side effects reported during clinical trials of Trimbow.
Possible symptoms include:
- Cough
- Congestion
- Sore throat
- Fever
To help lower your risk:
- Wash your hands regularly.
- Avoid close contact with people who are sick when possible.
- Stay up to date on recommended vaccines.
- Tell your health care provider if you have a history of tuberculosis or other chronic infections.
Contact your health care provider if you think you have an infection or if your symptoms are severe, do not go away, or get worse. Depending on the type of infection, treatment may be necessary.
3. Hoarseness and throat irritation
Voice hoarseness or inflamed vocal cords (laryngitis) are possible Trimbow side effects. Some people may also have discomfort in their mouth or throat while using Trimbow. Inhaled medicines can sometimes irritate your mouth and airways.
Possible symptoms include voice changes, sore throat, or discomfort in the back of your mouth or throat.
To help prevent or manage sore throat symptoms:
- Rinse your mouth with water after each dose and spit it out after rinsing.
- Drink plenty of fluids to prevent dehydration and keep your throat moist.
- Try a lozenge, a numbing throat spray, or sipping warm tea to soothe your throat.
- Gargle with salt water or suck on ice chips.
- Avoid smoking or inhaling other irritants.
Tell your health care provider if these symptoms become bothersome or do not improve. They can also guide you on how to use the inhaler correctly.
4. High blood pressure and heart-related effects
Trimbow contains formoterol, a long-acting beta-2 agonist (LABA). Medicines in this class can sometimes affect the heart and blood vessels. The risk may be higher for people who already have high blood pressure (hypertension) or heart problems.
A rise in blood pressure may not cause any symptoms, but let your health care provider know if you notice any of the following changes after using Trimbow:
- Fast heartbeat
- Irregular heartbeat
- Feeling shaky or jittery
To help lower your risk:
- Use Trimbow exactly as prescribed.
- Do not use another inhaler that contains a LABA unless your health care provider tells you to do so. If you are unsure about what’s in your inhalers, ask your pharmacist or prescriber.
- Eat a healthy diet and get regular exercise. It can help lower your chances of high blood pressure.
Your health care provider may suggest checking your blood pressure at home while using Trimbow. If your blood pressure gets too high, you may need medicines to control your blood pressure or other changes in your treatment plan. Do not change any medicines unless your health care provider tells you to do so.
5. Worsening asthma symptoms
Although Trimbow is used to help control asthma, it can sometimes cause serious breathing problems. In rare cases, people may experience paradoxical bronchospasm, which is a sudden tightening of the airways that occurs after using the inhaler. This can be life-threatening and requires immediate medical attention.
Possible symptoms include:
- Increased wheezing
- Shortness of breath
- Chest tightness
- Coughing after using the inhaler
- Rescue inhaler not working as well as usual
Contact your health care provider or get help right away if your asthma symptoms worsen, if you need your rescue inhaler more often than usual, or if you have sudden breathing problems after using Trimbow.
Trimbow Interactions
Trimbow can interact with other medicines. Some interactions may increase the risk of side effects, while others may make Trimbow less effective. This is not a complete list of interactions, but the following are important to know about.
Medicines that may increase the risk of side effects
Other medicines that contain a LABA. Trimbow contains formoterol, which is a LABA. Using additional medicines that contain formoterol or other LABA may increase the risk of heart-related side effects.
Examples of LABAs include:
- Arformoterol
- Indacaterol
- Olodaterol
- Salmeterol
- Vilanterol
When you start Trimbow, your health care provider will let you know if you should stop any controller inhalers that you were previously using. Do not use another LABA-containing medicine unless your health care provider tells you to do so.
Anticholinergic medicines. Trimbow contains glycopyrrolate, which is an anticholinergic medicine. Using additional anticholinergic medicines may raise the risk of certain side effects, such as dry mouth, urinary retention, or eye problems.
Examples of anticholinergic medicines are:
- Aclidinium
- Chlorpheniramine
- Dimenhydrinate
- Diphenhydramine
- Doxylamine
- Ipratropium
- Oxybutynin
- Scopolamine
- Tiotropium
Some of these medicines are found in prescription inhalers, and some are found in over-the-counter (OTC) products. Always check ingredient labels or ask a pharmacist for help to find OTC products that are safe for you. Avoid taking other anticholinergic medicines unless your health care provider recommends them.
Certain medicines that raise the risk of low potassium levels. Certain medicines can increase the risk of low potassium levels when used with Trimbow.
Examples include:
- Loop diuretics, such as furosemide
- Thiazide diuretics, such as hydrochlorothiazide
- Theophylline and other xanthine derivatives
- Corticosteroids
Your health care provider may recommend closer monitoring if you take these medicines together. Keep all appointments to have blood tests. If your potassium is low, your health care provider may prescribe a potassium supplement.
Certain antidepressants and medicines that affect heart rhythm. Formoterol should be used with caution in people taking:
- Monoamine oxidase inhibitors (MAOIs)
- Some antidepressants, such as amitriptyline and citalopram
- Macrolide antibiotics, such as azithromycin and clarithromycin
- Other medicines that can prolong the QT interval
These combinations may increase the risk of heart-related effects or abnormal heart rhythms.
Tell your health care provider about all medicines you take before starting Trimbow.
Medicines that could make Trimbow less effective
Some medicines may reduce how well Trimbow works.
Beta-blockers. These medicines may interfere with the effects of formoterol.
Examples of beta-blockers include:
- Atenolol
- Carvedilol
- Metoprolol
- Propranolol
In some cases, beta-blockers can make asthma symptoms worse or reduce how well Trimbow works. Do not stop or change any medicines without talking with your health care provider first.
FAQs About Trimbow Interactions
Does Trimbow interact with my rescue inhaler?
No. Most people using Trimbow will also have a rescue inhaler, such as albuterol or levalbuterol, for sudden asthma symptoms. You can and should continue using your rescue inhaler for asthma attacks. Rescue inhalers are commonly used to treat sudden asthma symptoms. Some people also use a rescue inhaler right before exercise to help prevent attacks.
Trimbow is not a rescue inhaler. It should not be used to treat sudden breathing problems or an asthma attack. People using Trimbow should continue to keep a rescue inhaler in case they have sudden asthma symptoms. Contact your health care provider right away if your breathing problems worsen or your rescue inhaler does not seem to work as well as usual.
Does Trimbow interact with supplements?
Possibly. But the drugmaker of Trimbow has not listed any specific supplement interactions in the medicine’s labeling.
Always tell your health care provider and pharmacist about all vitamins, supplements, herbs, and OTC products you take. They can check for any interactions and let you know of any unsafe combinations.
Reducing Your Risk of Side Effects and Interactions
You can help reduce your risk of side effects and interactions by using Trimbow exactly as prescribed and following all instructions from your health care provider.
Here are some helpful tips:
- Rinse your mouth with water after each dose and spit it out after rinsing.
- Keep all follow-up appointments and lab tests.
- Tell your provider about all medicines, vitamins, and supplements you take.
- Report any new or worsening symptoms.
Your health care provider can review your treatment plan and make adjustments if needed to help reduce risks and improve safety.
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