Inhalers, Respules & Bronchodilators

Budesonide Inhalation / Nebuliser Suspension (100mcg, 200mcg MDI; 400mcg Rotacaps; 1mg/2ml Respules) is a potent inhaled glucocorticoid on the WHO Model List of Essential Medicines. It diffuses into airway epithelial cells, binding to cytoplasmic glucocorticoid receptors to inhibit multiple pro-inflammatory transcription factors (NF-kB, AP-1), dramatically reducing recruitment of eosinophils, T-lymphocytes, and mast cells while downregulating inflammatory cytokines. Undergoes reversible intracellular esterification with fatty acids, creating a prolonged mucosal depot. Indicated for maintenance treatment of bronchial asthma, croup (laryngotracheobronchitis in infants/children), and severe COPD.

Budesonide Inhalation / Nebuliser Suspension (100mcg, 200mcg MDI; 400mcg Rotacaps; 1mg/2ml Respules) is a potent inhaled glucocorticoid on the WHO Model List of Essential Medicines. It diffuses into airway epithelial cells, binding to cytoplasmic glucocorticoid receptors to inhibit multiple pro-inflammatory transcription factors (NF-kB, AP-1), dramatically reducing recruitment of eosinophils, T-lymphocytes, and mast cells while downregulating inflammatory cytokines. Undergoes reversible intracellular esterification with fatty acids, creating a prolonged mucosal depot. Indicated for maintenance treatment of bronchial asthma, croup (laryngotracheobronchitis in infants/children), and severe COPD.

Budesonide Inhalation / Nebuliser Suspension (100mcg, 200mcg MDI; 400mcg Rotacaps; 1mg/2ml Respules) is a potent inhaled glucocorticoid on the WHO Model List of Essential Medicines. It diffuses into airway epithelial cells, binding to cytoplasmic glucocorticoid receptors to inhibit multiple pro-inflammatory transcription factors (NF-kB, AP-1), dramatically reducing recruitment of eosinophils, T-lymphocytes, and mast cells while downregulating inflammatory cytokines. Undergoes reversible intracellular esterification with fatty acids, creating a prolonged mucosal depot. Indicated for maintenance treatment of bronchial asthma, croup (laryngotracheobronchitis in infants/children), and severe COPD.

Etophylline and Theophylline Tablets (77mg/23mg, 115mg/35mg PR, 231mg/69mg PR, 400mg Theophylline PR) is an oral methylxanthine bronchodilator on the WHO Model List of Essential Medicines. Etophylline enhances the water solubility and gastric tolerance of theophylline. Inhibits phosphodiesterase and antagonizes adenosine receptors to provide continuous bronchodilation and enhance diaphragmatic muscle endurance. Indicated for long-term maintenance of reversible bronchospasm in bronchial asthma, chronic bronchitis, and COPD.

Salbutamol / Albuterol Inhalation (100mcg MDI, 200mcg Rotacaps) is the quintessential short-acting selective beta-2 adrenergic receptor agonist (SABA) on the WHO Model List of Essential Medicines. It binds to beta-2 adrenergic receptors on airway smooth muscle cells, activating adenylyl cyclase, elevating cyclic AMP, and causing rapid relaxation of bronchial smooth muscle within 3 to 5 minutes, lasting 4 to 6 hours. Indicated for immediate relief of acute bronchospasm in bronchial asthma, acute exacerbations of COPD, and prevention of exercise-induced bronchoconstriction.

Salbutamol Tablets (2mg, 4mg) and Syrup (2mg/5ml) is an oral selective beta-2 adrenergic receptor agonist on the WHO Model List of Essential Medicines. Relaxes bronchial smooth muscle via adenylyl cyclase activation. Indicated for relief of bronchospasm in asthma and reversible obstructive airway disease when inhalation devices cannot be used (e.g. young children or severely arthritic patients).

Salbutamol Tablets (2mg, 4mg) and Syrup (2mg/5ml) is an oral selective beta-2 adrenergic receptor agonist on the WHO Model List of Essential Medicines. Relaxes bronchial smooth muscle via adenylyl cyclase activation. Indicated for relief of bronchospasm in asthma and reversible obstructive airway disease when inhalation devices cannot be used (e.g. young children or severely arthritic patients).

Salbutamol (100mcg) and Ipratropium Bromide (20mcg Inhaler) combines a short-acting beta-2 agonist (SABA) with a short-acting muscarinic antagonist (SAMA) on the WHO Model List of Essential Medicines. Salbutamol relaxes bronchial smooth muscle via cyclic AMP elevation; ipratropium blocks vagal acetylcholine-mediated bronchoconstriction at muscarinic M3 receptors. This dual-pathway approach produces greater, longer-lasting bronchodilation than either agent alone without added sympathomimetic side effects. Indicated for management of bronchospasm in Chronic Obstructive Pulmonary Disease (COPD) and acute severe asthma exacerbations.

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Budesonide Inhalation / Nebuliser Suspension (100mcg, 200mcg MDI; 400mcg Rotacaps; 1mg/2ml Respules) is a potent inhaled glucocorticoid on the WHO Model List of Essential Medicines. It diffuses into airway epithelial cells, binding to cytoplasmic glucocorticoid receptors to inhibit multiple pro-inflammatory transcription factors (NF-kB, AP-1), dramatically reducing recruitment of eosinophils, T-lymphocytes, and mast cells while downregulating inflammatory cytokines. Undergoes reversible intracellular esterification with fatty acids, creating a prolonged mucosal depot. Indicated for maintenance treatment of bronchial asthma, croup (laryngotracheobronchitis in infants/children), and severe COPD.

Acebrophylline Capsules / Tablets (100mg, 200mg Sustained Release; alone or with Montelukast 10mg or Acetylcysteine 600mg) is a fixed salt of ambroxol and theophylline-7-acetic acid on the PMBI formulary. It exerts a triple therapeutic action: potent bronchodilation via phosphodiesterase inhibition; mucoregulatory and surfactant-stimulating action via ambroxol (stimulating alveolar type II pneumocytes to produce pulmonary surfactant, reducing mucus viscosity and improving mucociliary clearance); and anti-inflammatory inhibition of phospholipase A2 and leukotriene C4. Indicated for bronchial asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, and chronic spastic bronchitis with thick viscid sputum.

Doxofylline Tablets (400mg; alone or with Montelukast 10mg) is a novel xanthine derivative bronchodilator on the PMBI formulary. Unlike theophylline, it contains a dioxolane group at position 7 that specifically inhibits phosphodiesterase without binding to adenosine receptors or interfering with calcium influx. This confers potent bronchodilatory and anti-inflammatory activity with dramatically fewer cardiac, gastric, and CNS side effects (negligible tachycardia, insomnia, or gastric hypersecretion) and a 10-fold wider therapeutic window. Indicated for maintenance treatment of bronchial asthma, COPD, and spastic bronchitis.

Tiotropium Bromide (18mcg) and Formoterol Fumarate (12mcg, with or without Ciclesonide 400mcg / Inhaler / Rotacaps) is a dual/triple bronchodilator therapy for advanced COPD and severe refractory asthma. Tiotropium is a long-acting muscarinic antagonist (LAMA) with prolonged M3 receptor dissociation kinetics (>36 hours); formoterol is a fast-acting LABA; ciclesonide is an on-site activated corticosteroid prodrug. Indicated for maintenance treatment of severe COPD and persistent severe asthma with frequent exacerbations.

Tiotropium Bromide (18mcg) and Formoterol Fumarate (12mcg, with or without Ciclesonide 400mcg / Inhaler / Rotacaps) is a dual/triple bronchodilator therapy for advanced COPD and severe refractory asthma. Tiotropium is a long-acting muscarinic antagonist (LAMA) with prolonged M3 receptor dissociation kinetics (>36 hours); formoterol is a fast-acting LABA; ciclesonide is an on-site activated corticosteroid prodrug. Indicated for maintenance treatment of severe COPD and persistent severe asthma with frequent exacerbations.

Ipratropium Bromide Inhaler (20mcg) and Respirator Solution (250mcg per ml) is an inhaled synthetic quaternary ammonium anticholinergic bronchodilator on the WHO Model List of Essential Medicines. It competitively antagonizes muscarinic M1, M2, and M3 receptors on bronchial smooth muscle, blocking acetylcholine released from parasympathetic vagal efferents. Because of its quaternary structure, it does not cross mucosal membranes or the blood-brain barrier, exerting localized bronchodilation with minimal systemic anticholinergic adverse effects. Indicated for maintenance bronchodilation and acute relief of bronchospasm in Chronic Obstructive Pulmonary Disease (COPD) and adjunctive management of severe acute asthma.

Salbutamol (100mcg) and Ipratropium Bromide (20mcg Inhaler) combines a short-acting beta-2 agonist (SABA) with a short-acting muscarinic antagonist (SAMA) on the WHO Model List of Essential Medicines. Salbutamol relaxes bronchial smooth muscle via cyclic AMP elevation; ipratropium blocks vagal acetylcholine-mediated bronchoconstriction at muscarinic M3 receptors. This dual-pathway approach produces greater, longer-lasting bronchodilation than either agent alone without added sympathomimetic side effects. Indicated for management of bronchospasm in Chronic Obstructive Pulmonary Disease (COPD) and acute severe asthma exacerbations.

Etophylline and Theophylline Tablets (77mg/23mg, 115mg/35mg PR, 231mg/69mg PR, 400mg Theophylline PR) is an oral methylxanthine bronchodilator on the WHO Model List of Essential Medicines. Etophylline enhances the water solubility and gastric tolerance of theophylline. Inhibits phosphodiesterase and antagonizes adenosine receptors to provide continuous bronchodilation and enhance diaphragmatic muscle endurance. Indicated for long-term maintenance of reversible bronchospasm in bronchial asthma, chronic bronchitis, and COPD.

Etophylline and Theophylline Tablets (77mg/23mg, 115mg/35mg PR, 231mg/69mg PR, 400mg Theophylline PR) is an oral methylxanthine bronchodilator on the WHO Model List of Essential Medicines. Etophylline enhances the water solubility and gastric tolerance of theophylline. Inhibits phosphodiesterase and antagonizes adenosine receptors to provide continuous bronchodilation and enhance diaphragmatic muscle endurance. Indicated for long-term maintenance of reversible bronchospasm in bronchial asthma, chronic bronchitis, and COPD.

Salbutamol / Albuterol Inhalation (100mcg MDI, 200mcg Rotacaps) is the quintessential short-acting selective beta-2 adrenergic receptor agonist (SABA) on the WHO Model List of Essential Medicines. It binds to beta-2 adrenergic receptors on airway smooth muscle cells, activating adenylyl cyclase, elevating cyclic AMP, and causing rapid relaxation of bronchial smooth muscle within 3 to 5 minutes, lasting 4 to 6 hours. Indicated for immediate relief of acute bronchospasm in bronchial asthma, acute exacerbations of COPD, and prevention of exercise-induced bronchoconstriction.

Etophylline and Theophylline Tablets (77mg/23mg, 115mg/35mg PR, 231mg/69mg PR, 400mg Theophylline PR) is an oral methylxanthine bronchodilator on the WHO Model List of Essential Medicines. Etophylline enhances the water solubility and gastric tolerance of theophylline. Inhibits phosphodiesterase and antagonizes adenosine receptors to provide continuous bronchodilation and enhance diaphragmatic muscle endurance. Indicated for long-term maintenance of reversible bronchospasm in bronchial asthma, chronic bronchitis, and COPD.

Acebrophylline Capsules / Tablets (100mg, 200mg Sustained Release; alone or with Montelukast 10mg or Acetylcysteine 600mg) is a fixed salt of ambroxol and theophylline-7-acetic acid on the PMBI formulary. It exerts a triple therapeutic action: potent bronchodilation via phosphodiesterase inhibition; mucoregulatory and surfactant-stimulating action via ambroxol (stimulating alveolar type II pneumocytes to produce pulmonary surfactant, reducing mucus viscosity and improving mucociliary clearance); and anti-inflammatory inhibition of phospholipase A2 and leukotriene C4. Indicated for bronchial asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, and chronic spastic bronchitis with thick viscid sputum.

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Indacaterol (110mcg) and Glycopyrronium (50mcg Powder for Inhalation) is a dual-bronchodilator combination (LABA + LAMA) on the WHO Model List framework. Indacaterol relaxes airway smooth muscle by stimulating beta-2 adrenergic receptors; glycopyrronium competitively blocks muscarinic M3 receptors on bronchial smooth muscle, inhibiting acetylcholine-mediated bronchoconstriction. Combining two distinct bronchodilator mechanisms delivers superior lung function improvement (FEV1), dyspnea reduction, and exacerbation prevention compared to either monotherapy. Indicated for once-daily maintenance bronchodilator treatment of Chronic Obstructive Pulmonary Disease (COPD).

Levosalbutamol (50mcg/100mcg) and Beclomethasone Dipropionate (50mcg/100mcg/200mcg Inhaler, Rotacaps) combines the active (R)-enantiomer of salbutamol with a synthetic glucocorticoid. Levosalbutamol provides rapid-acting selective beta-2 bronchodilation without the adverse tachycardia, tremor, and pro-inflammatory effects associated with the inert (S)-isomer. Beclomethasone suppresses underlying eosinophilic airway inflammation and edema. Indicated for maintenance and symptomatic treatment of mild-to-moderate bronchial asthma.

Levosalbutamol (50mcg/100mcg) and Beclomethasone Dipropionate (50mcg/100mcg/200mcg Inhaler, Rotacaps) combines the active (R)-enantiomer of salbutamol with a synthetic glucocorticoid. Levosalbutamol provides rapid-acting selective beta-2 bronchodilation without the adverse tachycardia, tremor, and pro-inflammatory effects associated with the inert (S)-isomer. Beclomethasone suppresses underlying eosinophilic airway inflammation and edema. Indicated for maintenance and symptomatic treatment of mild-to-moderate bronchial asthma.

Levosalbutamol (50mcg/100mcg) and Beclomethasone Dipropionate (50mcg/100mcg/200mcg Inhaler, Rotacaps) combines the active (R)-enantiomer of salbutamol with a synthetic glucocorticoid. Levosalbutamol provides rapid-acting selective beta-2 bronchodilation without the adverse tachycardia, tremor, and pro-inflammatory effects associated with the inert (S)-isomer. Beclomethasone suppresses underlying eosinophilic airway inflammation and edema. Indicated for maintenance and symptomatic treatment of mild-to-moderate bronchial asthma.

Budesonide Inhalation / Nebuliser Suspension (100mcg, 200mcg MDI; 400mcg Rotacaps; 1mg/2ml Respules) is a potent inhaled glucocorticoid on the WHO Model List of Essential Medicines. It diffuses into airway epithelial cells, binding to cytoplasmic glucocorticoid receptors to inhibit multiple pro-inflammatory transcription factors (NF-kB, AP-1), dramatically reducing recruitment of eosinophils, T-lymphocytes, and mast cells while downregulating inflammatory cytokines. Undergoes reversible intracellular esterification with fatty acids, creating a prolonged mucosal depot. Indicated for maintenance treatment of bronchial asthma, croup (laryngotracheobronchitis in infants/children), and severe COPD.

Salbutamol (100mcg) and Ipratropium Bromide (20mcg Inhaler) combines a short-acting beta-2 agonist (SABA) with a short-acting muscarinic antagonist (SAMA) on the WHO Model List of Essential Medicines. Salbutamol relaxes bronchial smooth muscle via cyclic AMP elevation; ipratropium blocks vagal acetylcholine-mediated bronchoconstriction at muscarinic M3 receptors. This dual-pathway approach produces greater, longer-lasting bronchodilation than either agent alone without added sympathomimetic side effects. Indicated for management of bronchospasm in Chronic Obstructive Pulmonary Disease (COPD) and acute severe asthma exacerbations.

Salbutamol / Albuterol Inhalation (100mcg MDI, 200mcg Rotacaps) is the quintessential short-acting selective beta-2 adrenergic receptor agonist (SABA) on the WHO Model List of Essential Medicines. It binds to beta-2 adrenergic receptors on airway smooth muscle cells, activating adenylyl cyclase, elevating cyclic AMP, and causing rapid relaxation of bronchial smooth muscle within 3 to 5 minutes, lasting 4 to 6 hours. Indicated for immediate relief of acute bronchospasm in bronchial asthma, acute exacerbations of COPD, and prevention of exercise-induced bronchoconstriction.

Pirfenidone Tablets (200mg, 400mg) is an oral synthetic pyridone antifibrotic and anti-inflammatory agent on the WHO Model List framework. It suppresses the synthesis of transforming growth factor-beta (TGF-beta), basic fibroblast growth factor (bFGF), and platelet-derived growth factor (PDGF), inhibiting fibroblast proliferation and extracellular matrix (collagen) deposition in pulmonary parenchyma. It also scavenges reactive oxygen species and inhibits TNF-alpha and IL-1beta. Clinically proven to reduce the rate of forced vital capacity (FVC) decline and disease progression. Indicated for the treatment of mild-to-moderate Idiopathic Pulmonary Fibrosis (IPF).

Salbutamol / Albuterol Inhalation (100mcg MDI, 200mcg Rotacaps) is the quintessential short-acting selective beta-2 adrenergic receptor agonist (SABA) on the WHO Model List of Essential Medicines. It binds to beta-2 adrenergic receptors on airway smooth muscle cells, activating adenylyl cyclase, elevating cyclic AMP, and causing rapid relaxation of bronchial smooth muscle within 3 to 5 minutes, lasting 4 to 6 hours. Indicated for immediate relief of acute bronchospasm in bronchial asthma, acute exacerbations of COPD, and prevention of exercise-induced bronchoconstriction.

Tiotropium Bromide Inhalation (9mcg MDI, 18mcg Rotacaps) is a long-acting muscarinic antagonist (LAMA) on the WHO Model List of Essential Medicines. It binds to muscarinic M1, M2, and M3 receptors, but dissociates extremely slowly from M3 receptors (dissociation half-life ~35 hours), delivering sustained 24-hour bronchodilation from a single daily dose. Reduces lung hyperinflation, improves exercise tolerance, and significantly decreases the frequency of COPD exacerbations. Indicated for long-term, once-daily maintenance treatment of bronchospasm associated with Chronic Obstructive Pulmonary Disease (COPD) and add-on maintenance in severe persistent asthma.

Tiotropium Bromide Inhalation (9mcg MDI, 18mcg Rotacaps) is a long-acting muscarinic antagonist (LAMA) on the WHO Model List of Essential Medicines. It binds to muscarinic M1, M2, and M3 receptors, but dissociates extremely slowly from M3 receptors (dissociation half-life ~35 hours), delivering sustained 24-hour bronchodilation from a single daily dose. Reduces lung hyperinflation, improves exercise tolerance, and significantly decreases the frequency of COPD exacerbations. Indicated for long-term, once-daily maintenance treatment of bronchospasm associated with Chronic Obstructive Pulmonary Disease (COPD) and add-on maintenance in severe persistent asthma.

Etophylline (84.7mg) and Theophylline (25.3mg per ml) Injection (Deriphyllin) is a parenteral methylxanthine bronchodilator combination on the WHO Model List framework. It non-selectively inhibits phosphodiesterase (PDE) enzymes, elevating intracellular cyclic AMP, competitively antagonizes adenosine A1 and A2 receptors, and stimulates endogenous catecholamine release. This produces relaxation of bronchial smooth muscle, stimulates the medullary respiratory center, improves diaphragmatic contractility, and exerts mild diuresis. Indicated for acute relief of severe bronchospasm in bronchial asthma, status asthmaticus, chronic bronchitis, and left ventricular failure with pulmonary edema (cardiac asthma).

Pirfenidone Tablets (200mg, 400mg) is an oral synthetic pyridone antifibrotic and anti-inflammatory agent on the WHO Model List framework. It suppresses the synthesis of transforming growth factor-beta (TGF-beta), basic fibroblast growth factor (bFGF), and platelet-derived growth factor (PDGF), inhibiting fibroblast proliferation and extracellular matrix (collagen) deposition in pulmonary parenchyma. It also scavenges reactive oxygen species and inhibits TNF-alpha and IL-1beta. Clinically proven to reduce the rate of forced vital capacity (FVC) decline and disease progression. Indicated for the treatment of mild-to-moderate Idiopathic Pulmonary Fibrosis (IPF).

Budesonide Inhalation / Nebuliser Suspension (100mcg, 200mcg MDI; 400mcg Rotacaps; 1mg/2ml Respules) is a potent inhaled glucocorticoid on the WHO Model List of Essential Medicines. It diffuses into airway epithelial cells, binding to cytoplasmic glucocorticoid receptors to inhibit multiple pro-inflammatory transcription factors (NF-kB, AP-1), dramatically reducing recruitment of eosinophils, T-lymphocytes, and mast cells while downregulating inflammatory cytokines. Undergoes reversible intracellular esterification with fatty acids, creating a prolonged mucosal depot. Indicated for maintenance treatment of bronchial asthma, croup (laryngotracheobronchitis in infants/children), and severe COPD.

Beclomethasone Dipropionate Inhalation (100mcg, 200mcg Inhaler, 100mcg Rotacaps) is a halogenated synthetic corticosteroid prodrug on the WHO Model List of Essential Medicines. In lung tissue, esterases rapidly convert it to active beclomethasone-17-monopropionate (17-BMP), which possesses 30-fold higher affinity for glucocorticoid receptors, profoundly suppressing bronchial mucosal inflammation. Indicated for maintenance treatment of persistent bronchial asthma and chronic bronchitis.

Beclomethasone Dipropionate Inhalation (100mcg, 200mcg Inhaler, 100mcg Rotacaps) is a halogenated synthetic corticosteroid prodrug on the WHO Model List of Essential Medicines. In lung tissue, esterases rapidly convert it to active beclomethasone-17-monopropionate (17-BMP), which possesses 30-fold higher affinity for glucocorticoid receptors, profoundly suppressing bronchial mucosal inflammation. Indicated for maintenance treatment of persistent bronchial asthma and chronic bronchitis.

Beclomethasone Dipropionate Inhalation (100mcg, 200mcg Inhaler, 100mcg Rotacaps) is a halogenated synthetic corticosteroid prodrug on the WHO Model List of Essential Medicines. In lung tissue, esterases rapidly convert it to active beclomethasone-17-monopropionate (17-BMP), which possesses 30-fold higher affinity for glucocorticoid receptors, profoundly suppressing bronchial mucosal inflammation. Indicated for maintenance treatment of persistent bronchial asthma and chronic bronchitis.

Levosalbutamol (50mcg/100mcg) and Beclomethasone Dipropionate (50mcg/100mcg/200mcg Inhaler, Rotacaps) combines the active (R)-enantiomer of salbutamol with a synthetic glucocorticoid. Levosalbutamol provides rapid-acting selective beta-2 bronchodilation without the adverse tachycardia, tremor, and pro-inflammatory effects associated with the inert (S)-isomer. Beclomethasone suppresses underlying eosinophilic airway inflammation and edema. Indicated for maintenance and symptomatic treatment of mild-to-moderate bronchial asthma.

Ipratropium Bromide Inhaler (20mcg) and Respirator Solution (250mcg per ml) is an inhaled synthetic quaternary ammonium anticholinergic bronchodilator on the WHO Model List of Essential Medicines. It competitively antagonizes muscarinic M1, M2, and M3 receptors on bronchial smooth muscle, blocking acetylcholine released from parasympathetic vagal efferents. Because of its quaternary structure, it does not cross mucosal membranes or the blood-brain barrier, exerting localized bronchodilation with minimal systemic anticholinergic adverse effects. Indicated for maintenance bronchodilation and acute relief of bronchospasm in Chronic Obstructive Pulmonary Disease (COPD) and adjunctive management of severe acute asthma.

Tulobuterol Transdermal Patch (0.5mg) is a long-acting beta-2 adrenergic receptor agonist formulated as a sustained-release transdermal patch on the PMBI formulary. It delivers consistent transcutaneous systemic absorption of tulobuterol over 24 hours, stimulating bronchial beta-2 receptors and maintaining steady plasma concentrations that peak during the early morning hours (4:00 to 6:00 AM) to effectively prevent nocturnal asthma attacks ("morning dip"). Indicated for relief of dyspnea and bronchospasm in bronchial asthma and acute/chronic bronchitis.

Formoterol Fumarate (6mcg/12mcg) and Budesonide (100mcg/200mcg/400mcg Inhaler, Rotacaps, Powder, or Nebuliser Suspension) is a gold-standard fixed-dose combination on the WHO Model List of Essential Medicines. Budesonide is a potent inhaled glucocorticoid that suppresses airway mucosal inflammation, reduces microvascular permeability, and decreases hyperresponsiveness. Formoterol is a rapid-onset, long-acting beta-2 adrenergic agonist (LABA) that stimulates adenylyl cyclase, relaxes bronchial smooth muscle within 1-3 minutes, and provides sustained bronchodilation for >12 hours. Recommended by GINA guidelines as preferred Maintenance and Reliever Therapy (SMART / MART). Indicated for maintenance and rescue relief of bronchial asthma and symptomatic maintenance of Chronic Obstructive Pulmonary Disease (COPD).

Tiotropium Bromide (18mcg) and Formoterol Fumarate (12mcg, with or without Ciclesonide 400mcg / Inhaler / Rotacaps) is a dual/triple bronchodilator therapy for advanced COPD and severe refractory asthma. Tiotropium is a long-acting muscarinic antagonist (LAMA) with prolonged M3 receptor dissociation kinetics (>36 hours); formoterol is a fast-acting LABA; ciclesonide is an on-site activated corticosteroid prodrug. Indicated for maintenance treatment of severe COPD and persistent severe asthma with frequent exacerbations.