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BRONCHITOL 40 mg INHALATION POWDER, HARD CAPSULES

BRONCHITOL 40 mg INHALATION POWDER, HARD CAPSULES

Ask a doctor about a prescription for BRONCHITOL 40 mg INHALATION POWDER, HARD CAPSULES

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use BRONCHITOL 40 mg INHALATION POWDER, HARD CAPSULES

Introduction

PACKAGE LEAFLET: INFORMATION FOR THE USER

Bronchitol 40 mg powder for inhalation, hard capsules

Mannitol

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack

  1. What is Bronchitol and what is it used for
  2. What you need to know before you use Bronchitol
  3. How to use Bronchitol
  4. Possible side effects
  5. Storing Bronchitol
  6. Contents of the pack and other information

1. What is Bronchitol and what is it used for

What is Bronchitol

Bronchitol contains a medicine called mannitol, which is a mucolytic.

What is Bronchitol used for

Bronchitol is used in adults aged 18 years and older. In addition to using Bronchitol, the patient will continue to take their usual medication for cystic fibrosis.

How Bronchitol works

Bronchitol is inhaled into the lungs to improve cystic fibrosis, a genetic disease that affects the glands in the lungs, intestines, and pancreas that secrete fluids such as mucus and digestive juices.

Bronchitol helps to increase the amount of water present on the surface of the airways and in the mucus. This allows the lungs to clear the mucus more easily. It also helps to improve the condition of the lungs and breathing. As a result, a "productive cough" may occur, which also helps to clear the mucus from the lungs.

2. What you need to know before you use Bronchitol

Do not use Bronchitol

  • if you are allergic (hypersensitive) to mannitol.
  • if you are sensitive to mannitol. Before you start using Bronchitol, your doctor will check if your airways are too sensitive to mannitol. If you are too sensitive to mannitol, your airways will narrow and you may have difficulty breathing.

If any of the above applies to you (or if you are not sure), talk to your doctor or pharmacist before using this medicine.

Warnings and precautions

Talk to your doctor or pharmacist before using this medicine.

  • if you have asthma;
  • if you have ever coughed up blood or had blood in your sputum;
  • if you have severe cystic fibrosis, especially if your lung function measured by forced expiratory volume in one second (FEV1) is usually below 30%,

Inhaling medicines can cause chest tightness and wheezing, in some cases immediately after taking the medicine. Your doctor will help you take your first dose of Bronchitol and check your lung function before, during, and after administration. Your doctor may ask you to use other medicines such as a bronchodilator before taking Bronchitol.

Inhaling medicines can also cause coughing, this may happen with Bronchitol. Talk to your doctor if the cough does not go away or worries you.

Children and adolescents

Bronchitol should not be used in children and adolescents under 18 years of age. This recommendation is due to the limited information available in this patient group.

Using Bronchitol with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

You can continue to take your cystic fibrosis medicines when using Bronchitol, these include inhaled antibiotics such as tobramycin and colistimethate sodium. If you are unsure, talk to your doctor or pharmacist before taking Bronchitol.

Pregnancy and breastfeeding

  • If you are pregnant, think you may be pregnant, or plan to become pregnant, talk to your doctor before using this medicine. You should not take this medicine if you are pregnant.
  • If you are breastfeeding or plan to breastfeed, talk to your doctor before using this medicine. It is not known if this medicine is excreted in breast milk.

Driving and using machines

Bronchitol is unlikely to affect your ability to drive or use tools or machines.

3. How to use Bronchitol

Follow the instructions for administration of this medicine exactly as your doctor has told you. If you are not sure, talk to your doctor or pharmacist.

Always use your bronchodilator before using Bronchitol.

Recommended dose

Adults aged 18 years and older

Initial dose

Before your doctor prescribes Bronchitol, they will help you take your first dose of Bronchitol and perform a lung function test at each step to check that you are not sensitive to mannitol. The first dose is taken in four steps:

Step 1 - 1 capsule (40 mg)

Step 2 - 2 capsules (80 mg)

Step 3 - 3 capsules (120 mg)

Step 4 - 4 capsules (160 mg)

At the end of the initial dose, you will have taken 10 capsules (400 mg), which is the normal dose.

Treatment dose (2-week packs)

    • You should use Bronchitol every day.
  • The normal dose is 10 capsules (400 mg) inhaled in the morning and 10 capsules inhaled at night.
  • The evening dose should be taken at least 2 to 3 hours before bedtime.
  • For best results, inhale the capsules one after the other, leaving as little time as possible between them.

Order for using this medicine

Use Bronchitol as part of your normal daily treatment routine. The suggested order is as follows, unless otherwise directed by your doctor:

  1. Use your bronchodilator
  2. Wait between 5 and 15 minutes
  3. Use Bronchitol before physiotherapy if it is part of your treatment routine.
  4. Dornase alfa (Pulmozyme) if it is part of your treatment routine
  5. Inhaled antibiotics if they are part of your treatment routine

How to use Bronchitol

  • Bronchitol is inhaled (breathed in) as a powder from a capsule using the inhaler provided in the pack. It should only be inhaled and not administered by any other route.
  • The capsules should not be swallowed.
  • Only inhale the powder contained in the capsules using the inhaler provided in the pack.
  • Use a new inhaler each week.
  • Place the ten capsules one by one into the inhaler.
  • Inhale the contents of the capsule with the inhaler, taking one or two breaths.

For instructions on using the inhaler, see the end of the leaflet.

If you use more Bronchitol than you should

If you think you have taken too much of this medicine, talk to your doctor or pharmacist immediately. You may:

  • feel like you cannot breathe;
  • have wheezing;
  • cough a lot.

Your doctor will give you oxygen and medicine to help you breathe.

If you forget to use Bronchitol

  • If you forget a dose, use the inhaler as soon as you remember and continue as usual. However, if it is almost time for the next dose, skip the missed dose.
  • Do not take a double dose to make up for forgotten doses.

If you stop using Bronchitol

If you stop using Bronchitol, your symptoms may get worse. Do not stop using Bronchitol without talking to your doctor first, even if you feel better. Your doctor will tell you how long you should use this medicine.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Bronchitol can cause side effects, although not everybody gets them.

Stop using Bronchitol and talk to a doctor immediately if you notice any of the following serious side effects:

    • Difficulty breathing, which can be due to narrowing of the airways, worsening of asthma symptoms, or wheezing. These effects are common and may affect up to 1 in 10 people.
  • Coughing up blood or blood in your sputum. This effect is common.

Tell your doctor immediately if you notice any of the following side effects:

  • Severe cough. This effect is common.
  • Worsening of symptoms. This effect is common.

Other side effects are:

Common (may affect up to 1 in 10 people)

  • Cough
  • Chest discomfort
  • Headache
  • Pain in the back of the mouth and throat and difficulty swallowing
  • Vomiting, vomiting after coughing

Uncommon (may affect up to 1 in 100 people)

  • Burning sensation or pain in the tongue
  • Cystic fibrosis-related diabetes
  • Chest and abdominal pain
  • Change in voice
  • Cold sweat
  • Congestion
  • Dehydration
  • Decreased appetite
  • Diarrhea
  • Ear pain
  • Feeling tired
  • Feeling dizzy
  • Nausea
  • Feeling unwell
  • Flu and fever
  • Gas
  • Heartburn
  • Hernia pain
  • Hyperventilation
  • Itching, rash, acne
  • Stiffness and joint pain
  • Morbid thoughts
  • Mouth sores
  • Respiratory infection
  • Runny nose
  • Sputum infection
  • Sore throat
  • Difficulty sleeping
  • Oral thrush (candidiasis)
  • Loss of bladder control

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V*. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing Bronchitol

Keep out of the sight and reach of children.

Do not use Bronchitol after the expiry date which is stated on the carton and blister after 'EXP'. The expiry date is the last day of the month stated.

Store below 30°C.

Store in the original package to protect from moisture.

Once removed from the blister, the capsule should be used immediately.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Package Contents and Additional Information

Bronchitol Composition

The active ingredient is mannitol. Each capsule contains 40 mg of mannitol. The average inhaled dose per capsule is 32.2 milligrams of mannitol.

Product Appearance and Package Contents

Bronchitol is a powder for inhalation in hard capsules. Bronchitol 40 mg powder for inhalation, hard capsules, is a white or almost white powder in hard, transparent, and colorless capsules with the inscription «PXS 40 mg». The powder is inhaled into the lungs with the inhaler provided in the package.

Each initial dose package of Bronchitol contains 1 blister pack with 10 capsules and 1 inhaler. The initial dose package is used for the initial dose evaluation with your doctor.

Each 2-week treatment package of Bronchitol contains 28 blister packs with 10 capsules each (280 capsules in total) and 2 inhalers. The 2-week treatment package is for therapeutic use.

Marketing Authorization Holder and Manufacturer

Pharmaxis Europe Limited, 108 Q House, Furze Road, Sandyford, Dublin 18, D18AY29, Ireland

Manufacturer

MIAS Pharma Limited, Suite 1, Stafford House, Strand Road, Portmarnock, Co. Dublin, D13WC83, Ireland or Arvato Supply Chain Solutions SE, Gottlieb-Daimler Straβe 1, 33428 Harsewinkel, North Rhine-Westphalia, Germany.

You can request more information about this medication by contacting the local representative of the marketing authorization holder:

Belgium

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Lithuania

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Greece

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Luxembourg

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Czech Republic

4 Life Pharma CZ, s.r.o.

Tel: +420 244 403 003

Hungary

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Denmark

Chiesi Pharma AB

Tel: + 46 8 753 35 20

Malta

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Germany

Chiesi GmbH

Tel: +49 (0) 40 897 240

Netherlands

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Estonia

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Norway

Chiesi Pharma AB

Tel: + 46 8 753 35 20

Greece

Chiesi Hellas A.E.B.E.

Tel: + 30.210.617.97.63

Austria

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Spain

Chiesi España, S.A.U.

Tel: +34 93 494 8000

Poland

IMED Poland Sp. z o. o.

Tel: +48 22 663 43 10

France

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Portugal

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Croatia

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Romania

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Ireland

Cheisi Limited

Tel: + 44 (0)161 488 5555

Slovenia

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Iceland

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

Slovakia

4 Life Pharma SK, s.r.o.

Tel: + 420 244 403 003

Italy

Chiesi Farmaceutici S.p.A

Tel: +39 0521 2791

Finland

Chiesi Pharma AB

Tel: + 46 8 753 35 20

Cyprus

Chiesi Hellas A.E.B.E.

Tel: + 30.210.617.97.63

Sweden

Chiesi Pharma AB

Tel: + 46 8 753 35 20

Latvia

Pharmaxis Europe Limited

Tel: + 353 (0) 1431 9816

United Kingdom

Cheisi Limited

Tel: + 44 (0)161 488 5555

Date of the Last Revision of this Prospectus: MM/YYYY.

Other Sources of Information

Detailed information about this medication is available on the European Medicines Agency website: http://www.ema.europa.eu. There are also links to other websites about rare diseases and orphan medicines.

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How to Use the Inhaler

The following diagram explains how the inhaler works. Bronchitol capsules can only be used with the inhaler provided in the package.

Diagram of inhaler with spiral chamber, piercing buttons, filter, and mouthpiece, showing internal and external parts

Spinning Chamber: Spiral Chamber

Mouthpiece: Mouthpiece

Filter: Filter

Piercing Buttons: Piercing Buttons

Piercing Chamber: Piercing Chamber

Inhaler

The following steps explain how to use the inhaler. If you want more information on how to care for it, go to the end of the instructions.

  1. Remove the Cap
  • Using both hands, hold the inhaler in a vertical position and remove the cap.

Hand holding a white cylindrical medical device with lateral wings for application

  1. Open the Inhaler
  • Hold the base of the inhaler firmly with one hand.
  • You must hold it by the base to ensure that you do not press the piercing buttons.
  • Then open it by turning the mouthpiece in the direction indicated by the arrow on the inhaler.

Hand holding an auto-injector with a curved arrow indicating the rotation movement of the device

  1. Place the Capsule
  • First, make sure your hands are dry.
  • Then remove a capsule from the blister pack (just before using it).
  • Insert the capsule into the capsule-shaped space at the base of the inhaler.

Hands holding a white medical device with a cylinder and cross-shaped base

  1. Close the Inhaler
  • Hold the inhaler in a vertical position.
  • Then turn the mouthpiece until it clicks into place: when it closes, you will hear a «click».

Hand holding a white cylindrical medical device with a square base for nasal administration

  1. Pierce the Capsule
  • This will allow the powder contained in the capsule to come out when you inhale. In this prospectus, instead of «piercing», the term «making a hole» is used.
  • Hold the inhaler in a vertical position and press firmly on the two «piercing» buttons on the sides at the same time: then release them. Do this only once. If you pierce the capsule more than once, it may tear or break.

Woman in profile holding a white nasal inhaler in front of her nostrilsHand holding a medication applicator with two arrows pointing to its sides showing the direction of rotation

  1. Prepare for Inhalation
  • Tilt the inhaler so that the mouthpiece is slightly facing downwards.
  • This will allow the capsule to descend into the spiral chamber.
  • Keep the inhaler tilted in this position and exhale deeply (without having the inhaler in your mouth).
  1. Inhale
  • Tilt your head slightly backwards.
  • Keep the inhaler tilted downwards, place it in your mouth, and close your lips firmly around the mouthpiece.
  • Take a continuous and deep breath to fill your lungs and hold your breath for 5 seconds. When you inhale, you should hear a «noise» caused by the rotation of the capsule inside the inhaler. If this does not happen, it is possible that the capsule has become stuck.

Woman holding a buccal inhaler with both hands and breathing deeply through the mouthpiece

  • If you do not hear the noise, hold the inhaler with the mouthpiece facing downwards and hold the base firmly. Do not try to loosen the capsule by pressing the piercing buttons again. Repeat the inhalation to receive the dose.
  1. Exhale
  • Remove the inhaler from your mouth.
  • Exhale and then breathe normally again.

Female face profile with black arrows pointing from and to the open mouth

  1. Check the Capsule
  • Check if the capsule is empty: it must rotate in the inhaler to empty. If it has not emptied, repeat steps 6 to 8.

Hand holding a white medication applicator with a partially retracted protective cover

  1. Remove the Used Capsule
  • Put the inhaler in an inverted position, put the cap on the base, and throw away the empty capsule.
  1. Repeat Steps 3 to 10 for Each Capsule
  • Follow these steps for each of the ten capsules.
  • To get the best results with Bronchitol, inhale the capsules one after another.

Additional Information on Inhaler Care

  • Keep the inhaler dry and make sure your hands are dry before using it.
  • Never breathe or cough into the inhaler.
  • Never disassemble it.
  • Never place a capsule directly into the inhaler mouthpiece.
  • Never leave a capsule inside the inhaler chamber.
  • Use a new inhaler every week.
  • If the inhaler breaks, use the second inhaler and talk to your doctor.

Cleaning the Inhaler -Normally, the inhaler will deliver the correct dose of medication for 7 days without needing cleaning. If you need to clean it, follow these steps:

  1. Make sure the inhaler is empty.
  2. Wash it with hot water with the mouthpiece open.
  3. Shake it to remove excess water until large drops stop falling from it.
  4. Let the inhaler air dry: lay it on its side with the mouthpiece open.
  5. Let it dry completely, which may take up to 24 hours. While it is drying, use the other inhaler.

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  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

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€60
November 109:00
November 109:30
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Doctor

Karim BenHarbi

General medicine8 years of experience

Dr. Karim Ben Harbi is a licensed general practitioner based in Italy. He provides online consultations for adults and children, combining international clinical experience with evidence-based medicine. His care approach is focused on accurate diagnosis, preventive care, and personalised health guidance.

Dr. Ben Harbi received his medical degree from Sapienza University in Rome. His training included hands-on experience in diverse settings — tropical medicine, rural healthcare, and urban outpatient practice. He also conducted clinical research in microbiology, exploring the role of the gut microbiome in chronic gastrointestinal issues.

You can consult Dr. Ben Harbi for:

  • General health concerns, prevention, and primary care.
  • Hypertension, type 1 and type 2 diabetes, metabolic issues.
  • Cold, cough, flu, respiratory infections, sore throat, fever.
  • Chronic digestive issues: bloating, gastritis, IBS, microbiome imbalance.
  • Skin rashes, mild allergic reactions, basic dermatological complaints.
  • Medication guidance, treatment adjustments, prescription review.
  • Paediatric concerns — fever, infections, general well-being.
  • Lifestyle optimisation: stress, sleep, weight, and diet counselling.

Dr. Ben Harbi offers reliable, accessible medical support through online consultations, helping patients make informed decisions about their health with a clear, structured, and compassionate approach.

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€79
November 111:00
November 111:30
November 112:00
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5.0(14)
Doctor

Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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€55
November 113:30
November 114:15
November 115:00
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