For the treatment of respiratory tract infections due to Cystic Fibrosis (CF) and non -CF bronchiectasis PureIMS pharmacy delivers the Twincer® dry powder inhaler with the antibiotic Colistimethate Sodium, also known as Colistin. The Twincer® Colistin dry powder inhaler offers some advantages over other possibilities for the administration by inhalation of Colistin. It can be prescribed by medical specialists on the basis of the ‘medical necessity’.

The Twincer® dry powder inhaler provides the ability to inhale a full dosage of Colistin in only one inhalation. The Twincer® therefore provides a significant gain in time in relation to the nebulization of Colistin in liquid form. Nebulization of a full dose of Colistin can easily take half an hour including preparation, disinfection and cleaning of the nebulizer. A correct inhalation with the Twincer® can easily be carried out within only one to two minutes. Especially when taking Colistin on a daily basis this saves a lot of time. The Twincer® is a single use device. Therefore there is no need to disinfect, in contrast to a nebulizer that needs to be cleaned after each time used. You can return used inhalers to your pharmacy. In addition to time savings the Twincer® also provides more freedom on when and where to inhale the Colistin. The Twincer® is small and light and can therefore be easily carried and used discreetly. Furthermore, when using the Twincer® you are not dependent on an electricity source.

In addition to the Twincer®, there is already an alternative colistin dry powder inhaler available that also offers many of the above mentioned advantages with respect to nebulization. However for many patients this existing inhaler is no suitable alternative due to generating a strong cough stimulus while inhaling. This cough stimulus is most likely caused by the precipitation of a large proportion of the inhaled Colistin in the oral pharynx. This hardly occurs when using the Twincer® making it generally better tolerated. The Twincer® technology developed at the University of Groningen makes it possible to disperse the Colistin more effectively than the existing inhaler. In this way a lower nominal dose of Colistin (the amount of powder inside the inhaler) can be administered to end up inside the lungs compared to the existing inhaler (approximately 55 mg with the Twincer® versus 145 mg with the existing inhaler). The effectiveness of the therapy is therefore not adversely affected by the lower nominal dose in the Twincer®. Because a smaller chance of side effects, such as generating a strong coughs, the Twincer® can be a good alternative for patients that do not tolerate the existing inhaler.

The Twincer® Colistin dry powder inhaler is a single use device. As a consequence there is no risk of re-infection with potentially resistant bacteria through the Twincer® inhaler.

Interested and want more information about the Twincer® Colistin dry powder inhaler? Please consult your primary doctor.