mometasone furoate + formoterol fumarate + tiotropium bromide

**Mometasone furoate + formoterol fumarate + tiotropium bromide** is a triple combination inhaled pharmaceutical intended for treatment of chronic obstructive pulmonary disease (*COPD*) and asthma. - **Mometasone furoate** is a synthetic glucocorticoid corticosteroid that acts as a potent anti-inflammatory agent by binding to the glucocorticoid receptor, reducing airway inflammation. - **Formoterol fumarate** is a long-acting β2-adrenergic agonist (LABA) that stimulates β2-adrenoceptors on bronchial smooth muscle, causing prolonged bronchodilation. - **Tiotropium bromide** is a long-acting antimuscarinic bronchodilator (LAMA), acting as a competitive inhibitor of muscarinic M3 acetylcholine receptors, leading to sustained airway smooth muscle relaxation and improved airflow. While dual combinations (e.g., mometasone furoate + formoterol fumarate in the product *Dulera*) are approved and widely used, fixed triple combinations including tiotropium bromide are under investigation for enhanced maintenance therapy and exacerbation prevention in moderate to severe COPD and asthma.