Glycopyrronium bromide (Glycopyrrolate) Inhalation

Introduction: Glycopyrronium bromide inhalation is used as a once-daily maintenance bronchodilator treatment to relieve symptoms of patients with chronic obstructive pulmonary disease (COPD).

How it works: Glycopyrronium is a long-acting, specific antimuscarinic agent, in clinical medicine often called an anticholinergic. It has a similar affinity to the subtypes of muscarinic receptors M1 to M5. In the airways, inhibition of M3-receptors at the smooth muscle results in relaxation.

Important Information: One capsule once daily with the ConviHaler device at the same time of day. Do not take more than one time every 24 hours.

• Chronic obstructive pulmonary disease (COPD): Maintenance bronchodilator treatment to relieve symptoms in adult patients

Bronchodilator

Long-acting Muscarinic Antagonist (LAMA)

Glycopyrronium is a long-acting, specific antimuscarinic agent, in clinical medicine often called an anticholinergic. It has a similar affinity to the subtypes of muscarinic receptors M1 to M5. In the airways, inhibition of M3-receptors at the smooth muscle results in relaxation. The high potency and slow receptor dissociation found its clinical correlate in significant and long-acting bronchodilation in patients with COPD.

Glycopyrronium inhibits M3 muscarinic receptors to relax airway smooth muscle, causing bronchodilation.

Adult Dose:

• One 50 microgram capsule once daily using the inhalation device
• Administered at the same time of the day
• Should not be taken more than one time every 24 hours

* Use as directed by the registered physician

Inhalation capsule - use with ConviHaler device. Do not swallow the capsule. Remove from blister pack immediately before use.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and follow your regular schedule.

Common Side Effects:

• Dry mouth
• Cough
• Nasopharyngitis
• Vomiting
• Musculoskeletal pain
• Insomnia
• Diabetes mellitus
• Gastroenteritis

Rare Side Effects: Paradoxical bronchospasm, angioedema, hypersensitivity, pruritus, sinus congestion.

Precautions:

• Not indicated for initial treatment of acute bronchospasm (rescue therapy)
• Should not be used in patients under 18 years
• Use with caution in narrow-angle glaucoma or urinary retention
• Discontinue if signs of allergic reaction occur
• Discontinue if paradoxical bronchospasm occurs

Contraindications:

• Hypersensitivity to glycopyrronium or any excipients

Drug Interactions:

• Co-administration with other inhaled anti-cholinergic drugs is not recommended

Food Interactions: No interaction found/established.

Use in Pregnancy: Limited data in pregnant women. Use only if expected benefit justifies potential risk to the fetus.

Use in Lactation: Unknown if glycopyrronium bromide is excreted in human milk. Use with caution.

Pediatric Use: Should not be used in patients under 18 years.

Geriatric Use: Frequencies of urinary tract infection and headache are common in patients above 75 years.

Renal Impairment: Severe renal impairment (eGFR <30) should be used only if expected benefit outweighs potential risk.

Hepatic Impairment: No specific restrictions.

Overdose: High doses may lead to anticholinergic symptoms. Symptomatic treatment indicated. 100 and 200 microgram doses well tolerated for 28 days.

Storage: Store at a temperature not exceeding 30°C in a dry place. Protect from light and moisture.

Glycopyrronium Bromide Inhalation Capsule