Glycopyrrolate and Formoterol (Inhalation)

Overview

Known under US brand name Bevespi Aerosphere, glycopyrrolate and formoterol is a combination drug used in the long-term maintenance treatment of chronic obstructive pulmonary disease. This includes emphysema and chronic bronchitis. The medication works by helping to open the air passages in the lung to increase the air flow. Formoterol and glycopyrrolate are given via an inhaler that is breathed in via the mouth. This medication is only available via a prescription from your doctor and is available in the dosage form of aerosol powder.

Conditions treated

  • Prevention of Bronchospasm with Chronic Bronchitis

Type of medication

  • Combination anticholinergic and bronchodilator

Side effects

Alongside the intended effects of this medication, it can produce some unwanted side effects. Not all of these side effects may be present, but if they do occur, you may need to seek medical attention.

Inform your doctor or healthcare professional immediately if you suffer from any of the following side effects whilst taking Glycopyrrolate and Formoterol.

Less common side effects

Incidence not known

  • Eye pain

Some of the side effects that occur with this drug usually don't require medical attention. These side effects begin to reduce as your body starts adjusting to the medication. If they are bothersome, you should contact your local healthcare professional or doctor for advice on ways to reduce the intensity of these side effects. Seek medical attention if any of the side effects listed below continue or become persistent.

Less common side effects

  • Pain in the arms or legs

You may suffer from other side effects that are not listed above. If you notice anything unusual you should contact your doctor or healthcare professional. Report all side effects to the FDA on 1-800-FDA-1088.

Dosage

The amount of medication that you receive will depend on a number of factors including, the strength of the medication, your age, weight and height, the time between doses, the severity of your condition and what other medicines you are currently taking. Do not alter your dose without speaking to a medical professional beforehand. To do so could increase your risk of interactions or reduce the effectiveness of the drug.

For inhalation dosage form (aerosol):

Adults:

2 puffs in the morning and another two puffs in the evening. Each puff contains 4.8 mcg of formoterol and nine micrograms of glycopyrrolate.

Children:

  • this drug should not be used in children.

If you miss a dose of this medication, skip the dose you have missed and return to the original dosing schedule provided by your doctor. Do not double your doses.

Interactions

Drug interactions can reduce the effectiveness of either drug you are using as well as increasing your risk of severe side effects. To help minimize this risk, it's important to give your doctor or healthcare professional a full list of all the current medications you are taking, alongside any you have taken in the past. This should include prescription, nonprescription drugs, all vitamins and herbal products. You should also make them aware of any other medical conditions you are suffering from and any medical conditions that run in your families history.

The use of this medication is not recommended alongside any of the medications listed below. Your doctor may avoid treating you with this medication altogether or alter some of the other drugs you are taking.

  • Mesoridazine

The use of this medication is not recommended with any of the following medicines. However, in some cases, it may be necessary. If you are given both medications together, your doctor may change your dose or how often in which you use either medication.

  • Ivabradine

Let your doctor know if you are taking any of the following medications. Your doctor may alter the dose of frequency in which you are taking them:

  • Ezogabine

Other medical conditions

The presence of other medical conditions could affect the use of this drug. You should make your doctor or healthcare professional aware of any other medical conditions you are currently suffering from including:

Warnings

Allergies You should make your doctor aware of any allergies reactions you have suffered to this medication in the past, including similar medications. It's a good idea to inform them of any other allergies you suffer from including to preservatives, animals, dyes, and food.

Pediatric population Inhaled glycopyrrolate and formoterol combination has not been established for use in children. Therefore efficacy and safety have not yet been established.

Geriatric population Appropriate studies conducted to date have not indicated a geriatric-specific problem that could limit the effectiveness of inhaled glycopyrrolate and formoterol combination in the older population.

Use in pregnancy and breastfeeding

This drug is under FDA pregnancy category C. It is, therefore, unknown whether this medication could harm an unborn child. You should let your doctor know if you are pregnant now or you intend on falling pregnant when taking Glycopyrrolate and Formoterol.

It is unknown whether this drug can pass into breast milk or if it could harm a nursing infant. Make your doctor aware if you are breastfeeding a child.

Proper Use:

This drug combination comes with a Medication Guide. You should read and follow the instructions carefully before using. If you are not sure how to use the inhaler, then ask your doctor to demonstrate.

When you use the inhaler for the first time, there is a chance that it will not deliver the correct amount of medication with the first puff.

Therefore, before you use the inhaler, you should prime it by spraying the medication four times into the air away from the face, and shake it well before each spray. If you have not used this medication for seven days or longer, then re-prime it by spraying the medication two times into the air away, and shake it well before each spray.

To use the inhaler:

  • This medication comes in a sealed foil pouch. Don't open the sealed foil pouch until you are ready to take this medication.

If you are using this medication for a long period of time, you should ensure you attend regular checkups with your doctor. This will allow them to monitor the effectiveness of the medication and test for unwanted side effects.

This medication should be avoided if you are having a sudden COPD attack. Your healthcare professional or doctor will give you a short-acting inhaler for this condition. If you find that this short-acting inhaler is not working as it should, then seek medical advice immediately.

Seek assistance from a medical professional if:

  • Your symptoms don't improve after using this medication for a few days or if they worsen.

This medication can cause paradoxical bronchospasm, which means your wheezing or breathing will worsen. This can be a life-threatening situation, so seek advice from your doctor immediately if you suffer from difficulty with breathing, a cough, wheezing or a shortness of breath after using this medication.

If you develop hives, a skin rash, swelling of the lips, tongue, or face, or any allergic reaction to this medication, you should inform your doctor immediately.

This medication could cause an increase in blood pressure or heart rate. You should contact your doctor or healthcare team if you have a slow or fast heartbeat or your blood pressure is higher than usual.

Call your doctor immediately if you suffer from blurred vision, seeing halos around lights, or any other vision changes during or after treatment.

Check with your doctor immediately if you have suffered from a decrease in the frequency of urination, a decrease in urine volume, painful urination or difficulty in passing urine.

Storage

The canister should be stored at room temperature, away from direct light and heat. Do not freeze this medication and do not keep it inside a car where it could be exposed to extreme temperatures. Don't throw the canister into a fire, even when it is empty. Keep this drug out of the reach of children and dispose of any medication that you no longer need or that has passed the expiry date. You should ask your local pharmacist for advice on the best method of disposal for this medication.

Summary

When used correctly, Glycopyrrolate and Formoterol are successful in the treatment of muscle relaxation in the airways to improve breathing. Due to a large number of interactions possible, it's imperative that you give your doctor a full list of all the medications you're currently taking. You should let your doctor know if you are pregnant or intend to becoming pregnant whilst taking this medication. You should avoid breastfeeding whilst taking this medication.This drug is not approved for use by anyone younger than eighteen years old. You should contact your doctor if your symptoms do not begin to improve after a period of time on this drug, or if you are using the drug more frequently. If you have any further questions on the practical uses of this drug, then contact your local doctor or healthcare professional for advice.