Glycopyrrolate (Inhalation)

Overview

When patients are diagnosed with chronic obstructive pulmonary disorder (COPD), they typically present with shortness of breath, wheezing, tightness of the chest and/or a chronic cough. Although chronic bronchitis and emphysema are distinct conditions, they are both forms of COPD and can both cause patients to experience these types of symptoms.

Whilst chronic bronchitis tends to cause inflammation in the windpipe and passageways to the lungs, emphysema occurs when the air sacs in the lungs are destroyed. Although the conditions have different causes and present differently, their symptoms may be treated with the same types of medications.

Bronchodilators, such as Glycopyrrolate, can help to ease the symptoms to COPD by relaxing the lung muscles and allowing the airways to widen. As an anticholinergic, Glycopyrrolate effectively blocks the cholinergic nerves. When these nerves are active, they release chemicals which prompt the muscles lining the patient's airways to tighten. When Glycopyrrolate is used to block these nerves, the muscles don't tighten and the patient's airway is, therefore, dilated.

By relaxing the muscles and keeping the airways open, Glycopyrrolate allows patients to breathe more easily and reduces the symptoms associated with chronic bronchitis, emphysema and other forms of COPD.

Although chronic obstructive pulmonary disorder cannot be cured, physicians use various medications to treat the patient's symptoms and to try and stop their condition from worsening. Whilst Glycopyrrolate is normally used in conjunction with other medications, it is effective in reducing wheezing, chest tightness and coughing and should enable patients to breathe without obstruction.

Conditions Treated

  • Chronic obstructive pulmonary disorder (COPD)

Type Of Medicine

  • Anticholinergic bronchodilator

Side Effects

When patients use medication, they may experience some adverse effects. In some cases, these side effects may be expected and may be fairly mild but, in others, medical attention may be required. If patients experience the following side effects when using Glycopyrrolate, they may not require medical assistance:

  • Body pain or aches
  • Sneezing
  • Chills
  • Sore throat
  • Cough
  • Runny or stuffy nose
  • Ear congestion
  • Unusual weakness or tiredness
  • Loss of voice
  • Tenderness or pain around the cheekbones and/or eyes
  • Stomach or abdominal pain
  • Fruit-like breath odor
  • Diarrhea
  • Increased level of thirst
  • Dry mouth
  • Increased level of hunger
  • Dry, flushed skin
  • Trouble getting to sleep or staying asleep
  • Increased urination
  • Weakness
  • Loss of appetite
  • Unexplained weight loss
  • Loss of consciousness
  • Sweating
  • Pain in the legs or arms
  • Stomachache or stomach pain

The above side effects occur most often when patients first start using Glycopyrrolate and may decrease over time. Although the patient may not require medical assistance for the above adverse effects, they should obtain medical advice if the side effects persist or are severe. Furthermore, physicians may be able to advise patients how side effects can be relieved or prevented.

In addition to this, patients should seek medical advice if they experience any of the following side effects when using Glycopyrrolate:

  • Bladder pain
  • Cloudy or bloody urine
  • Pain in the side of lower back
  • Painful or burning urination
  • Fast heartbeat
  • Frequent urge to urinate
  • Fever
  • Difficulty urinating
  • Rash on the skin
  • Itching or hives
  • Hoarseness
  • Joint stiffness, swelling and/or pain
  • Redness of the skin
  • Irritation
  • Swelling of the face, eyelids, hands, lips or feet
  • Blindness
  • Tightness in the chest
  • Blurred vision
  • Difficulty swallowing
  • Decrease in the frequency of urination
  • Headache
  • Decrease in the amount of urine produced
  • Eye discomfort or pain
  • Decreased vision
  • Tearing
  • Red eyes
  • Difficulty in passing urine (dribbling)
  • Large, hive-like swelling on the eyelids, face, lips, throat, tongue, feet, legs, hands and/or sex organs
  • Seeing halos around lights
  • Nausea and/or vomiting

When using Glycopyrrolate, patients should also obtain medical assistance if they experience any side effects which are not listed above. If patients do experience adverse effects which are not currently associated with Glycopyrrolate, they can also report them to the Food and Drug Administration. This enables the FDA to recognize the side effects commonly associated with Glycopyrrolate. Patients can report the onset of any additional side effects to the FDA on 1-800-FDA-1088.

Dosage

When patients are prescribed Glycopyrrolate, their physician will tell them how often to use their medication and when it should be administered. In general, patients are advised to take two capsules of Glycopyrrolate per day, via oral inhalation. In most cases, patients will be instructed to use one capsule in the morning and one later in the day.

As Glycopyrrolate should be inhaled, patients will also be given a special type of inhaler so that they can administer the medication. Glycopyrrolate capsules should not be swallowed. Instead, patients should open the cap of the inhaler and place a Glycopyrrolate capsule in the capsule chamber. Patients should then close the inhaler completely and ensure they hear a clicking sound before proceeding.

Once the Glycopyrrolate capsule has been placed in the inhaler, patients should press both buttons on the inhaler. This should pierce the capsule and ensure the inhaler is ready to use. Patients should exhale fully and breathe out as much as possible before placing the mouthpiece of the inhaler into their mouth.

Patients should wrap their lips around the mouthpiece of the inhaler and breathe in quickly and deeply. If possible, patients should hold their breath for at least five to ten seconds before breathing out.

Once completed, patients should open the inhaler and remove the used Glycopyrrolate capsule from the capsule chamber. Patients should not leave a used capsule in the inhaler. Patients can then close the mouthpiece and please the inhaler in a safe location, ready for their next dose of medicine.

If possible, patients should aim to administer Glycopyrrolate at the same time each day.

Every time patients are given a new prescription of Glycopyrrolate, they should be given a new inhaler to use as well. As the inhaler needs to be kept dry, patients should not attempt to wash it.

If patients use other types of inhalation medications, they should not use their Glycopyrrolate inhaler to administer them. Patients should be given separate inhalers if they are required to use any other inhalation medicines.

Patients should only administer the dose of Glycopyrrolate that their doctor has prescribed and they should not stop using this medicine unless their physician has advised them to. If patients stop using Glycopyrrolate without medical supervision, their symptoms may increase.

When patients are prescribed Glycopyrrolate, they will be shown how to administer the medicine. Glycopyrrolate should also be prescribed with a medication guide which patients can refer to for further guidance. However, if patients are unsure how to use this medicine, they should seek advice from their doctor or pharmacist.

If patients forget to administer a dose of Glycopyrrolate, they should simply skip the missed dose and continue with their normal dosing schedule. Patients should not attempt to administer a double dose of Glycopyrrolate, even if an earlier dose has been missed.

Potential Drug Interactions:

As some medicines can interact with each other, patients will need to tell their doctor if they are taking any other medicines before they start using Glycopyrrolate. Due to the possibility of interactions occurring, patients may not be prescribed Glycopyrrolate if they are already taking:

  • Potassium

Similarly, Glycopyrrolate is not usually prescribed alongside the following medicines:

  • Donepezil
  • Bupropion
  • Tiotropium
  • Oxymorphone

Although Glycopyrrolate may interact with the above medications, doctors may prescribe Glycopyrrolate alongside the above medicines in some instances. If so, they may change the patient's dose or advise them to take their medicine at a specific time in order to reduce the chance of an interaction occurring.

As interactions can occur between over-the-counter medicines, vitamins and supplements, as well as prescription medications, patients will need to tell their doctor if they are taking any of these substances. Similarly, patients should seek medical advice before using any new over-the-counter medicines, vitamins or supplements once they have started to use Glycopyrrolate.

Warnings

If patients have any additional medical conditions, they should inform their doctor before using Glycopyrrolate. There are some conditions which may affect the patient's treatment with Glycopyrrolate and these may include:

  • Severe COPD attack
  • Glaucoma
  • Difficulty urinating
  • Enlarged prostate
  • Bladder problems
  • Allergy to lactose and/or milk proteins

Although Glycopyrrolate is used to treat the symptoms of COPD, it should not be used during the course of a severe COPD attack. Physicians should prescribe an alternative medicine which can be used if a COPD attack occurs and this should provide fast-acting relief from the symptoms of an acute attack. Glycopyrrolate is designed to treat the long-term symptoms of COPD and should not, therefore, be used once the symptoms of an attack have started.

Currently, Glycopyrrolate is not prescribed to pediatric patients as the safety of the medication has not been tested on this group.

Due to the possibility of harm occurring, Glycopyrrolate is not usually prescribed to patients who are pregnant. Physicians will only prescribe this medicine to pregnant patients if it is absolutely necessary and, if so, the patient should be made aware of the risks before using Glycopyrrolate.

If patients become pregnant when using Glycopyrrolate, they should seek medical advice. Similarly, if patients plan to become pregnant and are using Glycopyrrolate, they should obtain medical advice before trying to conceive.

As some medicines can be transferred to an infant via breastfeeding, patients are normally advised not to breastfeed while using Glycopyrrolate. It is not known if the medicine could pose a risk to infants if it is used by a nursing mother. Due to this, patients should refrain from breastfeeding while using Glycopyrrolate or should seek medical advice before breastfeeding.

When patients are using Glycopyrrolate, they will need to attend regular consultations with their physician. This will enable the patient's doctor to confirm the medicine is working effectively and rule out the possibility of any harmful effects taking place.

If patients do not notice an improvement in their symptoms within a few days of using Glycopyrrolate or if their symptoms worsen, they should obtain immediate medical help.

If patients notice that their short-acting inhaler is not working as well once they have started using Glycopyrrolate as well, they should obtain immediate medical assistance. Similarly, if patients are using their short-acting inhaler more often since starting treatment with Glycopyrrolate, they should obtain medical advice.

In some cases, Glycopyrrolate can cause patients to experience paradoxical bronchospasms. If so, the patient's wheezing and breathing may worsen. If patients experience difficulty breathing, coughing, wheezing and/or shortness of breath after using Glycopyrrolate, they should obtain urgent medical help. Paradoxical bronchospasms can be life-threatening so it's vital that patients obtain emergency medical assistance if this situation arises.

If patients experience changes to their vision when using Glycopyrrolate, they should obtain medical advice. This includes blurred vision, trouble reading and/or seeing halos around lights. In some cases, patients may be referred to an ophthalmologist so that a comprehensive examination of their eyes can be carried out.

Before using Glycopyrrolate, patients should tell their doctor if they have any existing allergies. This includes allergies to other medicines, foods, preservatives, dyes or animals. If patients experience an allergic reaction when using Glycopyrrolate, they should obtain immediate medical help. An allergic reaction may include the following symptoms:

  • Rash on the skin
  • Wheezing
  • Itching
  • Hives
  • Difficulty breathing
  • Hoarseness
  • Difficulty swallowing
  • Swelling of the face, hands, mouth, lips, tongue and/or throat

When they are severe, allergic reactions can be life-threatening. Due to this, patients should obtain emergency assistance if they experience the above symptoms.

Storage

When keeping medicines at home, patients should ensure that they use a secure location which is inaccessible to other people. It is particularly important that children and/or pets cannot gain access to Glycopyrrolate or any other medications which may be in the home. Using a locked medicine cabinet or medicine box may help to keep medications secure.

In order to store Glycopyrrolate appropriately, patients should follow the instructions on the packaging or in the medication guide. In general, Glycopyrrolate can be kept at room temperature but should be stored in a location which is free from moisture, heat and/or direct light. Due to this, Glycopyrrolate should not typically be kept in a kitchen or bathroom environment.

Glycopyrrolate should be kept in a closed container and patients should only remove a capsule from the blister pack when they are ready to use it.

If patients are advised to stop using Glycopyrrolate or if the medicine reaches its use-by date, patients will need to dispose of it. However, medicines should not be thrown out with regular household waste as they could cause harm to other people. Instead, patients should contact their pharmacist or their physician's office and use a specific medicine disposal service.

Summary

When patients are experiencing the symptoms of COPD, early diagnosis is extremely important. Whilst chronic obstructive pulmonary disorder cannot be cured, the condition can be managed. If patients are diagnosed quickly, physicians may be able to delay the progress of the condition and prevent the patient's symptoms from worsening.

If patients are experiencing chest tightness, shortness of breath and/or wheezing, they should be examined to determine exactly what is causing their symptoms. Once chronic bronchitis, emphysema or another form of COPD has been established, physicians can determine how their condition can be treated.

As Glycopyrrolate relaxes the muscles in the lungs and improves lung function, it can be used to manage the symptoms of all types of COPD. When used appropriately, Glycopyrrolate should relieve the patient's symptoms on a long-term basis and should improve their lung function. As a result, Glycopyrrolate can greatly improve the patient's quality of life and may enable them to carry out daily activities that their symptoms had previously stopped them from doing.

Whilst Glycopyrrolate is an effective treatment for COPD, it is not normally used in isolation. It is particularly important that patients are prescribed another medication to treat acute COPD attacks, for example. Once the patient's treatment regime has been established, Glycopyrrolate can be used alongside other medications to improve the patient's symptoms and relieve their discomfort.