Glycopyrrolate Formoterol

Glycopyrrolate Formoterol Brand Name– BEVESPI

What is Glycopyrrolate Formoterol

Glycopyrrolate formoterol is a combination of an inhaled long-acting muscarinic antagonist (LAMA) and a long-acting beta-2 adrenergic agonist (LABA).

It is indicated for the maintenance treatment of airflow obstruction in adult patients with chronic obstructive pulmonary disease (COPD).

In two 24-week efficacy studies (n = 3,699), the combination inhaler demonstrated a larger increase in mean change from baseline in trough FEV-1 at week 24 compared to the individual bronchodilator components and placebo. Improvements in FEV-1 were seen at 5 minutes after the first dose, and efficacy was sustained throughout the 12-hour dosing interval.

Treatment with glycopyrrolate; formoterol reduced use of rescue medication compared to placebo. 

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, glycopyrrolate; formoterol may be used as initial therapy for patients in group D (those with a high risk of exacerbation).

Combining bronchodilators with different mechanisms of action may further improve patient with a lower risk of adverse events compared to increasing the dose of a single bronchdilator.

Combination bronchodilators have a greater impact on patient reported outcomes and quality of life compared to monotherapies; however, more studies are needed to determine if combination therapy is more effective at preventing exacerbations.

Glycopyrrolate; formoterol is not indicated for the relief of acute bronchospasm or for the treatment of asthma.

Indications

1. chronic bronchitis
2. chronic obstructive pulmonary disease (COPD)
3. emphysema

For the maintenance treatment of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema

Adverse Reactions

• agitation
• anaphylactoid reactions
• angioedema
• anxiety
• arthralgia
• asthma-related death
• atrial fibrillation
• blurred vision
• bronchospasm
• chest pain (unspecified)
• cough
• dizziness
• fatigue
• headache
• hyperglycemia
• hypokalemia
• infection
• influenza
• insomnia
• muscle cramps
• nausea
• ocular hypertension
• ocular pain
• palpitations
• QT prolongation
• rash
• restlessness
• sinusitis
• ST-T wave changes
• supraventricular tachycardia (SVT)
• throat irritation
• tremor
• urinary retention
• urticaria
• vomiting
• wheezing
• xerostomia

Monitoring Parameters

• pulmonary function tests (PFTs)

Contraindications

• acute bronchospasm
• alcoholism
• anticholinergic medications
• asthma-related death
• bladder obstruction
• bradycardia
• breast-feeding
• cardiac arrhythmias
• children
• closed-angle glaucoma
• coronary artery disease
• diabetes mellitus
• geriatric
• heart failure
• hepatic disease
• hyperglycemia
• hypertension
• hyperthyroidism
• hypocalcemia
• hypokalemia
• hypomagnesemia
• labor
• long QT syndrome
• malnutrition
• MAOI therapy
• monotherapy treatment of asthma
• myocardial infarction
• ocular exposure
• paradoxical bronchospasm
• pheochromocytoma
• pregnancy
• prostatic hypertrophy
• QT prolongation
• renal failure
• renal impairment
• seizure disorder
• thyrotoxicosis

Interactions

• Abarelix
• Acebutolol
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
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• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
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• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Doxylamine
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• Acetaminophen; Dextromethorphan; Phenylephrine
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