Glycopyrronium is prescribed to help ease the long-term symptoms of cough, wheeze and breathlessness in adults with chronic obstructive pulmonary disease (COPD).
Make sure you know how to use the inhaler device properly. Ask your nurse, doctor or pharmacist to show you, if you are unsure.Use the inhaler regularly, once every day.
|Type of medicine||An antimuscarinic bronchodilator|
|Used for||Chronic obstructive pulmonary disease (COPD)|
|Also called||Glycopyrrolate (in US); Seebri Breezhaler®|
There are also combination brands called Ultibro® (glycopyrronium with indacaterol) and Trimbow® (glycopyrronium with beclometasone and formoterol)
|Available as||Dry powder capsules (for inhalation with a Breezhaler® device)|
Glycopyrronium belongs to the group of medicines known as antimuscarinic bronchodilators. It is given to improve the air flow to your lungs. It works by opening up the air passages in your lungs so that air can flow into your lungs more freely. The inhaler should be used regularly every day.
Glycopyrronium can be helpful in relieving symptoms of chronic obstructive pulmonary disease (COPD). In this condition, the air flow to the lungs is restricted and this causes symptoms such as cough, wheeze and breathlessness. You will have been prescribed glycopyrronium to help reduce these symptoms over the long term - it is not a rescue treatment for sudden breathlessness.
A brand of glycopyrronium inhaler (called Ultibro®) also contains a bronchodilator medicine called indacaterol. Another glycopyrronium combination inhaler (called Trimbow®) contains beclometasone and formoterol. You could be prescribed these combination brands to help reduce the number of inhalers you need to use each day.
Before using a glycopyrronium inhaler
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start using glycopyrronium it is important that your doctor knows:
- If you have problems with your prostate gland, or if you have any difficulty passing urine.
- If you have an eye condition called glaucoma.
- If you have a heart condition, or an unusual heart rhythm.
- If you are pregnant or breast-feeding.
- If you are taking or using any other medicines or inhalers. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to use the inhaler
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about glycopyrronium, diagrams to remind you how to use the inhaler, and a full list of side-effects which you could experience.
- Follow your doctor's instructions carefully and make sure you know how to use the Breezhaler® inhaler device properly. If you are not sure what to do, please ask your nurse, doctor or pharmacist to show you.
- Inhale the contents of one capsule each day, using the inhaler device. To do this:
- Remove the cap and open the device by tilting the mouthpiece backwards. This opens up a chamber at the base of the device.
- Carefully remove one capsule from the blister packaging by peeling away the protective backing, and then place it in the chamber at the base of the device.
- Close the device by pulling the mouthpiece forwards until it clicks into place over the capsule chamber.
- Press the two side buttons on the base of the device inwards to pierce the capsule, and then release them. You will hear a click as the capsule is pierced.
- Breathe out (away from the inhaler device) and then place your lips around the mouthpiece and breathe in as deeply as you can through the device - you will hear a whirring noise as you do this.
- Hold your breath for 5-10 seconds and then breathe out. Open the device and check to make sure the capsule is empty. If so, remove the empty capsule. If there is still some powder in the capsule, close the device again and repeat the previous step to breathe in the rest of the powder.
- You must NOT swallow the capsules. The powder in the capsules is for you to inhale.
- You can use the inhaler at a time of day that suits you, but try to use it at the same time each day, as this will help you to remember to use it regularly. If you do forget to use the inhaler at your usual time, use it as soon as you remember. If you do not remember until the following day, leave out the missed dose. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Treatment for COPD is usually long-term so you should continue to use the inhaler unless you are advised otherwise by your doctor. If you are currently using any other inhalers or nebulisers to help your breathing, please discuss with your doctor if there are any of these that you should no longer use. This is because you should not use other antimuscarinic bronchodilators as well as glycopyrronium.
- Try to keep your regular appointments with your doctor. This is so your doctor can review your condition on a regular basis.
- If you find that your symptoms are becoming worse or that you need to use a reliever (rescue) inhaler more regularly, contact your doctor or nurse for advice straightaway.
- COPD is usually caused by smoking, so the most important treatment is to stop smoking. Smoking causes irritation and damage to your lungs, and will make your condition worse. Speak with your doctor or practice nurse for further advice if you are having difficulty in stopping smoking.
- People with COPD who exercise regularly, tend to have a better quality of life. If you are not used to exercise, a daily walk is a good start if you are able to do this. Speak with your doctor about what level of activity will help your breathing and keep you as fit as possible.
- If you are overweight, it may help your breathing if you try to lose weight. This is because being overweight means that you have to work much harder to breathe in to inflate your lungs. A dietician will be able to give you advice on how to eat a healthy diet and lose weight.
- Remember to arrange to have your yearly 'flu jabs' each autumn. This will help protect you against influenza and any chest infections that develop due to it.
Can glycopyrronium cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with glycopyrronium. The best place to find a full list of the side-effects which can be associated with your inhaler, is from the manufacturer's printed information leaflet supplied with the inhaler. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common glycopyrronium side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Diarrhoea, or stomach ache||This should soon pass, but if it becomes troublesome, speak with your doctor|
|Sleeping problems, nose and throat irritation||If any of these become troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to the inhaler, please speak with your doctor or pharmacist for further advice.
How to store glycopyrronium inhalers
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Do not use the same inhaler device for longer than 30 days. You will be given a new inhaler to use with each supply of capsules.
Important information about all medicines
Never use more than the prescribed dose. If you suspect that you or someone else might have had an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Seebri Breezhaler® Inhalation Powder, Hard Capsules 44 micrograms; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated July 2015.
British National Formulary; 71st Edition (March-September 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London