Glycopyrrolate (brand name, Seebri Neohaler) is an anticholinergic medicine used as a long-term maintenance treatment of airflow obstruction in people with COPD. It has been approved in more than 80 countries, including the U.S. It works to relax and open the airways to the lungs, so as to make breathing easier.

Seebri Neohaler, glycopyrrolate inhalation powder, was developed by Novartis and, in the U.S. is marketed by Sunovion.

How does glycopyrrolate for COPD work?

Glycopyrrolate is a long-acting muscarinic antagonist, also known as anticholinergic. It connects to the muscarinic receptor subtypes M1 to M5. The M3 receptors are located on the muscle of the bronchi, and are responsible for bronchoconstriction. As glycopyrrolate has affinity to the M3 receptors, it works by inhibiting them on the muscle of the bronchi, leading to bronchodilation.

Studies of glycopyrrolate

Preclinical studies with glycopyrrolate gave early evidence of this treatment’s prolonged bronchodilation effect in people with COPD. Other studies have demonstrated that once-daily treatment is of substantial benefit to people with moderate to severe COPD, improving their lung function, breathing difficulties, health status, and use of rescue medication, while showing a good safety profile.

A Phase 3 study assessing the efficacy and safety of glycopyrrolate 15.6 mcg twice daily (NCT01715298) in more than 400 COPD patients showed that glycopyrrolate acts fast, generally in 5 to 15 minutes of dosing, and maintained bronchodilation for 24 hours. Statistically significant improvements in COPD symptoms and need to use rescue medication were reported, and the treatment was well-tolerated in patients with moderate-to-severe disease.

Indications and side effects

As recommended by the current Global initiative for chronic Obstructive Lung Disease (GOLD) strategy and American Thoracic Society / European Respiratory Society guidelines, glycopyrrolate is one of the bronchodilators of choice for COPD treatment. It is a prescription medicine for long-term use, not for sudden breath problems. It comes as a powder that is usually inhaled twice daily, every 12 hours.

The most common side effects include upper respiratory tract infection, sore throat, and runny nose. Medical help should be sought if symptoms such as shortness of breath, vision disorders, nausea or vomiting,  urinary retention or signs of allergic reactions appear.

 

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