Budesonide, Glycopyrrolate, And Formoterol Fumarate
Generic Name: budesonide, glycopyrrolate, and formoterol fumarate
Brand Names:
Breztri
11 DESCRIPTION BREZTRI AEROSPHERE (budesonide, glycopyrrolate and formoterol fumarate) Inhalation Aerosol is a pressurized metered-dose inhaler that delivers a combination of micronized budesonide [an inhaled corticosteroid (ICS)], micronized glycopyrrolate (an anticholinergic), and micronized formoterol fumarate [an inhaled long-acting beta 2 -adrenergic agonist (a LABA)] for oral inhalation.
Overview
11 DESCRIPTION BREZTRI AEROSPHERE (budesonide, glycopyrrolate and formoterol fumarate) Inhalation Aerosol is a pressurized metered-dose inhaler that delivers a combination of micronized budesonide [an inhaled corticosteroid (ICS)], micronized glycopyrrolate (an anticholinergic), and micronized formoterol fumarate [an inhaled long-acting beta 2 -adrenergic agonist (a LABA)] for oral inhalation.
Uses
1 INDICATIONS AND USAGE BREZTRI AEROSPHERE is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). Limitations of Use: BREZTRI AEROSPHERE is not indicated for the relief of acute bronchospasm or for the treatment of asthma [see Warnings and Precautions (5.1 , 5.2) ] . BREZTRI AEROSPHERE is a combination of budesonide, an inhaled corticosteroid (ICS); glycopyrrolate, an anticholinergic; and formoterol fumarate, a long-acting beta 2 -adrenergic agonist (LABA), indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). (1) Limitations of Use: Not indicated for the relief of acute bronchospasm or for the treatment of asthma. (1 , 5.1 , 5.2)
Dosage
2 DOSAGE AND ADMINISTRATION • For oral inhalation only. (2) • Maintenance treatment of COPD: 2 inhalations of BREZTRI AEROSPHERE twice daily administered by oral inhalation. (2) 2.1 Recommended Dosage and Administration The recommended dosage of BREZTRI AEROSPHERE is budesonide 320 mcg, glycopyrrolate 18 mcg and formoterol fumarate 9.6 mcg (administered as 2 inhalations of BREZTRI AEROSPHERE [budesonide/glycopyrrolate/formoterol fumarate 160 mcg/9 mcg/4.8 mcg]) twice daily, in the morning and in the evening, by oral inhalation. Do not take more than two inhalations twice daily. After inhalation, rinse mouth with water without swallowing. 2.2 Preparation Prime BREZTRI AEROSPHERE before using for the first time.
Side Effects
6 ADVERSE REACTIONS The following adverse reactions are discussed in greater detail in other sections of the labeling. • Serious asthma-related events – hospitalizations, intubations, death [see Warnings and Precautions (5.1) ] • Oropharyngeal candidiasis infection [see Warnings and Precautions (5.4) ] • Increased risk of pneumonia in COPD [see Warnings and Precautions (5.5) ] • Immunosuppression and risk of infections [see Warnings and Precautions (5.6) ] • Hypercorticism and adrenal suppression [see Warnings and Precautions (5.8) ] • Paradoxical bronchospasm [see Warnings and Precautions (5.10) ] • Hypersensitivity reactions including anaphylaxis [see Contraindications (4) and Warnings and Precautions (5.11) ] • Cardiovascular effects [see Warnings and Precautions (5.12) ] • Reduction in...
Interactions
7 DRUG INTERACTIONS No formal drug interaction studies have been performed with BREZTRI AEROSPHERE. • Strong cytochrome P450 3A4 inhibitors (e.g. ritonavir): Use with caution. May cause systemic corticosteroid effects. (7.1) • Other adrenergic drugs may potentiate effect: Use with caution. (7.2) • Diuretics, xanthine derivatives or steroids may potentiate hypokalemia or ECG changes. Use with caution. ( 7.3 , 7.4 ) • Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. May potentiate effect of formoterol fumarate on cardiovascular system. ( 7.5 ) • Beta-blockers: Use with caution. May block bronchodilatory effects of beta-agonists and produce severe bronchospasm.
Warnings
5 WARNINGS AND PRECAUTIONS • LABA as monotherapy (without an inhaled-corticosteroid) is associated with an increased risk of serious asthma-related events. (5.1) • Do not initiate in acutely deteriorating COPD. Do not use to relieve acute symptoms. (5.2) • Do not use in combination with an additional therapy containing a LABA because of the risk of overdose. (5.3) • Candida albicans infection of the mouth and pharynx may occur. Monitor patients periodically. Advise the patient to rinse his/her mouth with water without swallowing after inhalation to help reduce the risk. (5.4) • Increased risk of pneumonia in patients with COPD. Monitor patients for signs and symptoms of pneumonia. 4 CONTRAINDICATIONS BREZTRI AEROSPHERE is contraindicated in patients who have demonstrated hypersensitivity to budesonide, glycopyrrolate, formoterol, or any of the excipients [see Warnings and Precautions (5.11) and Description (11) ] . Hypersensitivity to budesonide, glycopyrrolate, formoterol fumarate, or to any of the excipients. (4)
Pregnancy
8.1 Pregnancy Risk Summary There are no adequate and well-controlled studies with BREZTRI AEROSPHERE or with two of its individual components, glycopyrrolate or formoterol fumarate, in pregnant women to inform a drug-associated risk; however, studies are available for the other component, budesonide.
Storage
16 HOW SUPPLIED/STORAGE AND HANDLING BREZTRI AEROSPHERE Inhalation Aerosol: • 160 mcg budesonide, 9.0 mcg glycopyrrolate, and 4.8 mcg formoterol fumarate per inhalation • is supplied as a pressurized aluminum canister with an attached dose indicator, a yellow plastic actuator, a white mouthpiece, and a grey plastic dust cap.
Frequently Asked Questions
What is Budesonide, Glycopyrrolate, And Formoterol Fumarate used for?▼
1 INDICATIONS AND USAGE BREZTRI AEROSPHERE is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). Limitations of Use: BREZTRI AEROSPHERE is not indicated for the relief of acute bronchospasm or for the treatment of asthma [see Warnings and Precautions (5.1 , 5.2) ] . BREZTRI AEROSPHERE is a combination of budesonide, an inhaled corticosteroid (ICS); glycopyrrolate, an anticholinergic; and formoterol fumarate, a long-acting beta 2 -adrenergic agonist (LABA), indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). (1) Limitations of Use: Not indicated for the relief of acute bronchospasm or for the treatment of asthma. (1 , 5.1 , 5.2)
What are the side effects of Budesonide, Glycopyrrolate, And Formoterol Fumarate?▼
6 ADVERSE REACTIONS The following adverse reactions are discussed in greater detail in other sections of the labeling. • Serious asthma-related events – hospitalizations, intubations, death [see Warnings and Precautions (5.1) ] • Oropharyngeal candidiasis infection [see Warnings and Precautions (5.4) ] • Increased risk of pneumonia in COPD [see Warnings and Precautions (5.5) ] • Immunosuppression and risk of infections [see Warnings and Precautions (5.6) ] • Hypercorticism and adrenal suppression [see Warnings and Precautions (5.8) ] • Paradoxical bronchospasm [see Warnings and Precautions (5.10) ] • Hypersensitivity reactions including anaphylaxis [see Contraindications (4) and Warnings and Precautions (5.11) ] • Cardiovascular effects [see Warnings and Precautions (5.12) ] • Reduction in...
Can I take Budesonide, Glycopyrrolate, And Formoterol Fumarate during pregnancy?▼
8.1 Pregnancy Risk Summary There are no adequate and well-controlled studies with BREZTRI AEROSPHERE or with two of its individual components, glycopyrrolate or formoterol fumarate, in pregnant women to inform a drug-associated risk; however, studies are available for the other component, budesonide.
What are the important warnings for Budesonide, Glycopyrrolate, And Formoterol Fumarate?▼
5 WARNINGS AND PRECAUTIONS • LABA as monotherapy (without an inhaled-corticosteroid) is associated with an increased risk of serious asthma-related events. (5.1) • Do not initiate in acutely deteriorating COPD. Do not use to relieve acute symptoms. (5.2) • Do not use in combination with an additional therapy containing a LABA because of the risk of overdose. (5.3) • Candida albicans infection of the mouth and pharynx may occur. Monitor patients periodically. Advise the patient to rinse his/her mouth with water without swallowing after inhalation to help reduce the risk. (5.4) • Increased risk of pneumonia in patients with COPD. Monitor patients for signs and symptoms of pneumonia. 4 CONTRAINDICATIONS BREZTRI AEROSPHERE is contraindicated in patients who have demonstrated hypersensitivity to budesonide, glycopyrrolate, formoterol, or any of the excipients [see Warnings and Precautions (5.11) and Description (11) ] . Hypersensitivity to budesonide, glycopyrrolate, formoterol fumarate, or to any of the excipients. (4)
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Medical Disclaimer
This drug information is for educational purposes only and should not replace professional medical advice. Drug information is sourced from the FDA National Drug Code Directory and Structured Product Labeling. Always consult with a healthcare provider before starting, stopping, or changing any medication.