Table 2.
Available glycopyrrolate and other LAMA formulations
| Formulation | Brand name | Delivery method | Regions approved | Approved dosage |
|---|---|---|---|---|
|
Glycopyrrolate formulations
| ||||
| Monotherapy6,33 | Seebri Neohaler | DPI | US | 15.6 µg BID |
| Seebri Breezhaler | DPI | Europe | 50 µg QD (glycopyrronium moiety in capsule) | |
|
| ||||
| Monotherapy78 | Lonhala Magnair | Nebulized | US | 25 µg BID |
|
| ||||
| Glycopyrrolate–formoterol34 | Bevespi Aerosphere | pMDI | US | 18/9.6 µg BID (as glycopyrrolate–formoterol fumarate) |
|
| ||||
| Glycopyrrolate–indacaterol35,36 | Utibron Neohaler | DPI | US | 15.6/27.5 µg BID |
| Ultibro Breezhaler | DPI | Europe | 50/110 µg QD (in capsule, as glycopyrronium/indacaterol) | |
|
| ||||
| Glycopyrrolate–beclomethasone–formoterol37 | Trimbow | pMDI | Europe | 12.5/100/6 µg BID (metered dose, as glycopyrronium bromide–beclomethasone dipropionate–formoterol fumarate dihydrate) |
|
| ||||
|
Tiotropium formulations
| ||||
| Monotherapy79,80 | Spiriva HandiHaler | DPI | US | 18 µg QD (as tiotropium bromide) |
| Spiriva Respimat | SMI | US | 5 µg QD (as tiotropium bromide) | |
|
| ||||
| Tiotropium–olodaterol81,82 | Stiolto Respimat | SMI | US | 5/5 µg QD |
| Spiolto Respimat | SMI | Europe | 5/5 µg QD (delivered dose, as tiotropium bromide monohydrate–olodaterol hydrochloride) | |
|
| ||||
|
Umeclidinium formulations
| ||||
| Monotherapy83,84 | Incruse Ellipta | DPI | US | 62.5 µg QD |
| Incruse Ellipta | DPI | Europe | 62.5 µg QD (predispensed dose, as umeclidinium) | |
|
| ||||
| Umeclidinium–vilanterol85,86 | Anoro Ellipta | DPI | US | 62.5/25 µg QD |
| Anoro Ellipta | DPI | Europe | 62.5/25 µg QD (predispensed dose, as umeclidinium–vilanterol trifenatate) | |
|
| ||||
| Umeclidinium–fluticasone furoate–vilanterol87 | Trelegy Ellipta | DPI | US | 62.5/100/25 µg QD (as umeclidinium–fluticasone furoate–vilanterol) |
|
| ||||
|
Aclidinium formulations
| ||||
| Monotherapy88–90 | Eklira Genuair | DPI | Europe | 400 µg BID (as aclidinium bromide) |
| Bretaris Genuair | DPI | Europe | 400 µg BID (as aclidinium bromide) | |
| Tudorza Pressair | DPI | US | 400 µg BID (as aclidinium bromide) | |
|
| ||||
| Aclidinium–formoterol91 | Duaklir Genuair | DPI | Europe | 400/12 µg BID (as aclidinium bromide–formoterol fumarate dihydrate) |
|
| ||||
|
Revefenacin formulation
| ||||
| Monotherapy92 | TBCa | Nebulized | Completed Phase III trials | NA |
Note:
a
Theravance Biopharma and Mylan submitted a new drug application for revefenacin use in patients with COPD in November 2017 and were waiting for a response at the time of submission of this review article.93
Abbreviations: BID, bis in die (twice daily); DPI, dry-powder inhaler; LAMA, long-acting muscarinic antagonist; NA, not applicable; pMDI, pressurized metered dose inhaler; QD, quaque die (once daily); SMI, soft-mist inhaler; TBC, to be confirmed.