Glycopyrrolate is a medicine used as a maintenance treatment for chronic obstructive pulmonary disease (COPD). It is a long-acting muscarinic antagonist (LAMA) that can be inhaled for maintenance treatment of airflow obstruction. It helps to relax muscles around airways in the lungs and to manage symptoms of COPD that make it hard to breathe.
Glycopyrrolate is part of a class of drugs for COPD called anticholinergics. There are long-acting and short-acting anticholinergics. Glycopyrrolate is the long-acting type. Do not exceed the recommended dose.2,4
Glycopyrrolate is a maintenance therapy for COPD and is not used for treating COPD flare-ups that have already started. Rescue inhalers should be used for symptoms that are severe and need rapid relief. 2,4
The medicine is available in two forms under two brand names. Seebri Neohaler and Lonhala Magnair. Seebri Neohaler is an encapsulated powder for oral inhalation. Lonhala Magnair is a solution for oral inhalation using a nebulizer.
What are the active ingredients?
The active ingredient in both Seebri Neohaler and Lonhala Magnair is glycopyrrolate.
How does Glycopyrrolate work?
Glycopyrrolate, like other anticholinergics, helps to treat COPD symptoms by relaxing the muscles that surround the airways. It helps to prevent symptoms such as wheezing, cough, tightness in the chest, and shortness of breath.1,2,3,4 COPD can cause irritation in the lungs that makes the muscles tighten up, which can make breathing symptoms worse.
In Seebri Neohaler, glycopyrrolate is delivered by inhalation powder contained in a Seebri capsule for use with the Neohaler. The usual dose for COPD patients is one 15.6 mcg capsule twice a day.3,4
Using Lonhala Magnair, glycopyrrolate is delivered by the contents of one Lonhala vial twice a day using the Magnair. The usual dose for COPD patients is one 25 mcg/mL vial twice a day.1,2
For most COPD patients, the medicine in glycopyrrolate starts improving lung function within a few minutes. It is not recommended for use as a rescue inhaler.
What are the possible side effects of Glycopyrrolate?
The most common side effects of glycopyrrolate are cough, runny nose and upper respiratory infection. 24 This is not an exhaustive list of all potential side effects. Talk to your healthcare provider or pharmacist for further information.
If you experience extreme breathlessness right after taking glycopyrrolate, stop taking it and seek medical help immediately. A small number of people have difficulty urinating while taking glycopyrrolate, as it can cause urinary retention especially in men with enlarged prostates.2,4
Things to know about Glycopyrrolate
The active ingredient glycopyrrolate may interact with concomitantly used anticholinergic medications. It’s important to avoid taking Seebri Neohaler and Lonhala Magnair with other anticholinergic-containing drugs. That is why it is important to tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Glycopyrrolate and certain other medicines may adversely interact with each other.1,2,3,4,5
If you experience an immediate hypersensitivity such as severe itching, swelling of the lips, tongue, or face, skin rash or hives, or difficulty breathing or swallowing after taking glycopyrrolate, stop taking it and seek medical help right away.2,4
Glycopyrrolate is not recommended for children, Tell your doctor if you:2,4
- Have any preexisting kidney, prostate, or bladder problems
- Are pregnant or planning to become pregnant
- Are breastfeeding, as it is not known if the medicine in glycopyrrolate enters the breast milk and if it can harm your baby
- Have eye problems such as glaucoma, as this drug can make glaucoma worse
For people who already have narrow-angle glaucoma, it can cause that condition to get worse. Consult your health care provider if you develop symptoms such as eye pain and discomfort, blurry vision, visual halos, or colored images in association with red eyes from conjunctival congestion and corneal edema.
Glycopyrrolate can cause a life-threatening narrowing of the airways called paradoxical bronchospasm. If this occurs the condition should be treated immediately with an inhaled, short-acting bronchodilator, and glycopyrrolate should be discontinued immediately. In that event, consult your physician about alternative therapy.2,4
Seebri Neohaler is administered twice a day. The 15.6 mcg Seebri capsule of powder is used for oral inhalation only with the Neohaler inhaler device. It should be taken at the same time each day, 1 capsule inhaled in the morning and 1 capsule inhaled in the evening. Seebri capsules come in a blister pack and should be removed immediately before use with Neohaler. To keep your Neohaler device clean, wipe the mouthpiece inside and outside with a dry cloth. Keep the inhaler dry.3,4
Lonhala Magnair is administered twice a day. The 25 mcg/mL Lonhala vials should be used only with the Magnair inhaler device. It should be taken at the same time each day, 1 vial in the morning and 1 vial in the evening. The vials should remain in their foil pouch, and only removed immediately before use.1,2
No dosage adjustment is required for geriatric patients, patients with mild and moderate hepatic impairment, or patients with mild-to-moderate renal impairment. It has not been studied in patients with severe renal or hepatic impairment.3,4
It is not recommended to use either Seebri Neohaler or Lonhala Magnair more than the prescribed usage. Increasing the frequency of administration can cause some patients to experience an increased risk of side effects associated with higher doses.1,2,3,4
For more details, read the full prescribing information of Seebri Neohaler and Lonhala Magnair.
- Lonhala Magnair. Available at: https://www.lonhalamagnair.com/. Accessed 3.21.19
- Prescribing Information. Available at: https://www.lonhalamagnair.com/LonhalaMagnair-Prescribing-Information.pdf. Accessed 3.21.19
- Seebri Neohaler. Available at: https://www.seebri.us/. Accessed 3.21.19
- Prescribing Information. Available at: https://www.seebri.us/Seebri-Prescribing-Information.pdf. Accessed 3.21.19
- Glycopyrrolate: Inhalation Route. Available at: https://www.mayoclinic.org/drugs-supplements/glycopyrrolate-inhalation-route/description/drg-20165175. Accessed 3.21.19