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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Adrenergics in combination with anticholinergics incl. triple combinations with corticosteroids
indacaterol, glycopyrronium bromide and mometasone
R03AL12
Forms & Strengths
- Inhalation powder, hard capsule: 150 mcg indacaterol / 50 mcg glycopyrronium / 80 mcg mometasone furoate
- Inhalation powder, hard capsule: 150 mcg indacaterol / 50 mcg glycopyrronium / 160 mcg mometasone furoate
Adult Dosing
- Maintenance treatment of COPD: One inhalation of 150/50/80 mcg or 150/50/160 mcg capsule once daily, administered at the same time of day using the provided inhaler.
Pediatric Dosing
- Not indicated for pediatric patients (<18 years of age) due to the lack of safety and efficacy data in this population for COPD.
Indications
- Maintenance treatment of chronic obstructive pulmonary disease (COPD) in adult patients inadequately treated by a combination of an inhaled corticosteroid and a long-acting beta2-agonist or a combination of a long-acting beta2-agonist and a long-acting muscarinic antagonist.
Mechanism of Action
- Indacaterol is a long-acting beta2-adrenergic agonist (LABA) that stimulates intracellular adenylate cyclase, causing bronchial smooth muscle relaxation.
- Glycopyrronium is a long-acting muscarinic antagonist (LAMA) that blocks the bronchoconstricting effects of acetylcholine on M3 receptors in airway smooth muscle.
- Mometasone furoate is a synthetic corticosteroid with high affinity for glucocorticoid receptors, exerting anti-inflammatory effects in the lungs.
Contraindications
- Hypersensitivity to indacaterol, glycopyrronium, mometasone furoate, or any of the excipients (including lactose).
- Primary treatment of acute episodes of bronchospasm or status asthmaticus.
Adverse Reactions
- Nasopharyngitis
- Upper respiratory tract infection
- Pneumonia
- Headache
- Oral candidiasis
- Urinary tract infection
- Hypokalemia
- Hyperglycemia
- Paradoxical bronchospasm
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) may increase systemic exposure to mometasone furoate.
- Beta-blockers can weaken or antagonize the effect of indacaterol; cardioselective beta-blockers should be used with caution.
- Concomitant use with other long-acting sympathomimetic agents or anticholinergics may potentiate adverse effects.
- Hypokalemic effects may be potentiated by concurrent treatment with non-potassium-sparing diuretics, xanthine derivatives, or corticosteroids.
Curated Content: Needs Vetting Before Put to Clinical Use