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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS › Anticholinergics
glycopyrronium bromide
R03BB06
Forms & Strengths
- Inhalation powder: 15.6 mcg per capsule
- Inhalation solution: 25 mcg per vial
- Oral solution: 1 mg/5 mL
- Injection: 0.2 mg/mL
Adult Dosing
- COPD (Inhalation): 15.6 mcg inhaled once daily via Neohaler
- Reversal of neuromuscular blockade (IV): 0.2 mg for each 1 mg neostigmine or 5 mg pyridostigmine administered
- Intraoperative antisialagogue (IV/IM): 0.1 mg repeated as needed every 2-3 minutes
Pediatric Dosing
- Reversal of neuromuscular blockade (IV, children > 1 month): 0.005 to 0.01 mg/kg given with an anticholinesterase
- Preoperative antisialagogue (IV/IM/SC, children 1 month to 12 years): 0.004 to 0.005 mg/kg, max single dose 0.1 mg
Indications
- Long-term maintenance bronchodilator treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD)
- Reversal of neuromuscular blockade induced by non-depolarizing neuromuscular blocking agents
- Preoperative reduction of salivary and tracheobronchial secretions
Mechanism of Action
- Long-acting, competitive antagonist at muscarinic acetylcholine receptors (anticholinergic/antimuscarinic)
- Inhibits bronchoconstriction and mucus hypersecretion by blocking M3 receptors on airway smooth muscle and submucosal glands
Contraindications
- Hypersensitivity to glycopyrronium or any formulation components
- Angle-closure glaucoma
- History of urinary retention or severe obstructive uropathy
- Severe ulcerative colitis or toxic megacolon
Adverse Reactions
- Dry mouth
- Nasopharyngitis
- Upper respiratory tract infection
- Urinary tract infection
- Constipation
- Tachycardia
- Blurred vision
Drug Interactions
- Other anticholinergic agents (additive toxicity and increased risk of adverse anticholinergic effects)
- Potassium chloride oral supplements (risk of gastrointestinal mucosal lesions due to delayed GI motility)
- Pramlintide (increased risk of severe gastrointestinal adverse reactions such as bowel obstruction)
Curated Content: Needs Vetting Before Put to Clinical Use