Pronunciation: brez-TREE
Generic name: budesonide, glycopyrrolate, and formoterol fumarate
Other brand names of budesonide, glycopyrrolate, and formoterol fumarate include: Breztri Aerosphere
Dosage form: inhalation aerosol, for oral inhalation (budesonide 160 mcg, glycopyrrolate 9 mcg, and formoterol fumarate 4.8 mcg per inhalation)
Drug class: Bronchodilator combinations

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 4, 2025.

What is Breztri? COPD Treatment

Breztri Aerosphere is a triple therapy inhaler used for the long-term treatment of chronic obstructive pulmonary disease (COPD) in adults. This ICS/LABA/LAMA combination inhaler combines 3 medicines in 1 inhaler:

1. Budesonide (inhaled corticosteroid/ICS): 160 mcg
2. Glycopyrrolate (anticholinergic medicine/LAMA): 9 mcg
3. Formoterol fumarate (long-acting beta2-agonist/LABA): 4.8 mcg.

COPD is a chronic lung disease that includes chronic bronchitis, emphysema, or both. Breztri is specifically designed for COPD triple therapy treatment and is not approved for asthma patients.

Breztri Aerosphere is not for sudden breathing problems and will not replace a rescue inhaler. Always have a rescue inhaler (such as albuterol) with you to treat sudden breathing problems.

• If you do not have a rescue inhaler, contact your healthcare provider to have one prescribed for you.

Key Facts About Breztri Aerosphere

• What it is: Triple therapy inhaler combining 3 COPD medications in one device
• Generic name: Budesonide/Glycopyrrolate/Formoterol fumarate
• Dosage: 2 puffs twice daily (morning and evening)
• FDA approved: July 23, 2020, for adults with COPD
• Manufacturer: AstraZeneca
• Not for: Asthma patients or children
• Generic available: No generic available.

How Does Breztri Work? Mechanism of Action

Each of the 3 active ingredients in this triple combination inhaler has a different mechanism of action to improve COPD symptoms:

Budesonide (ICS): This steroid component helps decrease inflammation in the lungs, which can lead to breathing problems in COPD patients.

Glycopyrrolate (LAMA): Blocks the effects of acetylcholine (a neurotransmitter) in the lungs, allowing the airways to relax and widen, making breathing easier.

Formoterol (LABA): Binds to and activates beta2-adrenergic receptors on smooth muscle cells in the airways. This activation also allows airways to relax and widen, making breathing easier. Formoterol provides long-lasting relief, typically lasting 12 hours or more. 

Breztri Side Effects

Common Side Effects

The most common side effects of Breztri are:

• Upper respiratory tract infection
• Pneumonia
• Back pain
• Thrush in your mouth and throat. Rinse your mouth with water without swallowing after use to help prevent this
• Joint pain
• Flu
• Headache
• High blood sugar levels
• Muscle spasms
• Cough
• Inflammation of the sinuses
• Diarrhea
• Hoarseness
• Painful and frequent urination (signs of a urinary tract infection)
• Nausea
• Difficulty sleeping
• Feeling anxious
• Heart palpitations.

Serious Side Effects and Warnings

Serious Allergic Reactions

There is a risk of serious allergic reactions with Breztri. Call your healthcare provider or get emergency medical care if you get any of the following symptoms of a serious allergic reaction after using your Breztri inhaler:

• Rash
• Hives
• Swelling of your face, mouth, and tongue
• Breathing problems.

Fungal Infections in Your Mouth or Throat (Thrush)

Breztri may increase your risk of fungal infections in your mouth and throat. Rinse your mouth with water and then spit the water out (do not swallow it) after using your Breztri inhaler to help reduce your chance of getting thrush.

Pneumonia Risk

COPD patients have a higher pneumonia risk. Watch for:

• Increased mucus production
• Change in mucus color
• Fever and chills
• Increased cough
• Worsening breathing problems.

Immune System Suppression

Breztri may make it harder for your body to fight infections because it can affect your immune system response.

Adrenal Insufficiency

Adrenal insufficiency is a condition where the adrenal glands do not make enough steroid hormones. This can happen when you stop taking oral corticosteroid medicines (such as prednisone) and start taking a medicine containing an ICS (such as Breztri Aerosphere). During this transition period, extra stress from fever, trauma (such as a car accident), infection, surgery, or worsening COPD symptoms can make adrenal insufficiency worse and potentially fatal. Symptoms include:

• Extreme fatigue
• Weakness
• Nausea and vomiting
• Low blood pressure (hypotension).

Immediate Breathing Problems

If you have sudden breathing problems immediately after using your Breztri inhaler, stop using it and call your healthcare provider right away.

Heart Effects

Breztri may affect your heart. Tell your healthcare provider immediately if your blood pressure increases or you develop a fast or irregular heartbeat or chest pain after using Breztri.

Nervous System Effects

Breztri may affect your nervous system. Tell your healthcare provider immediately if you develop a tremor or if you find yourself more anxious or nervous after using Breztri.

Osteoporosis

Breztri may reduce your bone density and cause thinning or weakness (osteoporosis).

Eye Problems

Breztri may cause new or worsened eye problems, including acute narrow-angle glaucoma and cataracts. Acute narrow-angle glaucoma can cause permanent loss of vision if not treated. Symptoms of acute narrow-angle glaucoma include:

• Eye pain or discomfort
• Nausea or vomiting
• Blurred vision
• Seeing halos or bright colors around lights
• Red eyes.

If you have these symptoms, call your healthcare provider right away before taking another dose.

Do not spray Breztri Aerosphere in your eyes. If Breztri Aerosphere accidentally gets in your eyes, rinse them well with water. If the redness persists, contact your healthcare provider.

Urinary Retention

May cause difficulty urinating. Stop using breztri and contact your healthcare provider if you experience: 

• • Difficulty starting urination
  • Weak urine stream
  • Frequent, painful urination.

Changes in Laboratory Tests

High blood sugar levels (hyperglycemia) and low potassium levels (hypokalemia) have been reported after using a Breztri inhaler. Low levels of potassium may cause symptoms of muscle spasm, muscle weakness, or abnormal heart rhythm.

These are not all the possible side effects of Breztri. Ask your healthcare provider or pharmacist for more information. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800- FDA-1088. You may also report side effects to AstraZeneca at 1-800-236-9933.

Related/similar drugs

Before Using

Absolute Contraindications:

Do not use Breztri if you:

• Are allergic to budesonide, glycopyrrolate, formoterol, or any of the other ingredients in your Breztri inhaler
• Have asthma (not FDA approved for asthma)
• Are under 18 years old
• Need immediate relief of breathing problems (use a rescue inhaler instead).

Before using Breztri Aerosphere

Tell your healthcare provider about all of your medical conditions, including if you have:

• Have heart problems or high blood pressure
• Seizures
• Thyroid problems
• Diabetes (Breztri may increase blood sugar)
• Liver or kidney problems
• Osteoporosis (weak bones)
• Immune system problems
• Eye problems (glaucoma or cataracts)
• Prostate, bladder problems, or urination problems 
• Current infections (viral, bacterial, parasitic, or fungal)
• Recent exposure to chickenpox or measles
• Pregnancy or breastfeeding plans.

Pregnancy and Breastfeeding Considerations

Pregnancy: It is not known if Breztri Aerosphere may harm your unborn baby.

Breastfeeding: It is not known if the medicines in Breztri Aerosphere pass into your breast milk and if they can harm your baby. You and your healthcare provider should decide if you will take Breztri Aerosphere while breastfeeding.

How to Use Breztri Inhaler Properly

Breztri Dosage and Administration

• Standard dose: 2 inhalations, 2 times daily (morning and evening)
• Total daily: 4 puffs per day maximum
• Timing: Space doses approximately 12 hours apart
• With or without food: Can be taken regardless of meals.

Proper Breztri Inhaler Technique

1. Remove the cap and shake the inhaler well before each use
2. Breathe out fully, away from the inhaler
3. Place the mouthpiece between the lips and seal tightly
4. Press down on canister while breathing in slowly and deeply
5. Hold your breath for 10 seconds or as long as comfortable
6. Repeat for second puff, waiting 30 seconds between puffs
7. Important: Rinse mouth with water and spit out after each dose.

What to Do if You Miss a Breztri Dose

If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose. Never take a double dose to make up for a forgotten dose.

What to Do if You Take Too Much Breztri

Contact your healthcare provider or emergency services if you experience unusual symptoms like severe shortness of breath, chest pain, rapid heartbeat, or shakiness.

When to Call Your Doctor While Using Breztri

Call immediately if you experience:

• Sudden worsening of breathing problems
• Signs of pneumonia (fever, colored mucus, increased cough)
• Allergic reaction symptoms (rash, swelling, severe breathing difficulty)
• Eye pain with nausea or vision changes
• Difficulty urinating
• Chest pain or irregular heartbeat.

Schedule an appointment if:

• You need a rescue inhaler more frequently
• Side effects persist or worsen
• COPD symptoms aren't improving after 4-6 weeks
• You have questions about proper inhaler technique.

Living with COPD While Using Breztri

What to Expect When Starting Breztri

• Week 1-2: May notice some improvement in breathing
• Week 2-4: Gradual improvement in daily symptoms
• Month 1-2: Should see a reduction in COPD flare-ups
• Ongoing: Continued maintenance of lung function

Lifestyle Considerations

• Continue prescribed exercise programs
• Maintain the diet your healthcare provider has recommended
• Stay up-to-date with vaccinations (especially flu and pneumonia)
• Avoid COPD triggers when possible
• Regular follow-ups with a healthcare provider.

What other drugs will affect Breztri?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Breztri Aerosphere and certain other medicines may interact with each other. This may cause serious side effects.

Do not use with:

• Other LABA medications (salmeterol, vilanterol, olodaterol, indacaterol)
• Other anticholinergic medications (tiotropium, ipratropium, umeclidinium)
• Other triple therapy inhalers (Trelegy Ellipta).

Use caution with:

• Antifungal medications
• Anti-HIV medications
• Beta-blockers
• Diuretics.

Breztri may be used with rescue inhalers, such as albuterol.

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist each time you get a new medicine.

Storage and Disposal

Proper Breztri Storage

• Store at room temperature (68°F to 77°F)
• Keep in original foil pouch until ready to use
• Protect from heat and sunlight
• Never store near heat sources or flames
• Temperatures above 120°F may cause the canister to burst
• Keep out of reach of children.

When to Discard

Throw away your Breztri inhaler:

• 3 months after opening the foil pouch (120-dose canister)
• 3 weeks after opening foil pouch (28-dose canister)
• When the dose counter reaches "0"
• Whichever comes first.

What are the ingredients in Breztri Aerosphere?

Active ingredients: budesonide, glycopyrrolate, and formoterol fumarate
Inactive ingredients: hydrofluoroalkane (HFA 134a) and porous particles (comprised of DSPC [1,2-Distearoyl-sn-glycero-3-phosphocholine] and calcium chloride)

Who makes Breztri?

Breztri Aerosphere is made by AstraZeneca, headquartered in Cambridge, UK.

Frequently Asked Questions About Breztri

Is Breztri a steroid inhaler?

Yes, Breztri contains budesonide, an inhaled corticosteroid (ICS). However, it's specifically a triple therapy steroid inhaler that also includes a LABA and LAMA for comprehensive COPD treatment.

Can I use Breztri for asthma?

No, Breztri is not approved for asthma treatment. Clinical trials have not been conducted in asthma patients.

Is there a Breztri generic available?

No, there is currently no generic version of Breztri available.

What's the difference between Breztri and other COPD medications?

Breztri is a triple therapy inhaler combining three different types of medications, while many other COPD treatments contain only one or two active ingredients.

Can I stop taking Breztri if I feel better?

No, continue taking Breztri as prescribed even if you feel better. COPD is a chronic condition requiring ongoing treatment.

Popular FAQ

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer