Medically reviewed by Drugs.com. Last updated on Feb 10, 2019.
(a kli DIN ee um)
- Aclidinium Bromide
- LAS-34273 Micronized
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Aerosol Powder Breath Activated, Inhalation, as bromide:
Tudorza Pressair: 400 mcg/actuation (1 ea) [contains milk protein]
Brand Names: U.S.
- Tudorza Pressair
- Anticholinergic Agent
- Anticholinergic Agent, Long-Acting
Competitively and reversibly inhibits the action of acetylcholine at type 3 muscarinic (M3) receptors in bronchial smooth muscle causing bronchodilation
Vd: ~300 L (following IV administration)
Rapid and extensive hydrolysis via plasma esterases to inactive alcohol and acid metabolites
Urine (<1% each of an inhaled dose)
Time to Peak
Plasma: Within 10 minutes (steady state, following inhalation)
5 to 8 hours (following inhalation)
Use: Labeled Indications
Chronic obstructive pulmonary disease: Long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD) including bronchitis and emphysema
Hypersensitivity to aclidinium or any component of the formulation; severe hypersensitivity to milk proteins
COPD: Oral inhalation: Dry powder inhaler: 400 mcg (one inhalation) twice daily
Refer to adult dosing.
Oral inhalation: Dry powder inhaler: Inhaler device is breath actuated; administer via oral inhalation. Remove inhaler from sealed pouch immediately prior to first use. Prior to each use, remove protective cap from the inhaler and prepare inhaler by pressing and releasing the green button to lead the dose; make sure the control window has changed from red to green (indicates inhaler ready for use). If the control window is red, retry activating the inhaler again by pressing and releasing the green button. Prior to inhaling the dose, breathe out completely before forming a tight seal with lips around mouthpiece and breathe in; there will be a “clicking” sound to ensure that the full dose has been given, although some patients may not hear the “click.” Use the control window, which should turn red after inhalation, to make sure the dose was inhaled correctly. If the control window is still green, repeat inhalation steps.
Store at 25°C (77°F); excursions permitted between 15°C to 30°C (59°F to 86°F). Product should be stored inside sealed pouch and only removed immediately before use. Discard product 45 days after opening pouch, when device locks out, or when dose indicator displays “0”, whichever comes first.
Acetylcholinesterase Inhibitors: Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Acetylcholinesterase Inhibitors may diminish the therapeutic effect of Anticholinergic Agents. Monitor therapy
Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Anticholinergic Agents: Aclidinium may enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Botulinum Toxin-Containing Products: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Exceptions: Cannabidiol. Monitor therapy
Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Monitor therapy
Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Avoid combination
Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Avoid combination
Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Monitor therapy
Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Monitor therapy
Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Avoid combination
Glycopyrronium (Topical): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Monitor therapy
Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Avoid combination
Loxapine: Agents to Treat Airway Disease may enhance the adverse/toxic effect of Loxapine. More specifically, the use of Agents to Treat Airway Disease is likely a marker of patients who are likely at a greater risk for experiencing significant bronchospasm from use of inhaled loxapine. Management: This is specific to the Adasuve brand of loxapine, which is an inhaled formulation. This does not apply to non-inhaled formulations of loxapine. Avoid combination
Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Monitor therapy
Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Monitor therapy
Opioid Agonists: Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Monitor therapy
Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination
Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Avoid combination
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Consider therapy modification
Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Monitor therapy
Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Avoid combination
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Consider therapy modification
Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Monitor therapy
Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Avoid combination
Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Monitor therapy
Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
1% to 10%:
Central nervous system: Headache (7%), falling (1%)
Gastrointestinal: Diarrhea (3%), toothache (1%), vomiting (1%)
Respiratory: Nasopharyngitis (6%), cough (3%), rhinitis (2%), sinusitis (2%)
<1%, postmarketing, and/or case reports: Anaphylaxis, angioedema (including swelling of the lips, tongue, or throat), bronchospasm, cardiac failure, cardiopulmonary arrest, diabetes mellitus, dizziness, dyspnea, dysuria, first degree atrioventricular block, hypersensitivity reaction (immediate), nausea, osteoarthritis, palpitations, pruritus, skin rash, tachycardia, urinary retention, urticaria, xerostomia
Concerns related to adverse effects:
• Bronchospasm: Paradoxical bronchospasm that may be life-threatening may occur with use of inhaled agents; this should be distinguished from inadequate response. If paradoxical bronchospasm occurs, discontinue use and institute alternative therapy.
• Hypersensitivity reactions: Immediate hypersensitivity reactions, including anaphylaxis, angioedema, pruritus, rash, and urticaria, may occur; discontinue immediately if signs/symptoms of a hypersensitivity reaction occur.
• Glaucoma: Use with caution in patients with narrow angle glaucoma; may increase intraocular pressure.
• Urinary retention: Use with caution in patients with urinary retention. Monitor for signs and symptoms of urinary retention, especially in patients with prostatic hyperplasia or bladder-neck obstruction.
Concurrent drug therapy issues:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
Dosage form specific issues:
• Lactose: Powder for oral inhalation may contain lactose; use is contraindicated in patients with severe milk protein allergy.
• Appropriate use: Not indicated for the initial (rescue) treatment of acute episodes of bronchospasm.
FEV1, peak flow, and/or other pulmonary function tests; signs/symptoms of glaucoma; hypersensitivity reactions; urinary retention
Pregnancy Risk Factor
Adverse events have been observed in animal reproduction studies.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience headache, pharyngitis, or rhinitis. Have patient report immediately to prescriber vision changes, blurred vision, eye pain, severe eye irritation, visual halos or bright colors around lights, urinary retention, painful urination, polyuria, or signs of breathing problems (shortness of breath, wheezing, coughing, or breathing gets worse) (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
More about aclidinium
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- En Español
- 16 Reviews
- Drug class: anticholinergic bronchodilators
Other brands: Tudorza Pressair