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Comparison of inhaled glycopyrrolate (glycopyrronium) preparations available in various countries*

Comparison of inhaled glycopyrrolate (glycopyrronium) preparations available in various countries*
Availability Brand (trade) name Dose Content per inhalation capsule or MDI puff:
Glycopyrrolate (glycopyrronium) base
Content per inhalation capsule or MDI puff:
Glycopyrrolate (glycopyrronium) bromide salt
Drug delivered from mouthpiece:
Glycopyrrolate (glycopyrronium) base
Drug delivered from mouthpiece:
Glycopyrrolate (glycopyrronium) bromide salt
Single agent dry powder inhalers (DPI)
Canada and Europe Seebri Breezhaler 1 inhalation once daily 50 mcg glycopyrronium base (labeling within Canada) 63 mcg glycopyrronium bromide 44 mcg glycopyrronium base (labeling within European Union) 55 mcg glycopyrronium bromide
Combination long-acting antimuscarinic (LAMA) and long-acting beta2 agonist (LABA) DPI
United States Utibron Neohaler 1 inhalation twice daily 12.5 mcg glycopyrrolate base and 27.5 mcg indacaterol 15.6 mcg glycopyrrolate bromide and 27.5 mcg indacaterol (labeling within United States) 10.2 mcg glycopyrrolate base and 20.8 mcg indacaterol 12.8 mcg glycopyrrolate bromide and 20.8 mcg indacaterol
Canada and Europe Ultibro Breezhaler 1 inhalation once daily 50 mcg glycopyrronium base and 110 mcg indacaterol (labeling within Canada) 63 mcg glycopyrronium bromide and 110 mcg indacaterol 43 mcg glycopyrronium base and 85 mcg indacaterol (labeling within European Union) 54 mcg glycopyrronium bromide and 85 mcg indacaterol
Combination LAMA and LABA metered dose inhaler (MDI)
United States, Canada, and Europe Bevespi AerosphereΔ 2 puffs twice daily 8.3 mcg glycopyrronium base and 5.8 mcg formoterol fumarate dihydrate per puff released from valve (labeling within Canada) 10.4 mcg glycopyrrolate bromide and 5.5 mcg formoterol fumarate per puff released from valve 7.2 mcg glycopyrronium base and 5 mcg formoterol fumarate dihydrate per puff delivered from mouthpiece (labeling within European Union) 9 mcg glycopyrrolate bromide and 4.8 mcg formoterol fumarate per puff delivered from mouthpiece (labeling within United States)
Combination LAMA, LABA, and inhaled corticosteroid (ICS) DPI
Canada and Europe Enerzair Breezhaler 1 inhalation once daily 50 mcg glycopyrronium base, 150 mcg indacaterol, and 160 mcg mometasone (labeling within Canada) 63 mcg glycopyrronium bromide, 150 mcg indacaterol, and 160 mcg mometasone 46 mcg glycopyrronium base, 114 mcg indacaterol, and 136 mcg mometasone (labeling within Europe) 58 mcg glycopyrronium bromide, 114 mcg indacaterol, and 136 mcg mometasone
Combination LAMA, LABA, and ICS MDI
United States, Canada, and Europe Breztri Aerosphere (United States and Canada), Trixeo Aerosphere (Europe) 2 puffs twice daily 8.2 mcg glycopyrrolate base, 4.7 mcg formoterol fumarate dihydrate, and 182 mcg budesonide per puff released from valve (labeling within Canada) 10.4 mcg glycopyrrolate bromide, 5.5 mcg formoterol fumarate, and 182 mcg of budesonide per puff released from valve 7.2 mcg glycopyrrolate base, 5 mcg formoterol fumarate dihydrate, and 160 mcg budesonide per puff delivered from mouthpiece (labeling within Europe) 9 mcg glycopyrrolate bromide, 4.8 mcg formoterol fumarate, and 160 mcg budesonide per puff delivered from mouthpiece (labeling within United States)
The long-acting antimuscarinic known as glycopyrrolate in the United States is called glycopyrronium in other countries. The dose of glycopyrrolate (glycopyrronium) can be expressed in any one of the four following ways depending upon country. This table provides the equivalence for doses expressed as:
  • Glycopyrrolate (glycopyrronium) base per inhalation capsule or per puff from MDI valve
  • Glycopyrrolate (glycopyrronium) bromide salt per inhalation capsule or per puff from MDI valve
  • Glycopyrrolate (glycopyrronium) base delivered from the mouthpiece
  • Glycopyrrolate (glycopyrronium) bromide salt delivered from the mouthpiece

NA: not applicable.

* Labeling detail shown according to approved product information within the countries of Europe, Canada, and United States. Labeling conventions may vary in other countries. For additional detail, refer to the Lexicomp drug monographs included within UpToDate and locally approved product information.

¶ Product is no longer available in the United States but may be available elsewhere.

Δ Formoterol content of Bevespi Aerosphere is expressed as formoterol fumarate in the United States and as formoterol fumarate dihydrate in Canada and Europe.
References:
  1. United States FDA approved prescribing information. Available at: http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm (Accessed on March 25, 2022).
  2. European Medicines Agency Summary of Product Characteristics. Available at: https://www.ema.europa.eu/en/medicines (Accessed on March 25, 2022).
  3. Health Canada Product Monograph: Available at: https://health-products.canada.ca/dpd-bdpp/index-eng.jsp (Accessed on March 25, 2022).
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