Glycopyrrolate is indicated for the long-term maintenance treatment for patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

Glycopyrrolate is a long-acting muscarinic antagonist which has similar affinity to the subtypes of muscarinic receptors M1 to M5. In the airways, it exhibits pharmacological effects through inhibition of M3 receptor at the smooth muscle leading to bronchodilation.

The recommended dose of Glycopyrrolate is the inhalation one ampoule twice-daily. It should be administered at the same time of the day, (1 ampoule in the morning and 1 ampoule in the evening), every day.

Sympathomimetics and Steroids: In clinical studies, concurrent administration of glycopyrrolate and other drugs commonly used in the treatment of COPD including sympathomimetics (long and short-acting beta2 agonists), anticholinergics (short-acting anti-muscarinic antagonists), oral and inhaled steroids showed no increases in adverse drug reactions.

Anticholinergics: There is a potential for an additive interaction with concomitantly used anticholinergic medications. Therefore, avoid unnecessary co-administration of glycopyrrolate with other anticholinergic containing drugs as this may lead to an increase in anticholinergic effects.

Glycopyrrolate is contraindicated in patients with a hypersensitivity to glycopyrrolate or any of the ingredients (Sodium Chloride, Citric Acid Monohydrate, Sodium Hydroxide, Hydrochloric Acid and Water for Injection).

The following adverse reactions are found:

• shortness of breath,
• urinary tract infection,
• wheezing,
• upper respiratory tract infection,
• runny nose,
• fatigue.

There are no adequate and well-controlled studies in pregnant women. Glycopyrrolate should only be used during pregnancy if the expected benefit to the patient outweighs the potential risk to the fetus. Glycopyrrolate is not indicated for use in children.

Glycopyrrolate should not be initiated in patients during acutely deteriorating or potentially life-threatening episodes of COPD. Glycopyrrolate should not be used as rescue therapy for the treatment of acute episodes of bronchospasm.

An overdose of glycopyrrolate may lead to anticholinergic signs and symptoms such as nausea, vomiting, dizziness, lightheadedness, blurred vision, increased intraocular pressure (causing pain, vision disturbances, or reddening of the eye), obstipation or difficulties in voiding

Bronchodilator

Keep in a dry place and store below 30°C. Protect from light and keep out of the reach of children.