Breztri Aerosphere is a combination inhaler that contains budesonide (an inhaled corticosteroid), glycopyrrolate (a long-acting muscarinic antagonist), and formoterol (a long-acting beta agonist). It's used for maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults. Breztri is inhaled through the mouth and into the lungs twice per day every day. The most common side effects are upper respiratory tract infections and pneumonia. Breztri is brand name only and not available as a lower-cost generic.
Maintenance treatment of chronic obstructive pulmonary disease (COPD)
Breztri is a combination inhaler containing three medications that work together so you can breathe more easily.
Budesonide is an inhaled corticosteroid. It's thought to lower inflammation and swelling in the lungs.
Glycopyrrolate is a long-acting muscarinic antagonist (LAMA), a type of anticholinergic medication. It blocks acetylcholine to relax the muscles in your airways.
Formoterol is a long-acting beta agonist (LABA). It relaxes the muscles in your lungs to open up your airways.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Lowers the risk of COPD flare-ups
Combination of three medications in a single inhaler
Can be used with a spacer to make it easier to take a dose
Need to rinse your mouth after each dose
Need to inhale 2 puffs twice daily
Doesn't treat sudden worsening symptoms of COPD
Take 2 puffs of Breztri in the morning and 2 puffs in the evening every day. Use Breztri as prescribed at the same times each day to make sure it works as best as possible to treat your COPD.
Breztri isn't meant to be used to treat sudden difficulty breathing. Always have your rescue inhaler (e.g., albuterol (Ventolin)), handy in case you have sudden trouble breathing.
Call your pulmonologist if your breathing or peak flow meter results worsen. Also contact your pulmonologist if you're using your rescue inhaler more often than usual. These could be signs that Breztri isn't working well to control your COPD symptoms.
Store Breztri at room temperature in a dry place away from heat or sunlight. Keep unused inhalers in the original foil pouch.
Tips for how to use Breztri:
After you've removed Breztri from the original pouch, this inhaler expires after 3 months. Throw the inhaler away after 3 months or when the dose indicator display window shows "0", whichever comes first.
You'll need to prime your Breztri inhaler to make sure you get the full dose. To prime it for the first time, shake it well and spray into the air away from your face 4 times. Make sure to shake before each spray. If you haven't used your Breztri inhaler in a week or longer, you'll need to prime it again by spraying it 2 times into the air.
Shake the Breztri inhaler well before each dose to mix the medication. When you're ready, place your lips firmly around the mouthpiece, and slightly tilt your head back. Then, take a slow and deep breath while you push the top of the canister down to deliver the medication.
Try to hold your breath for as long as you comfortably can (up to 10 seconds) so that the medication can reach deep into your lungs. Then, repeat these steps to take your second dose of Breztri.
Clean your Breztri inhaler once a week to prevent medication from building up in the mouthpiece. To do so, remove the cap and canister and set them aside. Then, rinse the mouthpiece and top of the inhaler with warm running water for 30 seconds each. Shake off any extra water and let it fully air dry before putting your inhaler back together.
When the pointer in the display window of the Breztri dose counter is in the yellow zone, you should get a refill.
Breztri can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Don't use Breztri if you're experiencing a COPD flare-up because this medication won't provide immediate relief. Use a rescue inhaler, such as albuterol (Ventolin HFA), if you're having trouble breathing.
If you're using your rescue inhaler more often than usual, let your pulmonologist know because this could be a sign that your condition is getting worse. Don't use more doses Breztri than recommended because this won't improve your breathing. Rather, this can raise your risk for serious side effects, such as heart problems, tremors, and dizziness.
In addition, don't use Breztri with other inhalers containing a LABA, such as Serevent Diskus (salmeterol) or formoterol (Perforomist). Doing so can also worsen side effects.
Breztri isn't FDA-approved to treat asthma. Don't use this medication if you have asthma.
Risk factors: Not rinsing and spitting after using Breztri | Weakened immune system from medical conditions or medications
Breztri contains budesonide, a steroid medication. When inhaled, it can cause a fungal infection in your mouth and throat called thrush. The risk is highest during the first 3 months after you start this medication. To lower your risk for thrush, rinse your mouth with water and spit after each inhalation of Breztri. If you develop thrush, your pulmonologist might prescribe you a medication to treat this condition and ask you to temporarily stop using Breztri. Let your pulmonologist know if you notice symptoms of thrush, such as white patches in your mouth, cotton-like feeling in your mouth, pain while eating or swallowing, or loss of taste.
Inhaled medications, including Breztri, can sometimes cause a muscle spasm in your lungs. This can lead to difficulty breathing, wheezing, cough, and chest discomfort. If you have a hard time breathing after inhaling Breztri, use your rescue inhaler and get medical attention right away.
Allergic reactions to Breztri are possible. These reactions can include life-threatening facial swelling, shock, and anaphylaxis (closing of the throat). Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after you use Breztri.
Like all corticosteroid-containing medications, Breztri can weaken your immune system and raise your risk for infections, including upper respiratory infections and pneumonia. Your risk for infections is higher if you're also taking other medications that also weaken your immune system. If you're currently being treated for a serious infection, such as tuberculosis, let your pulmonologist know. They might need to consider a different medication for your condition until you get better. Let your pulmonologist or primary care provider know right away if you have symptoms of infections, such as fever, chills, or body aches.
Risk factors: Using Breztri for a long time | Using too much Breztri
Use Breztri only as directed. Don't use more than the maximum number of inhalations each day. Doing so can cause more of the steroid to be absorbed into the body and raise your risk for symptoms such as higher blood sugar or blood pressure.
On the other hand, if you're transitioning to Breztri from oral steroids, you might experience symptoms of low steroid hormone, such as stomach pain, loss of appetite, and nausea. When you transition to Breztri, your pulmonologist will work with you to lower your dose of oral steroids slowly over time to prevent these side effects.
Risk factors: Long-term use of Breztri | History of glaucoma | History of high eye pressure
Although rare, people using inhaled steroids or anticholinergics over a long period of time have reported having higher pressure in the eyes, glaucoma, and cataracts. Since Breztri contains budesonide (a steroid) and glycopyrrolate (an anticholinergic), talk to your optometrist before using Breztri if you have glaucoma or cataracts because they might ask you to come in more often for eye exams. Also speak with them if you notice any changes to your vision while using the medication.
Risk factors: High blood pressure | Heart failure | Heart rate or rhythm problems | Using more Breztri than recommended
The formoterol in Breztri might cause changes in your blood pressure, heart rate, and heart rhythm. But these side effects are typically unlikely to happen if you're taking the recommended dose of Breztri. Your pulmonologist or cardiologist might ask you to regularly check your blood pressure and heart rate at home if you have high blood pressure or other heart problems. Don't use Breztri more often than recommended. If you find that you need to use Breztri more often, let your care team know so they can see if you need any changes to your treatment plan. Tell your pulmonologist if you have dizziness, fatigue, tremor, rapid heartbeat, or weakness after you use Breztri.
Risk factors: Using Breztri too much
Formoterol in Breztri can cause the potassium levels in your blood to drop too low. In most cases, this happens if you use more Breztri than recommended. Drops in blood potassium levels are typically mild and your levels should go back to usual with time. Sometimes, low potassium can cause tiredness, weakness, muscle cramps, a racing heart, and a "pins and needles" feeling in your hands and feet. Tell your prescriber if you experience any of these symptoms while you're using Breztri. Also let your prescriber know if you need to use Breztri more often than instructed. Your treatment plan might need to be adjusted to better control your symptoms.
Risk factors: Enlarged prostate | Bladder-neck obstruction (blockage)
Breztri should be used cautiously by people who have prostate problems or urinary retention, because glycopyrrolate in Breztri can cause difficulty urinating. Contact your prescriber if you notice difficulty urinating while using this medication.
Each inhalation of Breztri contains 160 mcg of budesonide, 9 mcg of glycopyrrolate, and 4.8 mcg of formoterol.
The typical dose is 2 inhalations by mouth twice per day (in the morning and in the evening).
Treatment of sudden trouble breathing
Allergy to budesonide (inhaled corticosteroid), glycopyrrolate (an anticholinergic), or formoterol (long-acting beta agonist)
Maintenance treatment of asthma
Maintenance treatment of chronic obstructive pulmonary disease (COPD)
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