Buy Seebri Breezhaler capsules 50 mcg + 110 mcg in a set with an inhaler of 30 pcs packaging
  • Buy Seebri Breezhaler capsules 50 mcg + 110 mcg in a set with an inhaler of 30 pcs packaging

Seebri Breezhaler® [Glycopyrronium bromide]

Novartis
1861 Items
2019-09-19
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$151.94
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Clinical Pharmacology

Seebri Breezhaler - long-acting inhalation drug. Glycopyrronium bromide - (m-holinoblokator), the mechanism of action of which is based on blocking the bronchoconstrictor action of acetylcholine on the smooth muscle cells of the respiratory tract, which leads to the bronchodilatory effect. In humans, 5 subtypes of muscarinic receptors have been identified (M1-5). It is known that only the M1-3 subtypes are involved in the physiological function of the respiratory system.



Glycopyrronium bromide, being an antagonist of muscarinic receptors, has a high affinity for receptors of the subtype M1-3. At the same time, glycopyrronium bromide has a 4-5 times greater selectivity for the M1 and M3 receptor subtype, compared with the M2 receptor subtype. This leads to the rapid emergence of a therapeutic effect after inhalation of the drug, which is confirmed by clinical studies. The duration of the effect of the drug after inhalation is due to the long-term maintenance of the therapeutic concentration of the drug in the lungs, as evidenced by the longer half-life of the drug after inhalation, compared with intravenous administration. Numerous clinical studies have shown that, against the background of the use of glycopyrronium bromide in patients with chronic obstructive pulmonary disease (COPD), pulmonary function is significantly improved (the assessment was carried out by changing the forced expiratory volume in 1 min 5 minutes after inhalation, with a significant increase in FEV) from baseline values ​​in the range of 0.091 l to 0.094 l, the bronchodilatory effect of glycopyrronium bromide persists for more than 24 hours after inhalation. According to clinical studies, there is no evidence of the development of tachyphylaxis to the bronchodilating effect of the drug against the background of regular use up to 52 weeks.



No changes in the heart rate (HR) and the duration of the QTc interval were observed with the use of the preparation Sibri Bryzhaler at a dose of 200 mcg in patients with COPD.

Indications

- supportive therapy of bronchial conduction disorders in patients with chronic obstructive pulmonary disease.

Composition

The composition of the capsule: hypromellose - 45.59 mg, water - 2.7 mg, carrageenan - 0.42 mg, sodium chloride - 0.18 mg, sunset sunflower yellow (E110) - 0.12 mg.

Ink composition: shellac, iron dye black oxide, propylene glycol, sodium hydroxide.

Glycopyrronium bromide is marketed under different brands and generic names, and comes in different dosage forms:

Brand nameManufacturerCountryDosage form
Ultibro Breezhaler Novartis Switzerland capsules
Seebri Breezhaler Novartis Switzerland powder

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Seebri Breezhaler® [Glycopyrronium bromide]

Dosage and Administration

For inhalation use only!

The drug is a capsule with powder for inhalation, which should be used only for inhalation through the mouth using a special device for inhalation Brizhaler®which is included in the package. The drug can not be taken orally. Capsules with powder for inhalation should be stored in a blister and removed from it immediately before use.

The recommended dose of the drug Sibri® Brizhaler® makes 50 mcg (contents of 1 capsule) 1 time / day. Inhalation of the drug is carried out daily 1 time / day at the same time. In case of missing inhalation, the next dose should be taken as soon as possible. Patients should be instructed not to take more than 1 dose of the drug (50 mcg) per day.

Before starting to use the drug Sibri® Brizhaler® patients should be instructed in the proper use of the inhaler.

In the absence of an improvement in respiratory function, you should ensure that the patient is using the drug correctly. The drug should be inhaled, not swallowed.

In patients with impaired renal mild and moderate severitySibri® Brizhaler® can be used at the recommended dose. In patients with severe renal impairment or end-stage renal disease requiring hemodialysis, Sibri® Brizhaler®should be used at the recommended dose only if the intended benefit outweighs the potential risk.

Special clinical studies in patients with impaired liver function was not conducted. Glycopyrronium bromide is excreted mainly by renal excretion, therefore, a significant increase in exposure in patients with impaired liver function is not expected. In patients with impaired liver function Sibri® Brizhaler® can be used at the recommended dose.

Patients aged 75 and older in Sibri® Brizhaler® can be used at the recommended dose.

Adverse reactions

Sibri drug safety profile® Brizhaler® characterized by symptoms associated with m-anticholinergic effects, including dry mouth (2.2%), while other effects on the gastrointestinal tract and signs of urinary retention were infrequent.

Adverse drug reactions associated with local tolerance of the drug included pharyngeal irritation, nasopharyngitis, rhinitis, and sinusitis. In the recommended doses of the drug Sibri® Brizhaler® does not affect blood pressure and heart rate.

Safety and tolerability of the drug Sibri® Brizhaler® It was investigated when used in 1353 patients with COPD at the recommended dose of 50 mg 1 time / day. Of these, 842 patients were treated for at least 26 weeks and 351 - at least 52 weeks.

Determination of the frequency of undesirable drug reactions: very often (≥1 / 10); often (≥1 / 100, <1/10); infrequently (≥1 / 1000, <1/100); rarely (≥1 / 10,000, 1/1000); very rarely (<1/10 000).

Infectious and parasitic diseases: often - nasopharyngitis; infrequently - rhinitis, cystitis.

On the part of metabolism: infrequently - hyperglycemia.

On the part of the psyche: often - insomnia.

On the part of the nervous system: often - headache; infrequently - hypesthesia.

Since the cardiovascular system: infrequently - atrial fibrillation, palpitations.

On the part of the respiratory system, organs of the chest and mediastinum: infrequently - congestion in the sinuses, productive cough, irritation of the pharynx, nosebleeds.

On the part of the digestive system: often - dry mouth, gastroenteritis; infrequently - dyspepsia, dental caries.

On the part of the skin and subcutaneous tissues: infrequently - skin rash.

On the part of the musculoskeletal system: infrequently - pain in the limbs, pain in the skeletal muscles of the chest.

From the urinary system: often - urinary tract infection; infrequently - dysuria, urinary retention.

General disorders: infrequently - fatigue, asthenia.

In a clinical study lasting for 12 months, the following additional adverse events were identified that occurred more frequently with the use of Sibri® Brizhaler® compared to placebo: nasopharyngitis (9.0% versus 5.6%), vomiting (1.3% versus 0.7%), muscle pain (1.1% versus 0.7%), pain in the neck (1.3% versus 0.7%), diabetes (0.8% against 0%).

Undesirable drug reactions obtained during post-marketing research and according to the literature: since the data are reported voluntarily from a population of uncertain size, it is not possible to determine their frequency (frequency unknown) - angioedema.

Contraindications

Elderly patients older than 75 years, the frequency of urinary tract infections and headache with the use of the drug Sibri®Brizhaler® was higher than in the placebo group (3.0% versus 1.5% and 2.3% versus 0%, respectively).

If any of the above side effects are exacerbated or any other side effects occur, the patient should inform the physician.

- hypersensitivity to glycopyrronium bromide or any other components that make up the drug;

- children's and teenage age up to 18 years;

- simultaneous intake with inhalation drugs containing other m-anticholinergics;

- galactose intolerance, lactase deficiency or glucose-galactose malabsorption (the product contains lactose).

Carefully

Angle-closure glaucoma, diseases associated with urinary retention, severe renal failure (GFR below 30 ml / min / 1.73 m2), including end-stage renal disease requiring hemodialysis (Sibri preparation® Brizhaler® should be used only if the expected benefit outweighs the potential risk); unstable ischemic heart disease, history of myocardial infarction, cardiac arrhythmias, prolongation of the QT intervalc (QT corrected> 0.44 s).

Drug interactions

Drug interaction

Pregnancy and Lactation

In preclinical studies it was shown that the drug has no teratogenic effect after inhalation. Due to the lack of clinical data on the use of the drug Sibri® Brizhaler® in pregnant women, the drug can be used during pregnancy only if the intended use for the patient exceeds the potential risk to the fetus.

It is not known whether glycopyrronium bromide passes into breast milk in humans. Use of the drug Sibri® Brizhaler® breastfeeding should only be considered if the benefit to the mother outweighs any potential risk to the infant.

Neither reproductive toxicity studies nor other animal studies suggest that the drug may affect fertility in men or women.

Overdosage

No data on drug overdose Sibri® Brizhaler®.

In patients with COPD, regular inhalation administration of the drug Sibri®Brizhaler® in the total dose of 100 and 200 mg once a day for 28 days was well tolerated. Acute intoxication upon accidental ingestion of the capsule of the drug Sibri® Brizhaler® unlikely due to the low bioavailability of glycopyrronium bromide when administered orally (about 5%).

Cmax in plasma and total systemic exposure after iv administration of 150 μg of glycopyrronium bromide (equivalent to 120 μg of glycopyrronium) in healthy volunteers were approximately 50 and 6 times higher, respectively, than Cmaxin blood plasma and general systemic exposure in the equilibrium state, achieved with the use of the drug Sibri® Brizhaler® inhalation at recommended doses (50 mcg 1 time / day). Signs of overdose were not detected.

  • Brand name: Seebri Breezhaler
  • Active ingredient: Glycopyrronium bromide, indacaterol
  • Dosage form: Capsules with powder for inhalation are solid, size No. 3, with transparent lid and orange case, with special marking "Novartis logo" under the black stripe on the lid and the inscription "GPL50" in black ink over the black stripe on the case; The contents of the capsules are white or almost white.
  • Manufacturer: Novartis
  • Country of Origin: Switzerland

Studies and clinical trials of Glycopyrronium bromide (Click to expand)

  1. Analysis of some antispasmodic drugs: oxyphencyclimine and glycopyrronium bromide
  2. Efficacy of iontophoresis with glycopyrronium bromide for treatment of primary palmar hyperhidrosis
  3. Glycopyrronium bromide blocks differentially responses mediated by muscarinic receptor subtypes
  4. Antimuscarinic properties of the stereoisomers of glycopyrronium bromide
  5. Evaluation of the anticholinergic actions of glycopyrronium bromide.
  6. Glycopyrronium bromide, an ultrapotent M1-selective muscarinic receptor antagonist in vitro
  7. Pharmacology and Treatment The treatment of idiopathic hyperhidrosis by glycopyrronium bromide and tap water iontophoresis
  8. Inhaled Glycopyrronium Bromide: A Review of its Use in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease
  9. A novel model-based approach for dose determination of glycopyrronium bromide in COPD
  10. Inhaled glycopyrronium bromide: a guide to its use in moderate to severe chronic obstructive pulmonary disease
  11. Cost-Effectiveness Analysis of Glycopyrronium Bromide in the Treatment of Chronic Obstructive Pulmonary Disease in Spain
  12. Efficacy and Safety of Indacaterol and Glycopyrronium Bromide in Patients with COPD and Heart Failure
  13. The in vitro and in vivo profile of aclidinium bromide in comparison with glycopyrronium bromide
  14. Stereochemistry of anticholinergic agents. Part II. Crystal and molecular structure of glycopyrronium bromide
  15. Glycopyrronium bromide
  16. Glycopyrronium bromide
  17. Glycopyrronium bromide +; neostigmine
  18. Neostigmine see Glycopyrronium bromide +; neostigmine
  19. Glycopyrronium bromide/scopolamine
  20. Scopolamine see Glycopyrronium bromide/scopolamine
  21. Glycopyrronium bromide
  22. Inhaled Glycopyrronium Bromide Produces Significant Bronchodilation
  23. Don't forget glycopyrronium bromide in Frey's syndrome
  24. Glycopyrronium bromide monotherapy controls acute asthma

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