Glycopyrronium (Seebri)

How does it work?

Seebri Breezhaler contains the active ingredient glycopyrronium bromide, which is a type of medicine known as an antimuscarinic or anticholinergic bronchodilator. It works by opening the airways to make it easier to breathe.

Glycopyrronium works in the lungs, where it blocks receptors called muscarinic receptors that are found on the muscle surrounding the airways. A natural chemical called acetylcholine normally acts on these receptors, causing the muscle in the airways to contract and the airways to narrow.

In chronic obstructive lung diseases (COPD), such as chronic bronchitis or emphysema, the airways are narrowed, and this makes breathing in and out difficult.

Glycopyrronium blocks the muscarinic receptors in the lungs and therefore stops the action of acetylcholine on them. This allows the muscle around the airways to relax and the airways to open. This makes it easier for people with COPD to breathe.

Glycopyrronium is taken using an inhaler device called a Breezhaler inhaler. Inhaling the medicine allows it to act directly in the lungs where it is needed most. It also reduces the potential for side effects in other parts of the body, as the amount absorbed into the blood through the lungs is lower than if it is taken by mouth.

What is it used for?

  • Chronic obstructive pulmonary disease (COPD).

This inhaler is used regularly on a daily basis to help keep the airways open.

How do I use it?

  • Seebri Breezhaler comes with capsules that contain the medicine in powder form. These capsules are put in the chamber in the inhaler. You then use the inhaler to pierce the capsule and breathe in the powder. Do not swallow the capsules. It is important to follow the instructions provided with the Breezhaler carefully, and talk to your doctor, pharmacist or nurse if you are unsure how to use the device, or have any problems using it.
  • The usual dose of Seebri is one capsule to be inhaled once daily. The daily dose should be taken at the same time each day. The effect of the medicine lasts for 24 hours.
  • If you forget to take your dose at your usual time, then take it as soon as you remember that day. Then take your next dose at your usual time the following day. If you forget to take a dose for a whole day then just leave out the missed dose. Do not take more than one dose in a day to make up for a missed dose.
  • Do not exceed the recommended dose of this medicine.
  • The Seebri Breezhaler should be disposed of after 30 days of use, preferably by returning it to your pharmacy.

Warning!

  • Do not swallow the capsules. Make sure you follow the instructions provided with your Seebri Breezhaler. These tell you how to put a capsule in the inhaler, how to pierce the capsule with the inhaler and how to breathe in the medicine using the inhaler, as well as how to clean the inhaler and various other pieces of information.
  • Inhalers may cause an unexpected increase in wheezing (paradoxical bronchospasm) straight after using them. If this happens, stop using the inhaler immediately and consult your doctor. The medicine should be stopped and an alternative treatment found.
  • Seebri should not be used to relieve an attack of breathing difficulty. Instead, it should be used regularly each day to keep the airways open and help prevent breathing difficulties. The medicine works over 24 hours so it is best to always take it at the same time of day.
  • This medicine can cause a dry mouth, which may increase the risk of tooth decay with long-term use of the medicine. It is therefore important to practise good oral hygiene and visit your dentist regularly for check-ups.

Use with caution in

  • People with severely decreased kidney function or kidney failure needing dialysis.
  • People who have difficulty passing urine, for example men with an enlarged prostate gland (prostatic hypertrophy) or people with an obstruction of the bladder.
  • Closed angle glaucoma.
  • People with a history of heart disease, such as heart failure, heart attack, angina or irregular heartbeats (arrhythmias).

Not to be used in

  • Children and adolescents under 18 years of age.
  • The capsules used in Seebri Breezhaler contain lactose. This medicine should not be used by people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The safety of this medicine in pregnancy has not been established. It should therefore be used with caution during pregnancy, and only if the benefits to the mother outweigh any risks to the unborn baby. Seek medical advice from your doctor.
  • It is not known if this medicine passes into breast milk after inhalation. You should seek medical advice from your doctor before breastfeeding while using this medicine.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

  • Dry mouth.
  • Inflammation of the nose and throat, causing a blocked or runny nose and sore throat (nasopharyngitis).
  • Difficulty sleeping (insomnia).
  • Headache.
  • Infection in the urinary tract.
  • Infection of the stomach and bowel (gastroenteritis).

Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Difficulty or pain passing urine.
  • Loss of sensation or numbness (hypoaesthesia).
  • Awareness of your heartbeat (palpitations).
  • Irregular heartbeat (atrial fibrillation).
  • Cough with mucus.
  • Throat irritation.
  • Nosebleeds.
  • Tooth decay (see warning section above).
  • Indigestion.
  • Rash.
  • Feeling weak and tired.
  • Pain in the hands and feet.
  • Increased blood glucose levels (hyperglycaemia).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to make sure that the combination is safe.

This medicine has not been studied in combination with other anticholinergic medicines such as those below, and these are therefore not recommended while you are using this medicine:

  • aclidinium
  • ipratropium
  • oxitropium
  • tiotropium.

If you experience a dry mouth as a side effect of this medicine you may find that medicines that are designed to dissolve and be absorbed from under the tongue, eg sublingual glyceryl trinitrate (GTN) tablets for angina, become less effective. This is because the tablets do not dissolve properly in a dry mouth. To resolve this, drink a mouthful of water before taking sublingual tablets.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK for treating COPD that contain glycopyrronium bromide as the active ingredient.