umeclidinium

Absorption: Minimal oral absorption; remainder of absorption occurs in lungs.

Distribution: Unknown.

Metabolism/Excretion: Primarily metabolized by the liver via the CYP2D6 isoenzyme; metabolites do not contribute to bronchodilation.

Half-Life: 11 hr.

Time/Action Profile ⬆ ⬇

(bronchodilation)

ROUTE	ONSET	PEAK	DURATION
inhaln	1 hr	2–12 hr	24 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Severe/acute symptoms of airflow obstruction;
Severe hypersensitivity to milk proteins or other ingredients;
Concurrent use with other anticholinergics.

Use Cautiously in:

Narrow-angle glaucoma (may cause acute angle closure);
Urinary retention, prostatic hyperplasia, bladder-neck obstruction;
Severe hepatic impairment;
OB: Safety not established in pregnancy;
Lactation: Use while breastfeeding only if potential maternal benefit outweighs potential risk to infant;
Pedi: Safety and effectiveness not established in children;
Geri: Older adults may be more sensitive to drug effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: chest pain

EENT: acute narrow-angle glaucoma, cough, nasopharyngitis

GU: urinary retention

MS: arthralgia

Resp: PARADOXICAL BRONCHOSPASM

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)

Interactions ⬆ ⬇

Drug-drug:

↑risk of anticholinergic adverse reactions when used concurrently with other anticholinergics; avoid concurrent use.

Route/Dosage ⬆ ⬇

Inhaln
(Adults ): One inhalation (62.5 mcg) once daily.

Availability ⬆ ⬇

Powder for inhalation in blister strips (contains lactose): 62.5 mcg/blister
In combination with: vilanterol (Anoro Ellipta), fluticasone and vilanterol (Trelegy Ellipta). See Appendix [not included in this PDA edition].

Assessment ⬆ ⬇

Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse) before administration and at peak of medication. Consult health care professional about alternative medication if severe bronchospasm is present; onset of action is too slow for patients in acute distress. If paradoxical bronchospasm (wheezing) occurs, withhold medication and notify health care professional immediately.

Implementation ⬆ ⬇

Inhaln: Follow manufacturer's instructions for use of inhaler. Breathe out; do not blow into mouthpiece. Close lips around mouthpiece. Breathe in a long, steady deep breath. Continue to hold breath as long as possible while removing inhaler from mouth. Slide cover over mouthpiece.

Patient/Family Teaching ⬆ ⬇

Instruct patient in the correct use of inhaler. Advise patient not to discontinue without consulting health care professional; symptoms may recur.
Inform patient that umeclidinium should not be used for treating sudden breathing problems.
Advise patient to notify health care professional if worsening symptoms; decreasing effectiveness of inhaled, short-acting beta₂-agonists; need for more inhalations than usual of inhaled, short-acting beta₂-agonists; or significant decrease in lung function occur.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to avoid concurrent use of Rx, OTC, and herbal products without consulting health care professional.
Advise patient to notify health care professional if signs and symptoms of worsening narrow-angle glaucoma (eye pain or discomfort, blurred vision, visual halos, colored images associated with red dyes from conjunctival congestion, corneal edema) or worsening urinary retention (difficulty passing urine, painful urination) occur.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇