Breyna is a Combination ICS-LABA Metered-Dose Inhaler
Breyna is a fixed-dose combination inhaler containing budesonide (an inhaled corticosteroid) and formoterol (a long-acting beta2-agonist) delivered via a pressurized metered-dose inhaler (pMDI) using co-suspension delivery technology 1.
Specific Formulations
Breyna is available in two strengths 1:
- 80 mcg budesonide / 4.5 mcg formoterol per actuation
- 160 mcg budesonide / 4.5 mcg formoterol per actuation
Each canister contains 120 actuations and comes with a blue plastic actuator with a grey dust cap 1.
Classification and Mechanism
This inhaler combines two medication classes in one device 1:
Inhaled Corticosteroid (ICS) Component - Budesonide:
- Decreases inflammation in the lungs
- Provides the anti-inflammatory foundation for asthma and COPD control
Long-Acting Beta2-Agonist (LABA) Component - Formoterol:
- Relaxes airway smooth muscle for at least 12 hours
- Prevents bronchospasm and acute symptoms
- Provides rapid onset bronchodilation
Clinical Role
For Asthma: Breyna is a long-term controller medication for adults and children ≥6 years with asthma requiring both ICS and LABA therapy 1. This aligns with guideline recommendations that LABAs combined with ICS are the preferred adjunctive therapy for moderate-to-severe persistent asthma (GINA step 3 or higher) 2, 3.
For COPD: The 160/4.5 mcg strength is approved for maintenance treatment of COPD, used as 2 inhalations twice daily to improve symptoms and reduce exacerbations 1.
Critical Safety Point
Breyna is NOT a rescue inhaler 1. It should never be used to treat acute breathing symptoms. Patients must have a separate short-acting beta2-agonist (like albuterol) for sudden symptom relief. The formoterol component, while long-acting, does not replace the need for rescue medication.
Guideline Context
The combination of ICS and LABA in a single inhaler represents the preferred treatment strategy for patients whose asthma is not controlled on ICS alone 4, 3. Evidence consistently demonstrates that adding a LABA to low-to-medium dose ICS provides superior outcomes compared to doubling the ICS dose or adding other long-term controllers like leukotriene modifiers 2, 4.