What are the brand names of LAMA (Long-Acting Muscarinic Antagonist) medications for Chronic Obstructive Pulmonary Disease (COPD)?

From the Guidelines

Long-acting muscarinic antagonists (LAMAs) for COPD include Spiriva (tiotropium), Incruse Ellipta (umeclidinium), Seebri Neohaler (glycopyrrolate), Tudorza Pressair (aclidinium), and Yupelri (revefenacin) as the most effective options for reducing symptoms and exacerbations in patients with moderate to severe COPD, as recommended by the 2023 Canadian Thoracic Society guideline 1.

Key Points

• These medications work by blocking muscarinic receptors in the airways, which helps prevent bronchoconstriction and reduces symptoms like shortness of breath.
• Spiriva is available as a HandiHaler (dry powder inhaler) or Respimat (soft mist inhaler) and is typically taken once daily.
• Incruse Ellipta is a dry powder inhaler also taken once daily.
• Tudorza Pressair is taken twice daily, while Seebri Neohaler is taken once daily.
• Yupelri is unique as it's administered via nebulizer once daily.

Benefits and Side Effects

• LAMAs are often prescribed as maintenance therapy for moderate to severe COPD to improve lung function and reduce exacerbations, as supported by the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 report 1.
• They're sometimes combined with long-acting beta-agonists (LABAs) in single inhalers for enhanced bronchodilation.
• Common side effects include dry mouth, constipation, and urinary retention, so patients with glaucoma or prostatic hyperplasia should use these medications with caution.

Treatment Recommendations

• The 2023 Canadian Thoracic Society guideline recommends LABD maintenance therapy in all symptomatic patients with COPD confirmed by spirometry and single inhaler dual therapy LABD in those with moderate to severe dyspnea and/or poor health status 1.
• The guideline also suggests single-inhaler triple therapy in those with persistent moderate to severe dyspnea and/or poor health status despite treatment with single inhaler dual therapy with LAMA/LABA or ICS/LABA.

From the FDA Drug Label

ANORO ELLIPTA is a light grey and red plastic inhaler containing 2 foil blister strips. The brand name of LAMA for COPD is ANORO ELLIPTA 2.

From the Research

Brand Names of LAMA for COPD

• The following are some brand names of LAMA (long-acting muscarinic antagonists) for COPD:
  • Tiotropium bromide 3, 4
  • Glycopyrronium bromide 3, 5
  • Umeclidinium bromide 3, 5
  • Aclidinium bromide 3, 5
• These LAMAs are administered via inhalation and are used to improve lung function, reduce symptoms, and decrease the risk of exacerbations in patients with COPD 3, 5, 4, 6.

Combination Therapies

• LAMA/LABA (long-acting β2-agonist) fixed-dose combinations are also available, including:
  • Indacaterol/glycopyrronium 3, 5
  • Umeclidinium/vilanterol 3, 5
  • Olodaterol/tiotropium 3, 7
• These combination therapies have been shown to provide clinical benefits in lung function, quality of life, and early morning COPD symptoms in patients with COPD 5, 7.