From the FDA Drug Label
Tiotropium is a long-acting, muscarinic antagonist which is often referred to as an anticholinergic. Umeclidinium is a long-acting muscarinic antagonist, which is often referred to as an anticholinergic.
Examples of LAMA inhalers include:
These are Long-Acting Muscarinic Antagonist (LAMA) inhalers used for the treatment of certain respiratory conditions, such as COPD.
From the Research
Long-Acting Muscarinic Antagonist (LAMA) inhalers include tiotropium, umeclidinium, aclidinium, and glycopyrrolate, which are typically prescribed for chronic obstructive pulmonary disease (COPD) and sometimes for severe asthma. These medications work by blocking muscarinic receptors in the airways, preventing acetylcholine from binding to these receptors on airway smooth muscle, which reduces bronchoconstriction and improves airflow 3.
Key Characteristics of LAMA Inhalers
- Tiotropium is often dosed at 18 mcg once daily via HandiHaler or 2.5 mcg once daily via Respimat inhaler.
- Umeclidinium is usually given as 62.5 mcg once daily.
- Aclidinium is administered as 400 mcg twice daily.
- Glycopyrrolate is given as 15.6 mcg twice daily.
Mechanism of Action and Side Effects
LAMAs have a long duration of action (typically 12-24 hours), allowing for once or twice daily dosing 4. Common side effects include dry mouth, constipation, and urinary retention. LAMAs should be used with caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder neck obstruction due to their anticholinergic properties 5.
Clinical Evidence and Guidelines
Recent studies have shown that fixed-dose combinations of LABA/LAMA are effective and safe for the management of COPD, with clinical evidence supporting their use in global and Asian populations 6. The latest clinical evidence from key studies on the efficacy and safety of approved LABA/LAMA fixed-dose combinations, such as indacaterol/glycopyrronium, vilanterol/umeclidinium, formoterol/aclidinium, and olodaterol/tiotropium, is also available 7, 6.