From the Guidelines
Trelegy inhaler should be used with caution in patients with narrow-angle glaucoma due to its umeclidinium component, which is an anticholinergic medication that can potentially worsen narrow-angle glaucoma by increasing intraocular pressure. The use of anticholinergic medications, such as umeclidinium, can induce angle narrowing and potentially precipitate an angle-closure attack in patients with narrow-angle glaucoma, as suggested by the primary angle closure preferred practice pattern guidelines 1.
When considering the use of Trelegy inhaler in patients with narrow-angle glaucoma, it is essential to weigh the benefits of the medication against the potential risks. The fluticasone furoate and vilanterol components of Trelegy do not typically affect glaucoma directly. However, the umeclidinium component may increase the risk of worsening narrow-angle glaucoma.
Key considerations for patients with narrow-angle glaucoma who are using or considering Trelegy inhaler include:
- Consulting with their doctor before using Trelegy to determine if the medication is appropriate for them
- Coordinating care with their ophthalmologist and pulmonologist to monitor eye pressure and adjust treatment as needed
- Possibly undergoing more frequent eye pressure monitoring while using Trelegy
- Exploring alternative respiratory treatments that do not contain anticholinergic agents, if necessary.
It is crucial for patients with narrow-angle glaucoma who are currently using Trelegy not to stop their medication suddenly, but rather to contact their healthcare provider promptly to discuss their specific situation and determine the best course of action 1.
From the Research
Trelegy Inhaler and Narrow Angle Glaucoma
- The Trelegy inhaler contains fluticasone furoate, umeclidinium, and vilanterol, which are used to treat chronic obstructive pulmonary disease (COPD) [(2,3,4,5,6)].
- Patients with narrow angle glaucoma should be cautious when using medications that may worsen their condition [(2,3,5,6)].
- Anticholinergic agents, such as umeclidinium, can increase the risk of acute angle-closure glaucoma in patients with narrow irido-corneal angles [(2,3,5,6)].
- Steroids, such as fluticasone furoate, can induce open-angle glaucoma, especially with topical use [(2,4,5)].
- Adrenergic agents, such as vilanterol, may also contribute to the risk of acute angle-closure glaucoma [(3,5,6)].
- It is essential for patients with narrow angle glaucoma to discuss the potential risks and benefits of using the Trelegy inhaler with their healthcare provider [(2,3,4,5,6)].
- Regular monitoring of intraocular pressure and eye exams may be necessary for patients with narrow angle glaucoma who are using the Trelegy inhaler [(2,3,5,6)].