What are examples of Long-Acting Beta Agonists (LABA) and Long-Acting Muscarinic Antagonists (LAMA)?

From the Guidelines

Long-Acting Beta Agonists (LABAs) include salmeterol, formoterol, indacaterol, olodaterol, and vilanterol, while Long-Acting Muscarinic Antagonists (LAMAs) include tiotropium, umeclidinium, aclidinium, and glycopyrronium, as reported in the 2017 Global Initiative for Chronic Obstructive Lung Disease report 1. These medications are essential for managing chronic obstructive pulmonary disease (COPD) and certain asthma cases.

• LABAs work by relaxing bronchial smooth muscle, providing bronchodilation for 12-24 hours, with common LABAs like salmeterol and formoterol lasting 12 hours, and newer agents like indacaterol, olodaterol, and vilanterol providing 24-hour coverage.
• LAMAs block muscarinic receptors in the airways, preventing acetylcholine-induced bronchoconstriction, with most LAMAs providing 24-hour bronchodilation, and tiotropium being the most widely used. The combination of LABA and LAMA is a preferred treatment option for patients with COPD, as it improves lung function, reduces symptoms, and decreases exacerbation rates, as shown in the 2018 Mayo Clinic Proceedings 1. Both medication classes are available in inhaler formulations and should be used regularly as maintenance therapy, rather than for acute symptom relief, to maximize their benefits in improving morbidity, mortality, and quality of life for patients with COPD. Key points to consider when prescribing LABAs and LAMAs include:
• Patient symptoms and exacerbation history
• Combination therapy with inhaled corticosteroids (ICS) for certain patient groups
• Potential side effects, such as increased risk of pneumonia with ICS, and benefits, such as improved lung function and reduced exacerbations, as discussed in the 2017 American Journal of Respiratory and Critical Care Medicine report 1.

From the FDA Drug Label

Aclidinium bromide is a long-acting antimuscarinic agent, which is often referred to as an anticholinergic Formoterol fumarate is a long-acting selective beta2-adrenergic receptor agonist (LABA)

• Examples of Long-Acting Muscarinic Antagonists (LAMA):
  • Aclidinium bromide
• Examples of Long-Acting Beta Agonists (LABA):
  • Formoterol fumarate 2, 3

From the Research

Examples of Long-Acting Beta Agonists (LABA) and Long-Acting Muscarinic Antagonists (LAMA)

• LABA Examples:
  • Salmeterol 4
  • Formoterol 4, 5, 6
  • Indacaterol 4, 5, 7, 8
  • Olodaterol 4
  • Vilanterol 4, 5
  • Milveterol 4
  • Carmoterol 4
  • Abediterol 4
• LAMA Examples:
  • Aclidinium 5, 6, 8
  • Glycopyrronium 5, 8
  • Tiotropium 8
  • Umeclidinium 5

Combination Therapies

• LABA/LAMA Combinations:
  • Aclidinium/Formoterol 5, 6
  • Glycopyrronium/Indacaterol 5
  • Umeclidinium/Vilanterol 5
• LABA/ICS Combinations:
  • Fluticasone/Salmeterol 4
  • Budesonide/Formoterol 4, 8
  • Beclomethasone/Formoterol 4
  • Formoterol/Mometasone 8
  • Salmeterol/Fluticasone 8