LABA/LAMA Combination Inhaler Examples
Common examples of LABA/LAMA combination inhalers include umeclidinium/vilanterol (Anoro Ellipta), glycopyrronium/indacaterol, aclidinium/formoterol, and tiotropium/olodaterol. 1, 2
Specific LABA/LAMA Products
Umeclidinium/Vilanterol (Anoro Ellipta)
- This is a once-daily dry powder inhaler containing umeclidinium bromide 62.5 mcg (LAMA) combined with vilanterol 25 mcg (LABA). 1
- The device delivers 55 mcg of umeclidinium and 22 mcg of vilanterol per actuation under standardized testing conditions. 1
- This combination has been proven safe, well-tolerated, and non-inferior or superior to other available LABA/LAMA combinations for COPD maintenance treatment. 2
Other Available LABA/LAMA Combinations
- Four fixed-dose LABA/LAMA combinations are currently available for maintenance bronchodilator treatment in COPD patients. 3
- These combinations include glycopyrronium/indacaterol, aclidinium/formoterol, and tiotropium/olodaterol in addition to umeclidinium/vilanterol. 3
Clinical Role and Efficacy
When LABA/LAMA Combinations Are Used
- LABA/LAMA combinations are recommended as initial therapy for patients with severe symptoms and high exacerbation risk (GOLD D). 4
- These combinations should be considered for patients with persistent breathlessness despite single long-acting bronchodilator therapy. 5
- LABA/LAMA combinations increase lung function to a greater degree than LAMA monotherapy alone. 5
Comparative Benefits
- LABA/LAMA combinations are more effective than either monotherapy for improving lung function, reducing dyspnea, and preventing exacerbations. 6, 7
- The combination provides enhanced FEV1 improvement compared to either drug in isolation and when compared with established LAMA drugs. 7
- These fixed-dose combinations offer a step beyond single inhaled maintenance agents while maintaining a single device for patient convenience. 2
Important Clinical Considerations
Mechanism of Action
- The LABA component (vilanterol, indacaterol, formoterol, or olodaterol) stimulates beta2-receptors causing bronchial smooth muscle relaxation. 1
- The LAMA component (umeclidinium, glycopyrronium, aclidinium, or tiotropium) blocks M3 muscarinic receptors at airway smooth muscle, producing bronchodilation. 1
- These represent two different medication classes with complementary mechanisms providing additive bronchodilation. 1
Practical Prescribing Points
- All LABA/LAMA combinations provide similar clinical benefits in terms of lung function improvement, dyspnea reduction, and quality of life enhancement. 6
- For patients requiring combination therapy where fixed-dose combinations are cost-prohibitive, separate LAMA and LABA inhalers can be considered. 6
- Insurance formularies often dictate which specific LABA/LAMA combination is most affordable for individual patients. 6