Breztri Dosing Frequency
Breztri (budesonide/glycopyrrolate/formoterol) is administered twice daily (BID), not once daily. 1, 2
Approved Dosing Regimen
Breztri is dosed as two inhalations twice daily using the Aerosphere metered-dose inhaler, delivering budesonide/glycopyrrolate/formoterol in either 320/18/9.6 mcg or 160/18/9.6 mcg strength per actuation 1, 3
The medication was specifically studied and approved as a twice-daily regimen in the pivotal ETHOS and KRONOS trials over 24-52 weeks 1, 3
Why BID Dosing Matters
Formoterol is a 12-hour long-acting beta-agonist (LABA), requiring twice-daily administration to maintain bronchodilation throughout the 24-hour period 4
This distinguishes formoterol from "ultralong-acting" beta-agonists like vilanterol or olodaterol, which provide 24-hour coverage with once-daily dosing 4
Glycopyrrolate in Breztri also requires twice-daily dosing to maintain consistent anticholinergic bronchodilation, unlike tiotropium which provides 24-hour coverage with once-daily administration 5, 6
Clinical Context
The budesonide/formoterol combination has consistently been studied as a BID regimen across multiple guidelines and clinical trials for both asthma and COPD 4, 7
In real-world use, Breztri is initiated in patients with moderate-to-very severe COPD who remain symptomatic despite current therapy, often with history of exacerbations 2
The BID dosing demonstrated significant improvements in exacerbation rates, lung function, dyspnea, rescue medication use, and quality of life over 52 weeks compared to dual therapy 1, 3
Common Pitfall to Avoid
Do not confuse Breztri with once-daily triple therapy combinations containing different LAMAs (like tiotropium) or ultralong-acting LABAs (like vilanterol), which are dosed once daily 4
Adherence to the twice-daily regimen is essential for maintaining therapeutic benefit throughout the day and night, as the formoterol component provides only 12 hours of bronchodilation 4