Breztri: Uses, Side effects, and Interactions

Overview

What is Breztri?

Breztri (Breztri aerosphere) is a trade-name prescription inhaler medication for treating COPD (chronic obstructive pulmonary disease).It is a long-term treatment for adults with COPD.

COPD is a lung disease that causes limited airflow from the lungs and breathing difficulty. Breztri makes it easier to breathe. It keeps the airways to the lungs open and reduces pain and swelling in the lungs.

Key Facts of Breztri

• In July 2020, the FDA (Food and Drug Administration, United States) approved Breztri for COPD treatment.
• It is the second inhaler with a triple-drug combination approved for COPD
• Breztri is available only as a trade-name medication. It is not available in its generic drug form¹Overview| Researched based study from Nlm.nih.gov ,²Overview| Researched based study from Sciencedirect.com

Composition

Composition of Breztri

Breztri is a triple therapy combination consisting of the following three active drugs.

Budesonide

• It is a corticosteroid (anti-inflammatory drug) that decreases the pain and swelling in the lung’s airways.

Glycopyrrolate

• It is an anticholinergic that clears and opens the lung’s airways
• Anticholinergic are drugs for inhibiting neurotransmitter (chemical messenger) activity

Formoterol fumarate

• It is a long-acting beta-agonist that clears the blocked airways
• Long-acting beta-agonists are bronchodilator drugs. Bronchodilators dilate the breathing passages³Composition| Researched based study from Dailymed.nih.gov ,⁴Composition| Researched based study from Nlm.nih.gov

Dosage

Dosage of Breztri

The commonly recommended dosage of Breztri for COPD is as follows:

• Two puffs twice daily by mouth, once in the morning and evening
• Breztri comes as an inhalation aerosol (vapor) within an inhaler. One has to inhale the drug in puffs through the mouth

Each puff of Breztri contains the following amounts

• Budesonide-160 microgram (mcg)
• Glycopyrrolate-9 mcg
• Formoterol fumarate-4.8mcg

However, one must follow the dose as recommended by the physician ⁵Dosage| Researched based study from Nlm.nih.gov

Uses

Uses of Breztri

COPD Treatment

• Breztri is prescribed as a maintenance treatment for chronic COPD to ease COPD symptoms and prevent lung functioning from worsening.
• COPD is a lung condition that gets worse with time. The condition is a mixture of bronchitis (airway inflammation) and emphysema (damaged lung air sacs) ⁶Uses| Researched based study from Nlm.nih.gov

How to use Breztri?

• One has to breathe in orally the puffs of the drug. After each dose, it is necessary to rinse the mouth with water to prevent oral thrush, which is one of the probable side effects of Breztri.
• One must ensure that the rinse water is spitted out and not swallowed

Side effects

Side effects of Breztri

Mild side effects

• Headache
• Nausea and vomiting
• Cough
• Sinus inflammation (sinusitis)
• Fungal infection in the throat and mouth (oral thrush)
• Common cold
• Flu
• Muscle pain
• Back pain
• Tremor (body shaking)
• Diarrhea
• Rough voice
• Anxiety

Serious side effects

• Irregular heartbeat
• High blood pressure
• Extreme tiredness
• Difficult breathing
• Chest pain
• Difficulty in urinating
• Pain while urinating
• Trouble emptying the bladder
• Extreme thirst
• Blurry vision
• Lung infections such as pneumonia
• Weakened bones
• Eye problems such as cataracts
• Itching
• Hives
• Swelling in the mouth, face, tongue, and lips ¹Side effects| Researched based study from Nlm.nih.gov

However, for more details, one must follow the manufacturer’s guide provided with the inhaler drug

Overdose

Overdose toxicity

One must not use more than the recommended dose of Breztri as it might cause serious side effects. However, in case of an accidental overdose, one must dial the emergency number based on the geographical location or head to the nearest emergency room.

Some of the symptoms of Breztri overdose are as follows:

• Extreme tiredness
• Nausea and vomiting
• Difficulty in urinating
• Blurred vision
• Eye pain
• Eye redness
• Heart palpitation
• Muscle pain
• Chest pain
• Headache
• Nervousness
• Seizures (changes in the brain’s electrical activity)
• Tremors ⁷Overdose| Researched based study from canjhealthtechnol.ca

Precautions

What to consider before taking Breztri?

Pregnant women and nursing mothers should abstain from using the Breztri drug due to the lack of knowledge on the safety and efficiency of the drug in these groups.

Before taking Breztri, it is best to consult a doctor about the health condition.

Breztri might not be suitable for persons with the following health conditions

• People allergic to the ingredients of the Breztri drug
• One with tuberculosis infection
• If one is having bacterial, viral, or fungal infection
• People with asthma problems
• Patient of ocular herpes (herpes in the eyes)
• With chicken pox or measles infection
• People with heart problems
• People with high blood pressure
• One with osteoporosis (weakened bones)
• People with weakened immune system
• If one is having kidney problems
• Person with thyroid problems
• People with heart problems
• People with an eye problem
• Diabetics
• People with liver problem
• Person with a seizure disorder
• People with an adrenal gland disorder
• People with urinary retention (difficulty emptying the bladder)⁸Precautions| Researched based study from Mskcc.org

Interactions

Interactions of Breztri

Breztri might interact with the following drugs

• Ketoconazole(antifungal medication)
• Clarithromycin(antibiotic)
• Theophylline (COPD and asthma drug)
• Hydrochlorothiazide (diuretic medication)
• Atazanavir (drugs for human immunodeficiency virus infection)
• Prednisone(anti-inflammatory drug)
• Tiotropium (COPD drug)
• Salmeterol(COPD drug)
• Metoprolol (high blood pressure drug)
• Selegiline(monoamine oxidase inhibitors)-antidepressant drugs
• Amitriptyline(antidepressant drug) ⁹Interactions| Researched based study from Nlm.nih.gov

Storage

Storage & Disposal of Breztri

Storage

• One should store the Breztri at room temperature ranging from 20 to 25 degrees centigrade. One can keep it at 30 degrees centigrade for short periods if required.
• One should also avoid keeping it in damp areas and under direct sunlight. Moreover, one should keep it out of reach of children and young kids.

Disposal

• Breztri must be disposed of safely in the trash to avoid accidental intake by young kids and pets. One must dispose of any leftover medication or medication whose expiry date is crossed over.Throwing the Breztri inhaler when the dose indicator window shows zero or three weeks after opening the pouch is essential ¹⁰Storage| Researched based study from Sagepub.com

Alternatives

Alternatives to Breztri

There are also other drugs to treat COPD. Some work better than others. If one is interested in finding an alternative to Breztri, It is best to consult a physician who can recommend the best fit based on the health condition.

The lists of example drugs that one can use for persistent COPD are as follows:

Triple therapy combination inhaler

• Trelegy Ellipta (combination of umeclidinium, fluticasone, and vilanterol)

Dual therapy combination inhaler

• Advair(fluticasone and salmeterol)
• Symbicort(budesonide and Formoterol)
• Breo Ellipta(fluticasone and vilanterol)
• Anoro Ellipta(umeclidinium and vilanterol)
• Duaklir Pressair(Formoterol and aclidinium)

Long-acting bronchodilator inhaler

• Brovana (arformoterol)
• Serevent(Salmeterol)
• Striverdi(Olodaterol)
• Perforomist(Formoterol)

Long-acting anticholinergic inhalers

• Incruse Ellipta (umeclidinium)
• Lonhala Magnair (glycopyrrolate)
• Tudorza Pressair(aclidinium) ¹¹Alternatives| Researched based study from Sciencedirect.com

Takeaway

Key Takeaways

• Breztri is an FDA-approved inhaler aerosol for persistent COPD
• Breztri is not a cure but a type of treatment for COPD
• One must always inform the healthcare professional about the medical condition before taking Breztri drug
• One must follow the Breztri dose as recommended by the physician to prevent unwanted side-effects