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Dosing instructions for BREZTRI AEROSPHERE1

BREZTRI AEROSPHERE – BUDESONIDE (ICS), GLYCOPYRRONIUM (LAMA), and FORMOTEROL (LABA) – IN 1 pMDI DEVICE*

BREZTRI AEROSPHERE is a fixed-dose combination of 3 types of medication in 1 pMDI device. The delivered BREZTRI AEROSPHERE dose per actuation contains:

  • 160 mcg budesonide
  • 7.2 mcg glycopyrronium
  • 5 mcg formoterol fumarate dihydrate

BREZTRI AEROSPHERE: Twice-daily administration with a single pMDI device

BREZTRI AEROSPHERE dosage is for oral inhalation only, and should be administered as:

Sun icon Moon icon
Sun icon Moon icon

Ensure that your patients are aware that for optimum benefit, BREZTRI AEROSPHERE must be used regularly, even when asymptomatic.

Guidance for patient administration

Access the following tools to help inform your patients about what the dosage is for BREZTRI AEROSPHERE and how to administer it correctly with step-by-step patient instructions for priming, using, cleaning, and storing the inhaler.

  • BREZTRI & Me Patient Education Booklet

    BREZTRI & Me Patient Education Booklet

    Provide patients this guide to help them understand their treatment with BREZTRI AEROSPHERE and learn how to use it.

    Download

  • BREZTRI AEROSPHERE Instructional Video

    BREZTRI AEROSPHERE Instructional Video

    Share this video with patients to show them step-by-step instructions for using the BREZTRI AEROSPHERE inhaler correctly.

    Watch

  • BREZTRI & Me Patient Education Booklet

    BREZTRI & Me Patient Education Booklet

    Provide patients this guide to help them understand their treatment with BREZTRI AEROSPHERE and learn how to use it.

    Download

  • BREZTRI AEROSPHERE Instructional Video

    BREZTRI AEROSPHERE Instructional Video

    Share this video with patients to show them step-by-step instructions for using the BREZTRI AEROSPHERE inhaler correctly.

    Watch

For complete dosing and administration instructions, please refer to the BREZTRI AEROSPHERE Product Monograph.

Dosing precautions and considerations for BREZTRI AEROSPHERE1

  • No smoking icon

    Counselling on smoking cessation, should be the first step in treating patients with COPD who smoke—independent of the clinical presentation (i.e., chronic bronchitis or emphysema).

    Cessation of smoking produces dramatic symptomatic benefits and has been shown to confer a survival advantage.

  • Caution icon

    BREZTRI AEROSPHERE should be used with caution in patients with symptomatic prostatic hyperplasia, urinary retention, or narrow angle glaucoma, due to its anticholinergic activity.

  • Lung icon

    BREZTRI AEROSPHERE is not indicated for the treatment of acute episodes of bronchospasm or asthma.

    BREZTRI AEROSPHERE should not be used to treat acute symptoms of COPD. Patients should be prescribed a SABA-inhaler to relieve the acute symptoms such as shortness of breath and be advised to always have this available for use.

  • Pill bottle icon

    BREZTRI AEROSPHERE should not be used more often, at higher doses than recommended, or in conjunction with other medicines containing LABA or LAMA, as an overdose may result.

    Patients taking rapid onset, short duration, inhaled beta2-agonists should be instructed to discontinue the regular use of these drugs and to use them only for symptomatic relief of acute respiratory symptoms while taking BREZTRI AEROSPHERE.

  • Heart icon

    Cardiovascular effects such as cardiac arrythmias (e.g., atrial fibrillation and tachycardia) may be seen after administration of sympathomimetic agents and muscarinic receptor agonists, including BREZTRI AEROSPHERE.

    In case such effects occur, treatment may need to be discontinued.

Find out more information about the safety profile of BREZTRI AEROSPHERE.

Learn more

Dosage adjustments

  • Children icon

    BREZTRI AEROSPHERE should not be used in patients under 18 years of age.

  • Elderly patients icon

    No dosage adjustment is required in patients 65 years of age or older.

  • Kidney and liver icons

    No dosage adjustment is necessary for patients with renal or hepatic impairment; however, these patients should be monitored closely.

    For patients with severe renal impairment (creatine clearance of ≤30 mL/min) or end-stage renal disease requiring dialysis, BREZTRI AEROSPHERE should only be used if the expected benefit outweighs the potential risk.

Missed dose

If a dose is missed, it should be administered as soon as possible. The next dose should be administered at the usual time.

A double dose should not be administered to make up for a forgotten dose.

Patients should not cease treatment with BREZTRI AEROSPHERE without speaking with a healthcare professional first.

Overdosage

There is limited evidence on the management of overdose with BREZTRI AERSOPHERE.

  • An overdose of BREZTRI AEROSPHERE may lead to exaggerated anticholinergic and/or beta2-adrenergic signs and symptoms (most frequent include blurred vision, dry mouth, nausea, muscle spasm, tremor, headache, palpitations, and systolic hypertension).
  • Acute overdosage with budesonide, even in excessive doses, is not expected to be a clinical problem, and may result in systemic glucocorticosteroid effects with chronic use.

BREZTRI AEROSPHERE should be discontinued in case of overdose.

  • Supportive and symptomatic treatment should be initiated.
  • Cardiac monitoring is recommended in cases of overdosage.
  • Cardioselective beta-receptor blockers may be considered but can produce bronchospasm.

For management of a suspected drug overdose, contact your regional poison control centre.

Drug-drug interactions

BREZTRI AEROSPHERE should be administered with caution to patients being treated with:

  • Monoamine oxidase inhibitors and tricyclic antidepressants
  • Strong cytochrome P450 3A4 inhibitors
  • Xanthine derivatives, steroid, or non-potassium sparing diuretics
  • Beta-blockers
  • Anticholinergic-containing drugs

* Clinical significance has not been established.

ICS: inhaled corticosteroid; LABA: long-acting beta2-adrenergic agonist; LAMA: long-acting muscarinic antagonist; pMDI: pressurized metered-dose inhaler.

Reference:

  1. BREZTRI AEROSPHERE Product Monograph. AstraZeneca Canada Inc.
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