Aclidinium Bromide

About Aclidinium Bromide

Aclidinium is a long-acting antimuscarinic bronchodilator, often called an anticholinergic. The label covers maintenance treatment of COPD at one 400 mcg inhalation twice a day, about 12 hours apart. It is not for the initial treatment of acute bronchospasm, so a separate rescue inhaler is still needed, and extra doses are not taken when breathing worsens. Safety and effectiveness in children are not established; COPD does not normally occur in children. The Pressair inhaler comes loaded and needs no priming: pressing the green button turns the control window green, and a strong, deep breath through the mouth brings a click and turns the window red, showing the dose was inhaled.

There is no boxed warning. It must not be used by anyone with a severe milk protein allergy or an allergy to aclidinium. Warnings cover wheezing or breathlessness right after a dose (paradoxical bronchospasm), immediate allergic reactions, worsening narrow-angle glaucoma, with eye pain, blurred vision, halos or red eyes, and worsening urinary retention, a particular concern with an enlarged prostate or a blocked bladder neck; anyone with those eye or urinary symptoms stops it and calls the prescriber at once. Headache, colds and cough are the most common side effects.

Duaklir Pressair pairs 400 mcg aclidinium with 12 mcg formoterol, a long-acting beta agonist, as one inhalation twice a day for COPD. It is not for asthma, and its label adds warnings on serious asthma-related events, heart effects, low potassium and high blood sugar, and against using another long-acting beta agonist with it. The Orange Book lists both inhalers as marketed brands held by Azurity Pharmaceuticals, with no generic approved; the patents listed for both run to 2029. Each is kept sealed in its bag until first use and thrown away when its indicator shows 0, when it locks, or a set time after the bag is opened: 45 days for Tudorza and two months for Duaklir.

Taking Aclidinium Bromide

How to take it

One inhalation twice a day, about 12 hours apart. Press the green button all the way down and release it; breathe out fully away from the inhaler, then take a strong, deep breath through your mouth until you hear a click and the control window turns red. No priming is needed; never clean it with water.

If you miss a dose

Skip the missed dose and take the next one at the usual time. Do not take two doses at once.

Storage

In a dry place at room temperature, not on a surface that vibrates, sealed in its bag until first use. Throw it away 45 days after opening the bag, when the indicator shows 0 on a red background, or when it locks, whichever comes first.

Interactions to know about

The label advises against using other anticholinergic medicines with it, since side effects add up: other COPD inhalers such as ipratropium, tiotropium and umeclidinium, some antihistamines, and some medicines for urinary problems, motion sickness or Parkinson’s disease.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Aclidinium Bromide differs from pharmacy to pharmacy

Tudorza Pressair is sold only as the brand, so quotes differ mainly in each pharmacy’s margin and in whether it keeps the inhaler in stock; a pharmacy that rarely dispenses it may need to order it. It cannot be swapped at the counter for another COPD inhaler, such as tiotropium, because that is a different drug that needs a new prescription.

A 60-dose inhaler lasts a month at one inhalation twice a day and is thrown away 45 days after its bag is opened, so a spare opened early is wasted. Duaklir Pressair is also brand-only and is priced as a separate product.

Ways to pay less for Aclidinium Bromide without insurance

• Ask the maker whether its savings or patient assistance program applies to someone paying cash; many copay cards require commercial insurance.
• Ask the prescriber whether tiotropium capsules for the HandiHaler, which have an approved generic, would suit you; a pharmacist cannot make that switch alone.
• Confirm the pharmacy has the inhaler in stock before the prescription is sent, and compare more than one pharmacy.
• Open a new inhaler only when the last one is finished, since each is discarded 45 days after its bag is opened.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Aclidinium Bromide

1. 1.Is this my maintenance inhaler or my rescue inhaler?
2. 2.Can you show me how the green button and the control window work?
3. 3.Which eye or urination symptoms mean I should stop it and call?
4. 4.Do any of my bladder, allergy or other inhaled medicines add to its side effects?

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