Indications

Beviprex is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

Composition

Each puff delivers-
. Through the actuator: Glycopyrronium Bromide EP 9 mcg and Formoterol Fumarate EP 4.8 mcg &
Through the valve: Glycopyrronium Bromide EP 10.35 mcg and Formoterol Fumarate EP 5.52 mcg.

Pharmacology

This preparation contains two bronchodilators: Glycopyrronium is a long-acting muscarinic antagonist (LAMA) and Formoterol is a long-acting ß2-adrenergic agonist (LABA) with a rapid onset of action.
Glycopyrronium has similar affinity to the subtypes of muscarinic receptors M1 to M5. In the airways, it exhibits pharmacological effects through inhibition of the M3 receptor at the smooth muscle
leading to bronchodilation. Formoterol causes direct relaxation of airway smooth muscle as a consequence of the increase in cyclic AMP through activation of adenylyl cyclase.

Dosage & Administration

Adults: Should be administered as 2 puffs twice daily, in the morning and in the evening.

Use in patients with severe renal impairment should be considered if the potential benefit of the treatment outweighs the risk.

Interaction

. Other adrenergic drugs may potentiate efect. Use with caution.
. Xanthine derivatives, steroids, diuretics or non-potassium sparing diuretics may potentiate hypokalemia or EDG changes. Use with caution.
. Diuretics: Use with caution.
. Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. May potentiate efect of formoterol fumarate on cardiovascular system.
. Beta-Blockers: Use with caution and only when medically necessary.
. Anticholinergics: May interact additively with concomitantly used anticholinergic medications. Avoid administrations of Beviprex with other anticholinergic-containing drugs.

Contraindications

All LABAs are contraindicated in patients with asthma without use of a long-term asthma control medication. This preparation is also contraindicated in patients with hypersensitivity to glycopyrronium
bromide, formoterol fumarate or to any component of the product.

Side Effects

The most common adverse reactions include cough and urinary tract infection. Possible side effects are sudden breathing problems, headache, tremor, nervousness, rash, swelling of the face, mouth
and tongue, hives, increase blood pressure, chest pain, irregular heartbeat, muscle spasm, muscle weakness, eye pain or discomfort and urinary retention.

Pregnancy & Lactation

There are no data on the use of this preparation in pregnant women.

Precautions & Warnings

. Beviprex should not be used with an additional medicine containing a LABA because of risk of overdose.
. Not indicated for the relief of acute bronchospasm
. Do not initiate in acutely deteriorating COPD or to treat acute symptoms
. If paradoxical bronchospasm occurs, discontinue Beviprex and institute alternative therapy