AdultPediatricDosage Forms & Strengths powder for inhalation 62.5mcg/actuation Chronic Obstructive Pulmonary Disease Indicated for the long-term, once-daily, maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema 62.5 mcg (1 actuation) inhaled PO qDay Dosage Modifications Renal impairment (including severe [CrCl <30 mL/min]): No dosage adjustment required Moderate hepatic impairment (Child-Pugh 7-9): No dosage adjustment required Severe hepatic impairment: Unknown, not evaluated Geriatric patients: No dosage adjustment required Administration Inhaler is not reusable Store at room temperature between 68-77°F (20-25°C); excursions permitted from 59-86°F (15-30°C) Store in a dry place away from direct heat or sunlight Before the inhaler is used for the first time, the counter should show the number 30 (7 if a sample or institutional pack); this is the number of doses in the inhaler See prescribing information for detailed description regarding how to administerSafety and efficacy not establishedInteraction CheckerEnter a drug name and umeclidinium bromideNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (3)glucagonglucagon increases toxicity of umeclidinium bromide by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .glucagon intranasalglucagon intranasal increases toxicity of umeclidinium bromide by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .revefenacinrevefenacin and umeclidinium bromide both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.Monitor Closely (28)abobotulinumtoxinAabobotulinumtoxinA increases effects of umeclidinium bromide by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .acetylcholineacetylcholine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.aclidiniumumeclidinium bromide and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsamantadineumeclidinium bromide, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.atropineumeclidinium bromide and atropine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsatropine IV/IMumeclidinium bromide and atropine IV/IM both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsatropine ophthalmicumeclidinium bromide and atropine ophthalmic both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsbelladonna alkaloidsumeclidinium bromide and belladonna alkaloids both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsbethanecholbethanechol increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.carbacholcarbachol increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.dicyclomineumeclidinium bromide and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsdonepezil transdermaldonepezil transdermal, umeclidinium bromide. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.echothiophate iodideechothiophate iodide increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.glycopyrrolateumeclidinium bromide and glycopyrrolate both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents glycopyrrolate inhaledumeclidinium bromide and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents glycopyrronium tosylate topicalglycopyrronium tosylate topical, umeclidinium bromide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.homatropineumeclidinium bromide and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents hyoscyamineumeclidinium bromide and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents hyoscyamine sprayumeclidinium bromide and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents ipratropiumumeclidinium bromide and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents methscopolamineumeclidinium bromide and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsneostigmineneostigmine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.physostigminephysostigmine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.pilocarpinepilocarpine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.propanthelineumeclidinium bromide and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentspyridostigminepyridostigmine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.scopolamineumeclidinium bromide and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentstiotropiumumeclidinium bromide and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsMinor (0)abobotulinumtoxinAMonitor Closely (1)abobotulinumtoxinA increases effects of umeclidinium bromide by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .acetylcholineMonitor Closely (1)acetylcholine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.aclidiniumMonitor Closely (1)umeclidinium bromide and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsamantadineMonitor Closely (1)umeclidinium bromide, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.atropineMonitor Closely (1)umeclidinium bromide and atropine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsatropine IV/IMMonitor Closely (1)umeclidinium bromide and atropine IV/IM both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsatropine ophthalmicMonitor Closely (1)umeclidinium bromide and atropine ophthalmic both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsbelladonna alkaloidsMonitor Closely (1)umeclidinium bromide and belladonna alkaloids both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsbethanecholMonitor Closely (1)bethanechol increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.carbacholMonitor Closely (1)carbachol increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.dicyclomineMonitor Closely (1)umeclidinium bromide and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsdonepezil transdermalMonitor Closely (1)donepezil transdermal, umeclidinium bromide. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.echothiophate iodideMonitor Closely (1)echothiophate iodide increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.glucagonSerious - Use Alternative (1)glucagon increases toxicity of umeclidinium bromide by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .glucagon intranasalSerious - Use Alternative (1)glucagon intranasal increases toxicity of umeclidinium bromide by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .glycopyrrolateMonitor Closely (1)umeclidinium bromide and glycopyrrolate both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents glycopyrrolate inhaledMonitor Closely (1)umeclidinium bromide and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents glycopyrronium tosylate topicalMonitor Closely (1)glycopyrronium tosylate topical, umeclidinium bromide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.homatropineMonitor Closely (1)umeclidinium bromide and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents hyoscyamineMonitor Closely (1)umeclidinium bromide and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents hyoscyamine sprayMonitor Closely (1)umeclidinium bromide and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents ipratropiumMonitor Closely (1)umeclidinium bromide and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents methscopolamineMonitor Closely (1)umeclidinium bromide and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsneostigmineMonitor Closely (1)neostigmine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.physostigmineMonitor Closely (1)physostigmine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.pilocarpineMonitor Closely (1)pilocarpine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.propanthelineMonitor Closely (1)umeclidinium bromide and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentspyridostigmineMonitor Closely (1)pyridostigmine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.revefenacinSerious - Use Alternative (1)revefenacin and umeclidinium bromide both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.scopolamineMonitor Closely (1)umeclidinium bromide and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentstiotropiumMonitor Closely (1)umeclidinium bromide and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents 1-10% Nasopharyngitis (8%) Upper respiratory tract infection (5%) Cough (3%) Arthralgia (2% Toothache (1%) Pharyngitis (1%) Viral upper respiratory tract infection (1%) Tachycardia (1%) <1% Atrial fibrillation Postmarketing Reports Hypersensitivity reactions, including anaphylaxis, angioedema, pruritus, rash, and urticaria Eye disorders: Eye pain, glaucoma, vision blurred Renal and urinary disorders: Dysuria, urinary retention Contraindications Severe hypersensitivity to milk proteins Demonstrated hypersensitivity to umeclidinium or any of the excipients Cautions Anaphylactic reactions reported in patients with severe milk protein allergy after inhalation of other powder products containing lactose (see Contraindications) Hypersensitivity reactions such as anaphylaxis, angioedema, pruritus, rash, and urticaria may occur; discontinue if reactions occur Do not initiate in patients during rapidly deteriorating or potentially life-threatening episodes of COPD; not be used for the relief of acute symptoms (ie, as rescue inhaler) from acute episodes of bronchospasm Paradoxical bronchospasm reported; discontinue and treat immediately with an inhaled, prompt-acting bronchodilator (eg, albuterol) Worsening of narrow-angle glaucoma may occur Worsening of urinary retention may occur; caution in patients with prostatic hyperplasia or bladder-neck obstruction Pregnancy There are insufficient data on use in pregnant women to inform a drug-associated risk Animal data Administered via inhalation or subcutaneously to pregnant rats and rabbits was not associated with adverse effect on embryofetal development at exposures approximately 50 and 200 times, respectively, the human exposure at maximum recommended human daily inhaled dose (MRHDID) Lactation There is no information available on presence of drug in human milk, effects on breastfed child, or on milk production; the drug was detected in plasma of offspring of lactating rats treated with umeclidinium suggesting its presence in maternal milk; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from umeclidinium or from underlying maternal conditionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Long-acting muscarinic antagonist (LAMA) often referred to as an anticholinergic; blocks action of acetylcholine at muscarinic receptors (M1 to M5) in the bronchial airways (M3) by preventing increase in intracellular calcium concentration, leading