Glyriva

Dilgly UniCap inhalation capsule is indicated as a once-daily maintenance bronchodilator treatment to relieve symptoms of patients with chronic obstructive pulmonary disease (COPD).

The recommended dose of one inhalation capsule once daily of the content of one 50 microgram capsule using the inhalation device. This should be administered once daily every day at the same time of the day by orally inhaled route. For a missed dose, the next dose should be taken, as soon as it is remembered. This inhalation capsule should not be taken more than one time every 24 hours.

The common side effects experienced are dry mouth, cough, nasopharyngitis, vomiting, musculoskeletal pain, neck pain, diabetes mellitus, gastroenteritis, insomnia. Some side effects may result in fewer instances such as paradoxical bronchospasm, dysphonia, angioedema, hypersensitivity, pruritus, sinus congestion, throat irritation. In elderly patients above 75 years of age, the frequencies of urinary tract infection and headache is common.

This inhalation capsule is a once daily long term maintenance treatment and it is not indicated for the treatment of acute cases of bronchospasm i.e. as a rescue therapy.
This inhalation capsule should not be used in patients under 18 years of age.
Like other anticholinergic drugs, this inhalation capsule should be used with caution in patients with narrow-angle glaucoma or urinary retention. If signs suggesting any allergic reaction occur, in particular, angioedema (including difficulties in breathing and swallowing, swelling of the tongue, lips and face), urticaria or skin rash, this inhalation capsule should be discontinued immediately and alternative therapy instituted. As with other inhalation therapy, administration of this inhalation capsule may result in paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs, this inhalation capsule should be discontinued immediately and alternative therapy instituted.
For patients with severe renal impairment (estimated glomerular filtration rate below 30 mL/min/1.73 m2) including those with end stage renal disease requiring dialysis, this inhalation capsule should only be used if only the expected benefit outweighs the potential risk.

Glycopyrronium is a long-acting, specific antimuscarinic agent, in clinical medicine often called an anticholinergic. It has a similar affinity to the subtypes of muscarinic receptors M1 to M5. In the airways, inhibition of M3-receptors at the smooth muscle results in relaxation. The high potency and slow receptor dissociation found its clinical correlate in significant and long-acting bronchodilation in patients with COPD.