Aclidinium Bromide; Indications, Dosage, Side Effects, Drug Interaction, Pregnancy

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Aclidinium is a synthetic anticholinergic agent that is used as an inhalant for treatment of acute bronchospasm due to chronic bronchitis or emphysema. Aclidinium has not been implicated in causing liver enzyme elevations or clinically apparent acute liver injury.

Aclidinium bromide (INN) is an anticholinergic for the long-term management of chronic obstructive pulmonary disease (COPD). It has a much higher propensity to bind to muscarinic receptors than nicotinic receptors. It is a long-acting, inhaled muscarinic antagonist (LAMA) approved in the US on July 24, 2012, as a maintenance treatment for the chronic obstructive pulmonary disease (COPD). Evidence shows that it can improve quality of life and prevent hospitalization in those with COPD. However, it does not appear to affect the risk of death or the frequency steroids are needed. It is unclear if it differs from the similar medication tiotropium or other commonly used medications from the class of LAMAs.

Mechanism of Action of Aclidinium

Aclidinium is a long-acting, competitive, and reversible anticholinergic drug that is specific for the acetylcholine muscarinic receptors. It binds to all 5 muscarinic receptor subtypes to a similar affinity. Aclidinium’s effects on the airways are mediated through the M3 receptor at the smooth muscle to cause bronchodilation. Prevention of acetylcholine-induced bronchoconstriction effects was dose-dependent and lasted longer than 24 hours.

Indications of Aclidinium

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Contra-Indications of Aclidinium

  • Closed-angle glaucoma
  • Blockage of Urinary Bladder
  • Enlarged Prostate
  • Cannot Empty Bladder
  • Chronic kidney disease stage 3A (moderate)
  • Chronic kidney disease stage 3B (moderate)
  • Chronic kidney disease stage 4 (severe)
  • Chronic kidney disease stage 5 (failure)
  • Allergies to anticholinergics – Quaternary
  • Ipratropium Analogues

Dosage of Aclidinium

Strengths: 400 mcg/inh

Chronic Obstructive Pulmonary Disease

  • 400 mcg (1 inhalation) orally twice a day

Side Effects of Aclidinium

The most common

More common

Rare

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Drug Interactions of Aclidinium

Aclidinium bromide may interact with following drugs, supplements & may change the efficacy of drugs

Pregnancy Catagory of Aclidinium

FDA Pregnancy Risk  Category C

Pregnancy  

There are no data available on the use of aclidinium bromide in pregnant women.Studies in animals have shown fetotoxicity only at dose levels much higher than the maximum human exposure to aclidinium bromide. Aclidinium bromide should only be used during pregnancy if the expected benefits outweigh the potential risks.

Lactation

It is unknown whether aclidinium bromide/metabolites are excreted in human milk. Animal studies have shown excretion of small amounts of aclidinium bromide/metabolites into milk. A risk to newborns/infants cannot be excluded. A decision must be made whether to discontinue breastfeeding or to discontinue/abstain from Eklira Genuair therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the woman.

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References

 

Aclidinium

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