Seebri Breezhaler Drug Interactions

The co-administration of SEEBRI BREEZHALER with inhaled anticholinergic-containing drugs has not been studied and is therefore, like for other anticholinergics, not recommended.
Concomitant administration of SEEBRI BREEZHALER and orally inhaled indacaterol, a beta₂-adrenergic agonist; under steady-state conditions of both drugs did not affect the pharmacokinetics of either drug.
Although no formal drug interaction studies have been performed, SEEBRI BREEZHALER has been used concomitantly with other drugs commonly used in the treatment of COPD without clinical evidence of drug interactions. These include sympathomimetic bronchodilators, methylxanthines, oral and inhaled steroids.
In a clinical study in healthy volunteers, cimetidine, an inhibitor of organic cation transport which is thought to contribute to the renal excretion of glycopyrronium, increased total exposure (AUC) to glycopyrronium by 22% and decreased renal clearance by 23%. Based on the magnitude of these changes, no clinically relevant drug interaction is expected when SEEBRI BREEZHALER is co-administered with cimetidine or other inhibitors of the organic cation transport.
In vitro studies showed that SEEBRI BREEZHALER is not likely to inhibit or induce the metabolism of other drugs, nor processes involving drug transporters. Metabolism in which multiple enzymes are involved, plays a secondary role in the elimination of glycopyrronium (see Pharmacology: Pharmacokinetics: Biotransformation/Metabolism and Elimination under Actions). Inhibition or induction of metabolism of glycopyrronium is unlikely to result in a relevant change of systemic exposure to the drug.