Antimuscarinics
Drug Safety Update
April 2025: Short-acting beta 2 agonists (SABA) (salbutamol and terbutaline): reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines
August 2022: Nebulised asthma rescue therapy in children: home use of nebulisers in paediatric asthma should be initiated and managed only by specialists
July 2018: Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects
NICE Guidance
NG115: Chronic obstructive pulmonary disease in over 16s - diagnosis and management, December 2018 (updated July 2019)
Local Guidance
See here for available local respiratory system guidance
Ipratropium and Spiriva Respimat are the only antimuscarinics licensed for asthma and COPD. The rest are licensed for COPD only.
Short-acting bronchodilator
| Pack |
|---|
| 200 dose |
| Pack |
|---|
| 20 unit dose |
| 60 unit dose |
| 1 unit dose |
Long acting bronchodilator used twice daily. Each 375 microgram inhalation of aclidinium bromide delivers 322micrograms of aclidinium
| Pack |
|---|
| 60 dose |
Long acting bronchodilator used once daily. Each capsule delivers 55 micrograms of glycopyrronium bromide equivalent to 44 micrograms of glycopyrronium
| Pack |
|---|
| 10 capsule |
| 30 capsule |
| 6 capsule |
| Pack |
|---|
| 30 capsule |
| 60 capsule |
| Pack |
|---|
| 30 capsule |
| Pack |
|---|
| 60 dose |
| Pack |
|---|
| 30 capsule |
Long acting bronchodilator
| Pack |
|---|
| 30 dose |
LAMA/LABA combination used twice daily
| Pack |
|---|
| 60 dose |
LAMA/LABA combination used twice daily
| Pack |
|---|
| 120 dose |
LAMA/LABA combination used once daily
| Pack |
|---|
| 10 capsule |
| 30 capsule (3 x 10 capsules) |
LAMA/LABA combination used once daily
| Pack |
|---|
| 60 dose |
LAMA/LABA combination used once daily
| Pack |
|---|
| 30 dose |
- On Formulary Preferred
- On Formulary Second Line
- On Formulary Third Line
- Specialist Initiation
- Secondary Care Only
- Not Approved for Formulary