Breztri Aerosphere dosage, forms, and strengths

Breztri Aerosphere is a brand-name prescription inhaler that provides maintenance treatment for chronic obstructive pulmonary disease (COPD), a group of lung diseases that include chronic bronchitis and emphysema. Breztri Aerosphere is not a rescue inhaler that helps resolve breathing problems during a COPD flare-up. Instead, twice daily Breztri Aerosphere doses help prevent COPD exacerbations and improve lung function. It contains three active ingredients: budesonide, glycopyrrolate, and formoterol fumarate. Budesonide is an inhaled corticosteroid (ICS) that reduces inflammation of the lung’s airways. Glycopyrrolate is a long-acting muscarinic antagonist (LAMA), an anticholinergic medication that relaxes airway muscles to keep airways open and improve breathing. Formoterol is a long-acting beta-2 agonist (LABA), a bronchodilator that relaxes and widens the lung’s airways. 

Breztri Aerosphere forms and strengths

Breztri Aerosphere is only available in one dosage form, a metered dose inhaler or MDI.

• Metered dose inhaler: 160 mcg/9 mcg/4.8 mcg per actuation

Breztri Aerosphere dosage for adults

Breztri Aerosphere is approved by the U.S. Food and Drug Administration (FDA) as a maintenance treatment for COPD. It should never be used as a treatment for asthma or as a rescue inhaler when breathing becomes difficult.

Breztri Aerosphere dosage for COPD

Healthcare professionals prescribe Breztri Aerosphere only for the maintenance treatment of COPD, never for asthma or as a rescue inhaler. For oral inhalation only, Breztri Aerosphere doses are taken once in the morning and once in the evening. Each dose consists of two puffs from the metered inhaler. Over time, regular Breztri Aerosphere dosing helps reduce the number of COPD flare-ups that people experience, improves COPD symptoms when flare-ups do happen, and generally improves lung function. 

• Standard Breztri Aerosphere dosage for the maintenance treatment of COPD: 2 puffs taken once in the morning and 2 puffs taken once in the evening (640 mcg/36 mcg/19.2 mcg per day taken in two divided doses) 

Breztri Aerosphere dosage for children

Breztri Aerosphere is not FDA-approved for use in children.

Breztri Aerosphere dosage restrictions

No dosage adjustments are required for people with liver disease or kidney disease. However, people with severe kidney disease or liver disease will require extra monitoring for side effects.

Breztri Aerosphere dosage for pets

Veterinarians routinely prescribe inhalation aerosols to treat chronic bronchitis in dogs and cats. Inhalers like Breztri Aerosphere can be used in dogs and cats if they’re used with proper spacers, but the cost of Breztri Aerosphere as a veterinary treatment may be prohibitive. There are no standardized Breztri Aerosphere veterinary dosages. 

How to take Breztri Aerosphere

Like all inhaled medicines, Breztri Aerosphere has instructions that must be followed to guarantee that doses are correctly administered. A healthcare provider will instruct you on how to use the inhaler. Make sure you understand these instructions and that all your questions are answered. Since the inhaler is slightly different from other metered inhalers, some of the instructions may be unfamiliar:

• Use the medication as directed. Use only what is prescribed.

• Take only two daily doses, two puffs in the morning and two in the evening.

Before the first use

• Read the instructions included with the medicine.

• Know the various parts of the actuator, including the puff indicator.

• Remove the inhaler from its foil pouch.

• Before using the inhaler, it must be primed.

  • To prime the inhaler, remove the mouthpiece cover.

  • Shake the inhaler well.

  • Point the inhaler away from you and squeeze out a single test puff.

  • Shake the inhaler well again and squeeze out a test puff three more times, shaking the inhaler before each test puff.

  • The inhaler is ready to use.

• You do not need to re-prime the inhaler unless:

  • The inhaler is dropped.

  • The inhaler isn’t used for more than seven days.

  • The actuator is rinsed and dried.

• Re-priming only requires two test puffs, shaking before each test puff.

Taking a dose

• Remove the mouthpiece cover. Check for foreign objects in the mouthpiece and remove them before use.

• Shake the inhaler well before each puff.

• Breathe out of your mouth fully.

• Place the mouthpiece in your mouth and form a tight seal around it with your lips.

• Breathe in slowly and squeeze out one puff while breathing in. Continue breathing in until you can’t do it any longer.

• Hold your breath for as long as you can, up to 10 seconds.

• Take a second puff in the same way.

• Put the mouthpiece cover back on.

• Rinse your mouth out with water. Spit the water out. Do not swallow it.

Managing your inhaler

• Rinse the actuator weekly to remove debris or build-up in the mouthpiece. 

  • Detach the top portion containing the canister and set it aside. Do not allow it to get wet

  • Remove the mouthpiece cover

  • Run warm water through the mouthpiece for 30 seconds

  • Run warm water through the top of the actuator for 30 seconds

  • Shake out as much water as possible

  • Let the actuator air-dry overnight—do not use a towel or tissue to dry the actuator

  • Place the mouthpiece cover back on after the actuator is completely dry

  • Gently push the canister back into the actuator after the mouthpiece cover is back on

  • Re-prime with two test puffs

• When the puff indicator is in the yellow zone, it’s time to order a new inhaler.

• Do not try to use the inhaler if the puff indicator reads “0.”

• Throw away the inhaler when the puff indicator reads “0,” or it has been three weeks (for a 28-inhalation canister) or three months (for a 120-inhalation canister) after removing it from its foil pouch.

• Store the inhaler at room temperature. Keep it away from humid environments like bathrooms. Keep it out of reach from children.

Breztri Aerosphere dosage FAQs

How long does it take Breztri Aerosphere to work?

Breztri Aerosphere is a long-term medication intended to reduce COPD flare-ups and improve COPD symptoms. Breztri Aerosphere has been shown to improve lung function within five minutes of taking the first dose. However, it is not a rescue inhaler, and it can take longer before a full benefit is noticed.

How long does Breztri Aerosphere stay in your system?

Breztri Aerosphere combines three different medicines that all work differently in the body. Some will stay in the body longer than others, usually one to three days. To be effective, Breztri Aerosphere doses must be taken once in the morning and once in the evening to maintain a steady state in the body.

What happens if I miss a dose of Breztri Aerosphere?

If a dose is missed, take it as soon as it’s remembered. Take the next dose on schedule.

How long can you take Breztri Aerosphere?

Breztri Aerosphere is intended for long-term use. As long as it works and doesn’t cause problems with side effects, it can be taken continuously to prevent and minimize COPD flare-ups. 

How do I stop taking Breztri Aerosphere?

COPD is a chronic and lifelong condition that can cause significant breathing problems. Do not stop taking your COPD medications or change to another medication except under the direction of a healthcare professional. If Breztri Aerosphere causes serious side effects or an allergic reaction, immediately contact the prescriber or other healthcare professional.

What is the maximum dosage for Breztri Aerosphere?

The maximum dosage for Breztri Aerosphere is two puffs taken twice per day. Never take more than two puffs for a dose or more than two doses in a day.

Can you overdose on Breztri Aerosphere?

Do not take more than the maximum dosage of Breztri Aerosphere. It will not provide additional COPD benefits and may cause problems such as blood pressure changes, racing heartbeats, muscle spasms, nausea, or diarrhea. If you take too much Breztri Aerosphere, call the prescriber. If you have symptoms of an overdose, go to an emergency room.

What interacts with Breztri Aerosphere?

There’s an increased risk of side effects when Breztri Aerosphere is taken with certain drugs. Before you use Breztri Aerosphere, tell the prescriber about all prescription drugs, over-the-counter medications, or supplements that you’re taking.

Do not use Breztri Aerosphere with:

• Other long-acting beta agonists

• Other anticholinergic drugs, such as umeclidinium

Other drugs that may cause problems when taken with Breztri Aerosphere include:

• Antifungal medications such as ketoconazole

• HIV/AIDS medications

• Certain types of antibacterial drugs called macrolide antibiotics

• Atropine

• Steroids such as prednisone

• Diuretics

• Adrenergic drugs 

• Tricyclic antidepressants

• Monoamine oxidase inhibitors (MAOIs)

• Antipsychotic medications such as thioridazine

• Beta blockers

If you’re currently taking short-acting beta agonists (SABAs) like albuterol on a regular schedule, the doctor will ask you to stop. You should only use these medications as needed when breathing becomes difficult. If you use a rescue inhaler regularly, talk to the doctor.

What happens when you mix Breztri Aerosphere and alcohol?

Drinking alcohol may worsen some of Breztri Aerosphere’s side effects, such as drowsiness and dizziness. It’s not forbidden, but you should be careful. If you’re unsure, ask the prescriber about whether it’s safe to drink alcohol and how much you can drink.

Is it safe to take Breztri Aerosphere during pregnancy?

Healthcare professionals aren’t sure if Breztri Aerosphere is safe to take during pregnancy. Animal studies indicate that some of the individual active ingredients can cause birth defects, but this hasn’t been proven for oral inhalation of these drugs. In pregnant women, studies of inhaled budesonide alone have not shown an increased risk of birth defects. It’s up to women and their physicians to discuss possible risks and make the most appropriate decision.

Is it safe to take Breztri Aerosphere while breastfeeding?

As with pregnancy, healthcare professionals don’t know the answer. No one has studied the effects of Breztri Aerosphere on milk production or a nursing baby. Researchers have conducted studies on budesonide, so healthcare providers believe inhaled budesonide is safe to take while breastfeeding. Again, women should get medical advice about taking Breztri Aerosphere and breastfeeding before making a decision.

What should I know about the side effects of Breztri Aerosphere?

Before you take Breztri Aerosphere, ask the prescribing healthcare professional about possible side effects. Breztri Aerosphere contains three medications, each of which can have its own side effects, drug interactions, and risks.

Here are some common problems you may experience when you use Breztri Aerosphere:

• Upper respiratory tract infection

• Back pain

• Muscle spasms

• Cough

• Sinusitis

• Urinary tract infection

• Yeast infection in the mouth and throat (oral thrush)

What should I know about the serious side effects of Breztri Aerosphere?

Serious problems are less common, but you should know what to look for in case they happen. These include:

• Increased risk of pneumonia

• Serious and possibly fatal asthma-related problems may require hospitalization or intubation if using a LABA without an inhaled corticosteroid 

• Airway constriction (paradoxical bronchospasm)

• Increased risk of infections

• Worsening of urinary retention

• Palpitations and irregular heartbeats (arrhythmias) 

• Glaucoma

• Cataracts

• Worsening of seizures or overactive thyroid

• Weakening of the bones

• Low potassium

• High blood sugar

To avoid serious side effects, tell the doctor if you have any problems related to these serious side effects, such as heart problems, thyroid problems, eye problems, immune system problems, diabetes, seizures, or osteoporosis. 

Sources

• Breztri Aerosphere patient website, AstraZeneca

• Breztri Aerosphere prescribing information, DailyMed, NIH National Library of Medicine