Breztri Aerosphere is a brand-name prescription medication. It’s used for maintenance (long-term) treatment of chronic obstructive pulmonary disease (COPD) in adults. COPD is a long-term lung disease that gets worse over time.

See the “Breztri Aerosphere for COPD” section below for details about how to use Breztri Aerosphere.

Note: Breztri Aerosphere is not used to treat asthma. In addition, you should not use Breztri Aerosphere as a rescue medication. Rescue medications are used to quickly open your airways during breathing emergencies, such as sudden breathlessness. Breztri Aerosphere doesn’t work quickly enough to be used as a rescue medication. If you have sudden breathlessness, use your rescue inhaler (such as albuterol) as prescribed by your doctor. And if your symptoms feel life threatening, call 911 right away.

Drug details

Breztri Aerosphere works to make it easier for you to breathe. It does this by keeping your airways open and reducing inflammation (swelling) in your lungs.

Breztri Aerosphere comes as a metered-dose inhaler. Aerosphere is the name of the inhaler device. You’ll use the inhaler to breathe the medication into your lungs twice every day.

Breztri Aerosphere is called a triple-therapy combination inhaler. This is because it contains three active drugs. Each active drug belongs to a different class of drugs. (A class of drugs is a group of medications that work in a similar way.) Each puff of Breztri contains:

  • 160 micrograms (mcg) of budesonide, a corticosteroid that reduces inflammation in your airways
  • 9 mcg of glycopyrrolate, an anticholinergic that opens your airways
  • 4.8 mcg of formoterol fumarate, a long-acting beta agonist (LABA) that opens your airways

FDA approval

The Food and Drug Administration (FDA) approved Breztri Aerosphere for COPD treatment in July 2020. It was the second triple-therapy combination inhaler approved to treat COPD.

Effectiveness

For information about the effectiveness of Breztri Aerosphere, see the “Breztri Aerosphere for COPD” section below.

Breztri Aerosphere is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Breztri Aerosphere is called a triple-therapy combination inhaler because it contains three active drugs. It’s used for maintenance (long-term) treatment of chronic obstructive pulmonary disease (COPD).

Other drugs are available that can treat COPD. Some may be a better fit for you than others. If you’re interested in finding an alternative to Breztri Aerosphere, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other drugs that may be used for maintenance (long-term) treatment of COPD include:

You may wonder how Breztri Aerosphere compares with other medications that are prescribed for similar uses. Here we look at how Breztri Aerosphere and Trelegy Ellipta are alike and different.

Ingredients

Breztri Aerosphere and Trelegy Ellipta both contain three active drugs.

Breztri contains budesonide, glycopyrrolate, and formoterol fumarate. Trelegy contains fluticasone furoate, umeclidinium bromide, and vilanterol trifenatate.

Uses

Both Breztri Aerosphere and Trelegy Ellipta are approved for maintenance (long-term) treatment of chronic obstructive pulmonary disease (COPD) in adults.

Trelegy Ellipta is also FDA-approved for maintenance treatment of asthma in adults.

Note: You should not use Breztri Aerosphere and Trelegy Ellipta as rescue medications. Rescue medications are used to quickly open your airways during breathing emergencies such as sudden breathlessness. And, Breztri Aerosphere shouldn’t be used to treat asthma.

Drug forms and administration

Breztri comes in an inhaler device called the Aerosphere. This a metered-dose inhaler. To take a puff from this type of inhaler, you breathe in through the mouthpiece while pressing down the canister. Breztri Aerosphere is taken as two puffs twice a day. You’ll need to shake the canister well before you use the inhaler.

Trelegy comes in an inhaler device called the Ellipta. This is a dry powder inhaler. To take a puff from this type of inhaler, you open the cover of the inhaler and then breathe in through the mouthpiece. Trelegy Ellipta is taken as one inhalation once a day. You don’t need to shake this inhaler before use.

Side effects and risks

Breztri Aerosphere and Trelegy Ellipta both contain drugs from the same classes. (A class of drugs is a group of medications that work in a similar way.) Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with either Breztri Aerosphere or Trelegy Ellipta, as well as mild side effects that both drugs may share.

  • Can occur with Breztri Aerosphere:
    • muscle spasms (twitches)
  • Can occur with Trelegy Ellipta:
    • change in your sense of taste
    • mouth or throat pain
  • Can occur with both Breztri Aerosphere and Trelegy Ellipta:
    • oral thrush (a fungal infection in the mouth and throat)
    • sinusitis (sinus inflammation)
    • influenza (flu)
    • back pain
    • urinary tract infection (UTI)
    • cough
    • diarrhea
    • hoarse voice
    • headache

Serious side effects

This list contains examples of serious side effects that can occur with both Breztri Aerosphere and Trelegy Ellipta:

Effectiveness

The only condition both Breztri Aerosphere and Trelegy Ellipta are used to treat is COPD.

These drugs haven’t been directly compared in clinical studies. But studies have found both Breztri Aerosphere and Trelegy Ellipta to be effective for treating COPD.

Both drugs are triple-therapy combination inhalers. This means they contain three active drugs. And triple therapy is recommended for maintenance (long-term) treatment of COPD in current guidelines.

If you have questions about how Breztri Aerosphere compares with Trelegy Ellipta, talk with your doctor.

Costs

According to estimates on GoodRx.com, Breztri Aerosphere and Trelegy Ellipta generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Breztri Aerosphere and Trelegy Ellipta are both brand-name drugs. There are currently no generic forms of either drug. A generic drug is an exact copy of the active drug in a brand-name medication. Brand-name medications usually cost more than generics.

The Food and Drug Administration (FDA) approves prescription drugs such as Breztri Aerosphere to treat certain conditions. Breztri Aerosphere is FDA-approved to treat chronic obstructive pulmonary disease (COPD) in adults.

What COPD is

COPD is a long-term lung disease that gets worse over time. It’s typically caused by smoking. With COPD, you tend to have a mixture of:

  • emphysema, which is damage to the air sacs in your lungs, and
  • bronchitis, which is inflammation (swelling) in your airways

Emphysema makes it harder for your lungs to take oxygen into your blood and remove carbon dioxide from your body. And bronchitis narrows your airways and causes mucus to build up in your lungs. This mucus can be hard to cough up. All of these problems can make it hard to breathe in and out.

COPD causes symptoms such as:

  • breathlessness, especially with physical exertion
  • wheezing
  • chest tightness
  • a persistent cough that produces mucus
  • fatigue (lack of energy)
  • frequent lung infections that cause flare ups of the above symptoms

What Breztri Aerosphere does

Breztri Aerosphere is used for maintenance (long-term) treatment of COPD. The drug works to open your airways and keep them open. It also reduces inflammation in your lungs. This makes it easier to breathe.

Breztri Aerosphere can improve lung function and reduce the number of COPD flare ups you have. The drug can also reduce the risk of hospitalization or death due to COPD.

Note: Breztri Aerosphere is not used to treat asthma. In addition, you should not use Breztri Aerosphere as a rescue medication. Rescue medications are used to quickly open your airways during breathing emergencies such as sudden breathlessness. But Breztri Aerosphere doesn’t work quickly enough to be used as a rescue medication. If you have sudden breathlessness, use your rescue inhaler (such as albuterol) as prescribed by your doctor. And if your symptoms feel life threatening, call 911 right away.

Effectiveness for COPD

Two clinical studies found Breztri Aerosphere to be more effective than dual-therapy combination inhalers for treating moderate to very severe COPD. Breztri Aerosphere is a triple-therapy combination inhaler that contains three active drugs: budesonide, glycopyrrolate, and formoterol fumarate. Dual-therapy combination inhalers, on the other hand, contain only two active drugs.

In these studies, people took one of the following treatments twice a day using an Aerosphere inhaler device:

  • Breztri
  • glycopyrrolate and formoterol fumarate
  • budesonide and formoterol fumarate

Effectiveness for improving lung function

Researchers in these studies tested how effective the different treatments were for improving lung function. Lung function was assessed by measuring forced expiratory volume (FEV1). FEV1 is the amount of air you can force from your lungs in 1 second. FEV1 was measured each morning before people had used any medication.

After 24 weeks, people using Breztri Aerosphere had more improvement in their FEV1 than people using the other treatments. After using Breztri Aerosphere, people’s FEV1 was increased by:

  • 13 milliliters (mL) to 35 mL more than people using glycopyrrolate and formoterol
  • 74 mL to 76 mL more than people using budesonide and formoterol

Effectiveness for reducing flare-ups

In one of these studies, researchers also looked at how effective the treatments were for reducing moderate to severe COPD flare-ups. A flare up occurs when your COPD symptoms get worse for a time, usually because of a lung infection. In this study, moderate flare ups needed treatment with antibiotics, corticosteroids, or both. And severe flare ups may have required hospital treatment or resulted in death.*

Over 1 year of treatment in this study, people using Breztri Aerosphere had fewer moderate to severe COPD flare ups than people using the other treatments. Specifically, people using Breztri Aerosphere had:

  • 24% fewer flare ups than people using glycopyrrolate and formoterol fumarate
  • 13% fewer flare ups than people using budesonide and formoterol fumarate

In this study, people using Breztri Aerosphere also needed fewer doses of rescue medication per day than people using the other treatments.

* It isn’t reported whether any deaths occurred during this study due to severe COPD flare-ups. For details, see Breztri Aerosphere’s prescribing information.

Effectiveness for improving quality of life

Lastly, in both studies, more people using Breztri Aerosphere had improved health-related quality of life than people using other treatments.

Health-related quality of life was assessed using a questionnaire about often you get symptoms and how severe your symptoms are. This questionnaire also considers the impact your symptoms have on your daily activities and mental health.

Breztri Aerosphere and children

Breztri Aerosphere hasn’t been studied in children. It’s only approved to treat COPD in adults. This condition typically affects adults over 40 years old.

Breztri Aerosphere is used every day as a maintenance (long-term) treatment for chronic obstructive pulmonary disease (COPD). Your doctor may prescribe other medications for you to use with Breztri Aerosphere.

Breztri Aerosphere use with rescue medications

But it’s still possible to have breathing emergencies, such as sudden breathlessness, while you’re using Breztri Aerosphere.

Your doctor may prescribe a rescue medication for you to use if you have a breathing emergency. Rescue medications quickly open your airways. They belong to a class of drugs called short-acting beta-agonists. Rescue medications may be taken by inhaler or nebulizer. Examples include albuterol (ProAir, Proventil, Ventolin) and levalbuterol (Xopenex). Breztri Aerosphere is not a rescue medication.

Note: While you’re taking Breztri Aerosphere, contact your doctor if your rescue medication doesn’t work as well to treat your breathing emergencies. You should also contact your doctor if you need to use your rescue medication more often than usual while taking Breztri Aerosphere. These symptoms may mean that your COPD is getting worse, and you may need extra treatment.

Breztri Aerosphere use with other COPD treatments

Your doctor might also prescribe other medications to use with Breztri Aerosphere, depending on how severe your COPD symptoms are. Current guidelines recommend several types of drugs for maintenance (long-term) treatment of COPD. Examples of other treatments that your doctor may prescribe to use with Breztri Aerosphere include:

  • Theophylline (Theo-24, Elixophyllin, Theochron). Theophylline comes as a pill or liquid that’s taken every day. It works to relax and open your airways.
  • Roflumilast (Daliresp). This is a tablet that’s taken every day. It works to reduce inflammation (swelling) in your lungs.
  • Antibiotics to treat lung infections. Lung infections are a common complication of COPD. They often lead to flare-ups of COPD symptoms. Lung infections are usually treated with a short course of antibiotics. Sometimes, antibiotics are taken long-term to help prevent flare-ups.
  • Oxygen therapy. If the oxygen level in your blood is too low, your doctor may prescribe oxygen therapy. With oxygen therapy, you inhale oxygen from a portable tank using a face mask or nasal cannula. A nasal cannula is a flexible tube that sits under your nose with two short prongs that go inside your nostrils.

Note: You shouldn’t use Breztri Aerosphere with other medications that contain a long-acting beta-agonist (LABA) drug. Breztri Aerosphere contains the LABA drug formoterol. And taking Breztri Aerosphere with another LABA drug could have serious side effects on your heart. For more information and examples of LABA drugs, see the “Breztri Aerosphere interactions” section below.

The following information describes Breztri Aerosphere dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Breztri Aerosphere is a metered-dose inhaler. Aerosphere is the name of the inhaler device. The device contains an inhalation aerosol, which you’ll breathe in as puffs.

Each puff from Breztri Aerosphere contains:

  • 160 micrograms (mcg) of budesonide
  • 9 mcg of glycopyrrolate
  • 4.8 mcg of formoterol fumarate

Dosage for COPD

Breztri Aerosphere is used for maintenance (long-term) treatment of chronic obstructive pulmonary disease (COPD).

The usual dosage of Breztri Aerosphere for COPD is two puffs taken twice a day, in the morning and evening. Do not take more than four puffs of Breztri Aerosphere in a day.

Note: Breztri Aerosphere shouldn’t be used to treat breathing emergencies such as sudden breathlessness. A rescue inhaler, such as albuterol, should be used instead for this purpose. See “Breztri Aerosphere for COPD” above for details about Breztri Aerosphere is used.

What if I miss a dose?

If you miss a dose of Breztri Aerosphere, take your missed dose as soon as possible, unless it’s almost time for your next dose. In this case, skip the missed dose and take your next dose as usual. And if you miss a dose, don’t take extra puffs to make up for the missed dose.

If you missed a dose of Breztri Aerosphere and you aren’t sure whether to take the missed dose or skip it, contact your doctor or pharmacist.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. The timer on your phone or even a kitchen timer can work, too.

Will I need to use this drug long term?

Breztri Aerosphere is meant to be used as a long-term treatment. If you and your doctor determine that Breztri Aerosphere is safe and effective for you, you’ll likely use it long term.

Breztri Aerosphere can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Breztri Aerosphere. These lists do not include all possible side effects.

For more information about the possible side effects of Breztri Aerosphere, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may cause concern.

Note: The Food and Drug Administration (FDA) tracks the side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Breztri Aerosphere, you can do so through MedWatch.

Mild side effects

Mild side effects* of Breztri Aerosphere can include:

  • upper respiratory tract infections, such as the common cold†
  • oral thrush (a fungal infection in the mouth and throat)†
  • urinary tract infections (UTIs)†
  • sinusitis (sinus inflammation)
  • cough
  • influenza (flu)
  • back pain
  • diarrhea
  • muscle spasms (twitching)
  • hoarse voice
  • tremor (shaking in one or more body parts)
  • nervousness
  • headache
  • nausea

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Breztri Aerosphere. To learn about other mild side effects, talk with your doctor or pharmacist, or view Breztri Aerosphere’s patient information.
† For more information about these side effects, see “Side effect details” below.

Serious side effects

Serious side effects from Breztri Aerosphere aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Changes in your heartbeat or blood pressure. Symptoms can include:
    • fast or irregular heart rate (which may feel like your heart is racing or pounding)
  • Reduced adrenal gland function (which occurs when your body doesn’t make enough of the hormone cortisol). Symptoms can include:
    • tiredness or lack of energy
    • weakness
    • nausea and vomiting
    • low blood pressure, which can make you feel dizzy
  • Paradoxical bronchospasm (sudden, unexpected breathing problems immediately after inhaling the drug). Symptoms can include:
    • trouble inhaling enough air
    • wheezing
    • coughing
    • chest tightness or pain
  • Urinary retention (trouble emptying your bladder). Symptoms can include:
    • trouble urinating
    • pain when urinating
    • urinating more often than usual
    • passing urine with a weak flow or in drips
  • Low level of potassium in your blood, which can cause muscle and heart problems. Symptoms can include:
    • muscle spasms (twitches)
    • muscle weakness
    • abnormal heart rhythm
  • High blood sugar levels. Symptoms can include:
    • feeling thirsty
    • feeling tired
    • urinating more often than usual
    • blurry vision
    • headache
  • Weakened immune system and increased risk for infection.
  • Pneumonia (a type of lung infection).*
  • Reduced bone mineral density (weakened bones).*
  • Eye problems, such as glaucoma or cataracts.*
  • Allergic reaction.*

* For more information about these side effects, see “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Breztri Aerosphere. It’s not known how often allergic reactions occurred in clinical studies of Breztri Aerosphere.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth, swelling, or redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Breztri Aerosphere, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Increased risk of infection

It’s possible to have an increased risk of infection while using Breztri Aerosphere. This is because Breztri Aerosphere contains a corticosteroid drug called budesonide. Corticosteroids can weaken your immune system and make your body less able to fight off infections.

This means that while using Breztri Aerosphere, you may have frequent infections or infections that take a long time to clear up. The most common infections seen with Breztri Aerosphere in clinical studies were:

Oral thrush

Some people may develop oral thrush when using Breztri Aerosphere.

Oral thrush is a fungal infection in your mouth and throat. In clinical studies, oral thrush occurred in:

  • 3% of people using Breztri Aerosphere (which contains budesonide, glycopyrrolate, and formoterol)
  • 1.1% of people using glycopyrrolate and formoterol
  • 2.7% of people using budesonide and formoterol

Symptoms of oral thrush can include:

  • white spots or patches inside your mouth
  • redness, swelling, soreness, or a burning sensation inside your mouth
  • pain when swallowing

To reduce your risk for oral thrush, rinse your mouth with water after each time you use Breztri Aerosphere and spit the water out.*

If you have symptoms of oral thrush, contact your doctor. They can prescribe antifungal medication to treat this infection.

* See the “How to use Breztri Aerosphere” section below for more information about how to use the drug.

Upper respiratory tract infections

Breztri Aerosphere can cause upper respiratory tract infections, such as the common cold.

In clinical studies, upper respiratory tract infections occurred in:

  • 5.7% of people using Breztri Aerosphere (which contains budesonide, glycopyrrolate, and formoterol)
  • 4.8% of people using glycopyrrolate and formoterol
  • 5.4% of people using budesonide and formoterol

Symptoms of upper respiratory tract infections may include:

  • runny nose
  • congested nose
  • sinus pain
  • sneezing
  • headache
  • cough
  • sore throat

To help prevent upper respiratory infections, make sure to wash your hands often, avoid contact with people who are sick, eat healthily, and get enough sleep.

Upper respiratory infections are usually mild and tend to resolve on their own after a week or two. If your symptoms are bothersome, various over-the-counter medications may help relieve symptoms. Your pharmacist can recommend a medication for you. But if your symptoms don’t clear up after 2 weeks or start to get worse, see your doctor.

See your doctor right away if you start to develop symptoms of pneumonia (see below).

Pneumonia

Breztri Aerosphere increases your risk for pneumonia, which is a type of lung infection that can be serious. And people with chronic obstructive pulmonary disease (COPD) have an increased risk for pneumonia already.

In clinical studies, pneumonia occurred in:

  • 4.6% of people using Breztri Aerosphere (which contains budesonide, glycopyrrolate, and formoterol)
  • 2.9% of people using glycopyrrolate and formoterol
  • 5.0% of people using budesonide and formoterol

Symptoms of pneumonia can include:

  • fever
  • chills (shivering)
  • coughing more than usual
  • producing more mucus than usual
  • change in the color of mucus
  • more trouble breathing than usual

To help prevent pneumonia, talk with your doctor about having a pneumococcal vaccine. This vaccine helps to protect against the most common forms of pneumonia. Having influenza (flu) can sometimes lead to pneumonia. For this reason, it’s also important to have a flu vaccine every year.

It’s important to note that the pneumococcal vaccine and the flu vaccine don’t protect against all forms of these viruses. To further help prevent pneumonia and the flu, there are a few actions you can take. These include washing your hands often, avoiding contact with people who are sick, eating healthily, and getting enough sleep.

If you have symptoms of pneumonia, see your doctor right away. You may need treatment for the infection. In some cases, you may need treatment in the hospital.

Reduced bone mineral density

Long-term use of Breztri Aerosphere can cause reduced bone mineral density. Bone mineral density is a measurement of how strong your bones are.

Having reduced bone mineral density means that your bones are weakened. This can lead to osteoporosis. Osteoporosis occurs when your bones become weaker, and you have a higher risk for fractures.

In a clinical study, bone mineral density was measured using a type of X-ray called a DEXA scan. Compared with before treatment, bone mineral density after 1 year of treatment was:

  • reduced by an average of 0.1% in people using Breztri Aerosphere (which contains budesonide, glycopyrrolate, and formoterol)
  • increased by an average of 0.4% in people using glycopyrrolate and formoterol

Symptoms of reduced bone mineral density can include:

  • bone fractures that occur after a minor injury or without a clear cause
  • back pain
  • losing height over time

To help prevent the weakening of your bones, your doctor may prescribe calcium supplements or other medications that help protect your bones while you’re taking Breztri Aerosphere. And they may monitor your bone mineral density during your treatment.

Glaucoma and cataracts

Long-term use of Breztri Aerosphere can sometimes cause eye problems. These problems may include increased pressure in your eye, glaucoma, and cataracts.

It’s not known exactly how often these problems occurred in clinical studies of Breztri Aerosphere. In one study, cataracts occurred in 0.7% to 1% of people in the study, regardless of which COPD treatment was used. These treatments were either Breztri Aerosphere (which contains budesonide, glycopyrrolate, and formoterol), glycopyrrolate and formoterol, or budesonide and formoterol.

Symptoms of glaucoma and cataracts can include:

  • eye pain
  • red eye
  • blurry vision
  • nausea and vomiting
  • seeing halos around lights
  • trouble seeing at night
  • increased sensitivity to light and glare

If you have these symptoms or any other changes in your vision while using Breztri Aerosphere, contact your doctor. Medications such as eye drops can typically treat glaucoma and increased eye pressure. But cataracts may require surgery.

Alcohol is not known to interact with Breztri Aerosphere. But it’s not currently clear whether drinking alcohol can affect chronic obstructive pulmonary disease (COPD), which Breztri Aerosphere is used to treat.

If you have COPD and drink alcohol, talk with your doctor about how much is safe for you to drink.

Breztri Aerosphere can interact with several other medications.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Breztri Aerosphere and other medications

Below are lists of medications that can interact with Breztri Aerosphere. This article does not contain all drugs that may interact with Breztri Aerosphere.

Before taking Breztri Aerosphere, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Breztri Aerosphere and other long-acting beta-agonist (LABA) drugs

Breztri Aerosphere shouldn’t be used with other medications that contain a drug that’s a long-acting beta-agonist (LABA). One of the active drugs in Breztri Aerosphere is formoterol, which is a LABA drug.

Using other medications that contain LABA drugs with Breztri Aerosphere could cause serious heart problems. These problems include a fast or irregular heartbeat, high blood pressure, or chest pain.

LABA drugs that shouldn’t be taken with Breztri Aerosphere include:

LABA drugs are also found in some other combination inhalers used to treat chronic obstructive pulmonary disease (COPD).

Be sure to tell your doctor about all of the medications you use for COPD. They can make sure that you’re not using more than one LABA drug.

Breztri and certain antimicrobials

Antimicrobials are drugs used to treat infections. Taking certain antimicrobials with Breztri Aerosphere can stop your liver from breaking down budesonide, which is one of the active drugs in Breztri Aerosphere. As a result, budesonide can build up in your body. And this increases your risk for side effects from budesonide, such as reduced adrenal gland function.*

Examples of antimicrobials that can increase your risk for side effects with Breztri Aerosphere include:

  • certain antibiotics, such as:
    • telithromycin
  • certain antifungals, such as:
    • itraconazole (Sporanox)
    • voriconazole (Vfend)
    • posaconazole (Noxafil)
  • certain antiretroviral drugs (drugs used to treat HIV), such as:
    • atazanavir (Reyataz)
    • ritonavir (Norvir)
    • indinavir sulfate (Crixivan)
    • nelfinavir mesylate (Viracept)
    • saquinavir mesylate (Invirase)
    • cobicistat (Tybost)

If you need to take an antimicrobial with Breztri Aerosphere, talk with your doctor about possible interactions. Your doctor may want to monitor you more closely while you’re taking both medications.

* This is a condition in which your body doesn’t make enough of the hormone cortisol. For more information, see the “Breztri Aerosphere side effects” section above.

Breztri and drugs that can lower potassium levels

Breztri Aerosphere can sometimes lower the level of potassium in your blood. Certain other drugs can also have this effect. Taking these drugs with Breztri Aerosphere can cause the amount of potassium in your blood to fall very low. This is called hypokalemia. Hypokalemia can cause symptoms such as muscle spasms (twitches) and abnormal heart rhythms.

Examples of drugs that increase your risk for hypokalemia with Breztri Aerosphere include:

If you take any of these medications while you’re using Breztri Aerosphere, your doctor will likely order frequent blood tests to check your potassium level.

Breztri Aerosphere and beta-blockers

You should not use beta-blockers with Breztri Aerosphere unless there are no other treatments that are right for you.

Beta-blockers are drugs used to treat high blood pressure and certain heart conditions, such as angina (chest pain) and arrhythmias (irregular heartbeats). Some beta-blockers are also prescribed to help with symptoms of an overactive thyroid gland or anxiety. Certain eye drops for glaucoma also contain these drugs.

Beta-blockers (even those in eye drops) can narrow your airways. These drugs can cause severe breathing problems in people with COPD. Beta-blockers can also prevent formoterol (one of the active drugs in Breztri Aerosphere) from opening your airways.

Examples of beta-blockers include:

If you need a beta-blocker, your doctor will choose a drug that has the least effect on your airways. Talk with your doctor if you’re concerned about being prescribed a beta-blocker with Breztri Aerosphere.

Breztri Aerosphere and certain antidepressants

Taking certain antidepressants with Breztri Aerosphere can increase your risk of having a problem with your heart rhythm. You should not usually take these antidepressants with Breztri Aerosphere.

Examples of antidepressants that can increase your risk for an abnormal heart rhythm with Breztri Aerosphere include:

If you take any of these antidepressants, talk with your doctor before starting Breztri Aerosphere. They may recommend other treatments for you.

Breztri Aerosphere and other drugs that can affect your heart rhythm

Certain drugs can prolong (lengthen) part of your heart rhythm called the QT interval. Taking Breztri Aerosphere with these types of drugs can increase your risk for having a problem with your heart rhythm called long QT syndrome.

Examples of drugs that can increase your risk for an abnormal heart rhythm with Breztri Aerosphere include:

  • certain drugs for irregular heartbeats, such as:
    • dronedarone (Multaq)
    • sotalol (Betapace, Sorine, Sotylize)
  • certain antipsychotic drugs, such as:
    • thioridazine
    • ziprasidone (Geodon)

If you take one of these drugs or any other drug that can affect your heart rhythm, talk with your doctor before starting Breztri Aerosphere. They may recommend other treatments for you.

Breztri Aerosphere and other anticholinergic drugs

One of the active drugs in Breztri Aerosphere is glycopyrrolate, which is a type of drug called an anticholinergic. These drugs work to block the action of a chemical in your body called acetylcholine.

Other anticholinergic drugs generally shouldn’t be taken with Breztri Aerosphere. Taking these drugs together can increase your risk for anticholinergic side effects. These can include trouble urinating, blurry vision, and dry mouth.

Examples of anticholinergic drugs that may increase your risk for anticholinergic side effects with Breztri Aerosphere include:

If you need to take an anticholinergic drug while you’re using Breztri Aerosphere, your doctor will monitor you closely for side effects. Be sure to tell your doctor right away if you have any of the above symptoms.

Breztri Aerosphere and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Breztri Aerosphere. However, you should still check with your doctor or pharmacist before using any of these products while taking Breztri Aerosphere.

Breztri Aerosphere and foods

There aren’t any foods that have been specifically reported to interact with Breztri Aerosphere. If you have any questions about eating certain foods with Breztri Aerosphere, talk with your doctor.

As with all medications, the cost of Breztri Aerosphere can vary. To find current prices for Breztri Aerosphere in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Breztri Aerosphere. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

Before approving coverage for Breztri Aerosphere, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re unsure if you’ll need to get prior authorization for Breztri Aerosphere, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Breztri Aerosphere or need help understanding your insurance coverage, help may be available.

AstraZeneca, the manufacturer of Breztri Aerosphere, offers a program called BREZTRI Zero Pay. Through this program, you may be eligible to receive Breztri Aerosphere at no cost. For more information and to find out if you’re eligible for support, call 833-458-0440 or visit the program website.

Mail-order pharmacies

Breztri Aerosphere may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Breztri Aerosphere, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Breztri Aerosphere is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generic drugs tend to cost less than brand-name drugs.

You should use Breztri Aerosphere according to your doctor’s or healthcare provider’s instructions.

Breztri Aerosphere is metered-dose inhaler. With this type of inhaler, you take a puff by pressing down on the canister while breathing in through the mouthpiece. Your doctor or pharmacist will show you how to use the inhaler correctly. There are also detailed instructions and a video on the manufacturer’s website.

When to use

You should use Breztri Aerosphere twice every day. Take two puffs in the morning and two puffs in the evening.

After each time you use Breztri Aerosphere, you should rinse your mouth with water. Spit the water out, and don’t swallow it. Rinsing your mouth can reduce your risk of oral thrush (a fungal infection in the mouth and throat), which is a possible side effect of Breztri Aerosphere.*

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. The timer on your phone or even a kitchen timer can work, too.

* See the “Breztri Aerosphere side effects” section above for details.

Important information about using Breztri Aerosphere

  • Breztri Aerosphere is not a rescue medication. Rescue medications work quickly to open your airways and relieve breathing emergencies such as sudden breathlessness. Examples of rescue medications include albuterol (ProAir, Proventil, Ventolin) and levalbuterol (Xopenex). If you have a breathing emergency, use your rescue medication as prescribed by your doctor.
  • If you have sudden breathing problems right after taking a puff of Breztri Aerosphere, use your rescue medication right away. Don’t use the Breztri Aerosphere inhaler again. Call your doctor as soon as possible so they can determine a different treatment for you. And if your symptoms feel life threatening, call 911 right away.
  • If your rescue medication doesn’t work as well as it did before you started Breztri Aerosphere treatment, or if you need to use your rescue medication more often than before, contact your doctor as soon as possible. And make sure to call 911 if your symptoms feel life threatening or if your rescue medication doesn’t work as well as usual.

Breztri Aerosphere is used for maintenance (long-term) treatment of chronic obstructive pulmonary disease (COPD).

What happens with COPD

With COPD, you have damage to the air sacs in your lungs. This makes it harder for your lungs to take oxygen into your blood and remove carbon dioxide from your body. COPD also causes inflammation (swelling) in your airways. This narrows your airways and causes mucus to build up in your lungs. This mucus can be hard to cough up. All of these problems can make it hard to breathe.

COPD symptoms may include breathlessness, wheezing, chest tightness, and a persistent cough that produces mucus. COPD can also lead to frequent lung infections. And lung infections can cause flare-ups of COPD symptoms.

What Breztri Aerosphere does

Breztri Aerosphere works to improve lung function and can help reduce the number of COPD flare ups you have.

Breztri Aerosphere is a triple-therapy inhaler for COPD. It contains a combination of three different active drugs in one inhaler. These drugs are:

  • Budesonide. Budesonide is a type of drug called a corticosteroid. It reduces inflammation in your airways and reduces the amount of mucus that your airways produce. This can help your chest feel less tight and can make it easier to breathe.
  • Glycopyrrolate. Glycopyrrolate is a type of drug called a long-acting anticholinergic. This type of drug is also sometimes called a long-acting muscarinic antagonist (LAMA). Glycopyrrolate stops a chemical called acetylcholine from tightening your airways. This allows your airways to relax and open.
  • Formoterol fumarate. Formoterol is a type of drug called a long-acting beta-agonist (LABA). Formoterol mimics the effect of the hormone epinephrine* on your airways. This drug also causes your airways to relax and open.

Glycopyrrolate and formoterol work to make it easier for you to breathe and get more oxygen. These drugs can also make it easier to cough mucus out of your lungs.

* Epinephrine, also known as adrenaline, is a chemical in the body that opens airways in the lungs and narrows blood vessels.

How long does it take to work?

Breztri Aerosphere starts working soon after you take your first dose. The drug should open your airways within a few minutes of taking a dose. And it helps to keep your airways open for 12 hours. But Breztri Aerosphere’s anti-inflammatory effect builds up over time as you continue to use the drug.

You might notice an improvement in your breathing symptoms with your first dose. But Breztri Aerosphere is a long-term treatment that works over time to improve your COPD symptoms. So it’s important to keep using the drug regularly every day.

Note: You should not use Breztri Aerosphere as a rescue medication. Rescue medications are used to quickly open your airways during breathing emergencies, such as sudden breathlessness. Breztri Aerosphere doesn’t work quickly enough to be used as a rescue medication. If you have sudden breathlessness, use your rescue inhaler (such as albuterol) as prescribed by your doctor. And if your symptoms feel life threatening, call 911 right away.

It’s not known if Breztri Aerosphere is safe to use during pregnancy. It hasn’t been adequately studied in pregnant people. But inhaled budesonide, the third active drug in Breztri Aerosphere, has been studied in pregnant people. Budesonide use during pregnancy wasn’t found to increase the risk of birth abnormalities in developing fetuses.

Breztri Aerosphere’s two other active drugs, formoterol and glycopyrrolate, haven’t been adequately studied in pregnancy. However, formoterol can cause your uterus to relax. So if you use this drug during late pregnancy, it could prevent contractions and cause problems during labor and delivery.

In animal studies, harmful effects were seen in offspring of pregnant females given very high doses of formoterol by mouth. However, these effects weren’t seen when pregnant females were given lower doses of formoterol by inhalation. Also, in animal studies, no harmful effects were seen in offspring of pregnant females given glycopyrrolate. However, animal studies don’t always predict what will happen in humans.

If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of using Breztri Aerosphere. If you get pregnant while using Breztri Aerosphere, contact your doctor as soon as possible.

It’s not known if Breztri Aerosphere is safe to use during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Breztri Aerosphere.

For more information about taking Breztri Aerosphere during pregnancy, see the “Breztri Aerosphere and pregnancy” section above.

It’s not known if Breztri Aerosphere is safe to use while breastfeeding. It’s not known if two of the active drugs in Breztri, formoterol and glycopyrrolate, pass into breast milk. The third active drug in Breztri, budesonide, does pass into breast milk. It’s not known what effect this may have on a breastfed child.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the possible risks and benefits of using Breztri Aerosphere.

Here are answers to some frequently asked questions about Breztri Aerosphere.

Should I use Breztri Aerosphere for sudden breathing problems?

No. Breztri Aerosphere is not a rescue medication. The drug doesn’t work quickly enough to relieve sudden breathing problems. Instead, you’ll need to use your rescue medication to relieve sudden breathing problems. Examples of rescue medications include albuterol (ProAir, Proventil, Ventolin) and levalbuterol (Xopenex). Be sure to keep your rescue medication with you at all times.

Does Breztri Aerosphere have a taste?

Some people taste Breztri Aerosphere after taking a puff, but some people don’t. However, you should feel a puff of the medicine in your mouth when you take a dose from this inhaler.

If you notice a particularly strong taste when taking a puff, this could be because you’re not using the inhaler correctly. The drug could be landing on your tongue rather than being inhaled into your lungs.

If you can taste Breztri Aerosphere, ask your doctor or pharmacist to check that you’re using the inhaler correctly.

Can I use Breztri Aerosphere if I have diabetes?

Yes, you typically can, as long as your doctor approves.

However, Breztri Aerosphere can sometimes increase your blood sugar level. So your doctor may want to monitor your blood sugar more often than usual after you start using Breztri Aerosphere. Make sure to talk with your doctor about managing your diabetes during your Breztri Aerosphere treatment.

Will Breztri Aerosphere cure my COPD?

No, there’s not currently a cure for chronic obstructive pulmonary disease (COPD). However, taking Breztri Aerosphere regularly every day can help improve your COPD symptoms. It can also help prevent flare-ups and reduce the risk of hospitalization or death due to COPD.

Before taking Breztri Aerosphere, talk with your doctor about your health history. Breztri Aerosphere may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Asthma. You should not use Breztri Aerosphere to treat asthma. It’s not known if Breztri Aerosphere is safe or effective for people with asthma. Talk with your doctor about asthma treatments that might be right for you.
  • Allergic reaction. If you’ve had an allergic reaction to Breztri Aerosphere or any of its ingredients, you shouldn’t use Breztri Aerosphere. Ask your doctor what other medications are better options for you.
  • Tuberculosis (TB) infection in your lungs. Breztri Aerosphere contains a corticosteroid drug called budesonide that can make the immune system less able to fight infections. If you have an active TB infection, you’ll typically need to take medication to treat this before starting Breztri Aerosphere. If you’ve had TB in the past, talk with your doctor before beginning Breztri Aerosphere treatment. TB can stay inactive in your body for many years. But if Breztri Aerosphere weakens your immune system, it could cause TB to become active again. Your doctor can recommend whether you should be monitored for TB, or if you should take medication to treat TB, while using Breztri Aerosphere.
  • Bacterial, viral, fungal, or parasitic infections. Breztri Aerosphere contains a corticosteroid drug called budesonide that can make the immune system less able to fight off infections. If you have a serious infection, you’ll typically need to take medication to treat it before you start using Breztri Aerosphere. If you develop an infection while using Breztri, talk with your doctor. Your doctor will typically prescribe medication to treat the infection.
  • Ocular herpes (herpes infection in your eye). Breztri Aerosphere contains a corticosteroid drug called budesonide that can make the immune system less able to fight off infections. If you have ocular herpes, you’ll typically need to take antiviral medication to treat this before you start Breztri Aerosphere. And if you’ve had ocular herpes in the past, Breztri Aerosphere could cause this infection to flare up. Talk with your doctor about whether it’s safe for you to use Breztri Aerosphere. You may need to take an antiviral medication to help prevent ocular herpes from flaring up and damaging your eyes.
  • Lack of immunity to measles or chickenpox. Breztri Aerosphere contains a corticosteroid drug called budesonide that can make the immune system less able to fight off infections. Infections caused by both measles and chickenpox viruses can be more serious than usual in people using Breztri Aerosphere. If you haven’t been immunized and you’ve never had chickenpox or measles, avoid contact with anyone who has one of these infections. If you do come into contact with someone who has chickenpox or measles, contact your doctor right away. You may need medication to prevent or treat these infections.
  • Reduced adrenal function. With reduced adrenal gland function, your adrenal glands don’t make enough cortisol. Cortisol is a hormone that your body produces in response to stress. If you’ve been taking high doses of corticosteroids over a long period, you may have reduced adrenal function. Breztri Aerosphere can also cause reduced adrenal function. If you have reduced adrenal function while you’re using Breztri Aerosphere, discuss this with your doctor. Your doctor may recommend that you take more corticosteroids if you’ll be experiencing stress (such as if you have a serious illness, infection, injury, or surgery).
  • Heart problems. Breztri Aerosphere can cause high blood pressure and a fast or irregular heart rate. If you have a heart problem, such as heart failure, angina (chest pain), or an irregular heart rate, Breztri Aerosphere could make this worse. Talk with your doctor about whether Breztri Aerosphere is right for you.
  • High blood pressure. Breztri Aerosphere can sometimes cause high blood pressure. If you already have high blood pressure, Breztri Aerosphere could make this worse. Talk with your doctor about whether Breztri Aerosphere is right for you.
  • Reduced bone mineral density (weakened bones). Long-term use of Breztri Aerosphere can weaken your bones, which can cause them to fracture more easily than usual. If you’re already at risk for having weak bones, your doctor may check your bone mineral density before you start using Breztri Aerosphere. And they may prescribe medications to help strengthen your bones while you use Breztri Aerosphere. You’re more at risk of having weak bones if you:
    • have a family history of osteoporosis (a condition in which your bones become weaker and you have a higher risk for fractures)
    • have gone through menopause
    • have an inactive lifestyle or don’t exercise often
    • smoke tobacco
    • eat a diet that’s not very nutritious
    • are older than 65 years
    • have been taking medications that can weaken your bones (for example, anticonvulsants or corticosteroids taken by mouth) for a long time
  • Eye problems. Long-term use of Breztri Aerosphere can cause or worsen certain eye problems. These problems include increased pressure in your eye, glaucoma, and cataracts. If you have these eye problems, you may need more frequent eye exams while you’re using Breztri Aerosphere. Tell your doctor right away if you notice any changes to your vision while using this medication.
  • Urinary retention (trouble emptying your bladder). If you have trouble urinating or emptying your bladder (such as due to a prostate or bladder problem), Breztri Aerosphere can make this worse. Talk with your doctor about whether Breztri Aerosphere is right for you.
  • Overactive thyroid gland. Breztri Aerosphere can make certain symptoms of an overactive thyroid gland worse, such as a fast heart rate. Talk with your doctor about whether Breztri Aerosphere is right for you.
  • Seizure disorders such as epilepsy. If you experience seizures (changes in electrical activity in your brain), Breztri Aerosphere could make them worse. Talk with your doctor about whether this medication is right for you.
  • Diabetes. Breztri Aerosphere can sometimes increase your blood sugar level. If you have diabetes, your doctor may monitor your blood sugar more often than usual during your Breztri Aerosphere treatment.
  • Liver problems. Two of the drugs in Breztri Aerosphere, budesonide and formoterol, are broken down by your liver. If you have severe liver problems, these drugs could build up in your body. This could increase your risk for side effects from Breztri Aerosphere. For this reason, your doctor may monitor you more closely than usual while you use Breztri Aerosphere.
  • Kidney problems. Breztri Aerosphere hasn’t been studied in people with kidney problems. If you have severe kidney problems, talk with your doctor about whether Breztri Aerosphere is right for you.
  • Pregnancy. It’s not known if Breztri Aerosphere is safe to use during pregnancy. For more information, see the “Breztri Aerosphere and pregnancy” section above.
  • Breastfeeding. It’s not known if Breztri Aerosphere is safe to use while breastfeeding. For more information, see the “Breztri Aerosphere and breastfeeding” section above.

Note: For more information about the potential negative effects of Breztri Aerosphere, see the “Breztri Aerosphere side effects” section above.

Using more than the recommended dosage of Breztri Aerosphere can lead to serious side effects.

Do not use more Breztri Aerosphere than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

  • nausea
  • vomiting
  • dizziness
  • blurred vision
  • trouble urinating
  • increased pressure in your eyes, which can cause eye pain or eye redness
  • fast heart rate
  • chest pain
  • heart palpitations (feeling like your heart is fluttering, racing, or pounding)
  • nervousness
  • headache
  • tremor (shaking in one or more body parts)
  • muscle cramps
  • seizures (changes in electrical activity in your brain)

What to do in case of overdose

If you think you’ve used too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Breztri Aerosphere from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Breztri Aerosphere at a room temperature of 68°F to 77°F (20°C to 25°C). If needed, it can be kept at a temperature of 59°F to 86°F (15°C to 30°C) for short periods. Keep the inhaler away from heat and sunlight. And avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Breztri Aerosphere comes in a foil pouch. You’ll typically receive an inhaler that contains 120 puffs of medication. Don’t open the pouch until you’re ready to start using the inhaler. And when you open the pouch, write down the date on the label of the inhaler. This is important because you should dispose of the Aerosphere inhaler when the dose indicator window displays zero or 3 months after you take it out of the foil pouch (whichever comes first).

Sometimes you might be given an inhaler that contains 28 puffs of medication. This might be the case if you were given Breztri Aerosphere in a hospital. Dispose of this inhaler when the dose indicator window displays zero or 3 weeks after you take it out of the foil pouch (whichever comes first).

Disposal

If you no longer need to use Breztri Aerosphere and have leftover medication, it’s important to dispose of the inhaler safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

Improperly disposing of used inhalers devices can also affect the environment. Ask your pharmacist or someone at your local recycling or trash center how to best dispose of inhalers in your area.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, you should not use this article as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.