Description

Simple

An inhaled medication that opens the airways and is used to treat a type of lung disease called chronic obstructive pulmonary disease (COPD).

Clinical

An inhaled long-acting anticholinergic used as a maintenance bronchodilator in patients with chronic obstructive pulmonary disease (COPD).

Overview

Aclidinium 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. FDA approved on July 24, 2012.

Pharmacology

Indication

Aclidinium bromide inhalation powder is indicated for the long-term, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

Pharmacodynamic

Aclidinium does not prolong the QTc interval or have significant effects on cardiac rhythm.

Mechanism of action

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 musc... Read more

Absorption

Bioavailability, healthy subjects = 6%;
T max, healthy subjects = 10 minutes;
Time to steady state, healthy subjects = 2 days;

Protein binding

Information currently not available.

Volume of distribution

Following IV administration, the volume of distribution is 300 L

Clearance

Total clearance, IV dose, young healthy subjects = 170 L/h (inter-individual variability of 36%)

Half life

Plasma half-life = 2.4 minutes (indicating that aclidinium is very rapidly hydrolyzed in plasma into its two inactive metabolites and has a low chance of causing systemic side effects).
Effective half-life = 5-8 hours.

Route of elimination

Intravenously administered radiolabelled aclidinium bromide was administered to healthy volunteers and was extensively metabolized with 1% excreted as unchanged aclidinium. Approximately 54% to 65% of the radioactivity was excreted in urine and 20% to 33% of the dose was excreted in feces. The combi... Read more

Toxicity

Most common adverse reactions (≥3% incidence and greater than placebo) are headache, nasopharyngitis and cough.

Adverse Effects

Contraindications

  • Regions: US
  • Patient Conditions:
      • Name: Severe allergy to milk proteins
      • Drugbank Id: DBCOND0108543

Food Interactions

    Information currently not available.

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
1,10-Phenanthroline
The therapeutic efficacy of Aclidinium can be decreased when used in combination with 1,10-Phenanthroline.
2,5-Dimethoxy-4-ethylamphetamine
The risk or severity of Tachycardia can be increased when 2,5-Dimethoxy-4-ethylamphetamine is combined with Aclidinium.
2,5-Dimethoxy-4-ethylthioamphetamine
2,5-Dimethoxy-4-ethylthioamphetamine may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
4-Bromo-2,5-dimethoxyamphetamine
4-Bromo-2,5-dimethoxyamphetamine may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
4-Methoxyamphetamine
4-Methoxyamphetamine may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
5-methoxy-N,N-dimethyltryptamine
5-methoxy-N,N-dimethyltryptamine may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
7-Nitroindazole
7-Nitroindazole may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
Abacavir
Abacavir may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Abediterol
The risk or severity of Tachycardia can be increased when Aclidinium is combined with Abediterol.
Acarbose
Acarbose may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Aceclofenac
Aceclofenac may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acemetacin
Acemetacin may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acepromazine
Acepromazine may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
Aceprometazine
Aceprometazine may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
Acetaminophen
Acetaminophen may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acetazolamide
Acetazolamide may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
Acetophenazine
Acetophenazine may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
Acetylglycinamide chloral hydrate
Acetylglycinamide chloral hydrate may increase the central nervous system depressant (CNS depressant) activities of Aclidinium.
Acetylsalicylic acid
Acetylsalicylic acid may decrease the excretion rate of Aclidinium which could result in a higher serum level.
3 References
  1. 1 . Reid DJ, Pham NT: Emerging Therapeutic Options for the Management of COPD. Clin Med Insights Circ Respir Pulm Med. 2013 Apr 9;7:7-15. doi: 10.4137/CCRPM.S8140. Print 2013.PubMed: 23641160
  2. 2 . Cazzola M, Page CP, Matera MG: Aclidinium bromide for the treatment of chronic obstructive pulmonary disease. Expert Opin Pharmacother. 2013 Jun;14(9):1205-14. doi: 10.1517/14656566.2013.789021. Epub 2013 Apr 9.PubMed: 23566013
  3. 3 . Jones P: Aclidinium bromide twice daily for the treatment of chronic obstructive pulmonary disease: a review. Adv Ther. 2013 Apr;30(4):354-68. doi: 10.1007/s12325-013-0019-2. Epub 2013 Apr 2.PubMed: 23553509