Glycopyrrolate oral inhalation is used as a long term treatment to control wheezing, shortness of breath, coughing, and chest tightness in patients with chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways, that includes chronic bronchitis and emphysema). Glycopyrrolate is in a class of medications called anticholinergics. It works by relaxing the muscles around the airways in your lungs, making it easier to breathe.

Glycopyrrolate oral inhalation comes as a powder-filled capsule to inhale by mouth using a special inhaler and as a solution (liquid) to inhale by mouth using a special nebulizer (machine that turns medication into a mist that can be inhaled). It is usually inhaled twice a day, once in the morning and once in the evening. Inhale glycopyrrolate at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use glycopyrrolate exactly as directed. Do not use more or less of it or take it more often than prescribed by your doctor.

Do not swallow gylcopyrrolate capsules or nebulizer solution.

Do not use glycopyrrolate oral inhalation during a sudden COPD attack. Your doctor will prescribe a short-acting (rescue) inhaler to use during COPD attacks.

Call your doctor or get emergency medical help if your breathing problems worsen, if you have to use your short-acting inhaler to treat attacks of COPD more often, or if your short-acting inhaler does not relieve your symptoms.

Glycopyrrolate oral inhalation controls COPD but does not cure it. Continue to use glycopyrrolate even if you feel well. Do not stop using glycopyrrolate without talking to your doctor. If you stop using glycopyrrolate inhalation, your symptoms may get worse.

Before you use glycopyrrolate oral inhalation for the first time, read the written instructions that come with the inhaler or nebulizer. Ask your doctor, pharmacist, or respiratory therapist to show you how to assemble and use the inhaler or nebulizer. Practice using the inhaler or nebulizer while he or she watches.

Do not use the nebulizer or inhaler to inhale any other medications.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before using glycopyrrolate,

• tell your doctor and pharmacist if you are allergic to glycopyrrolate, any other medications, or any of the ingredients in the glycopyrrolate powder capsule or nebulizer solution. If you will be using the powder capsule also tell your doctor if you are allergic to lactose (milk proteins). Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines; atropine (in Lomotil, Motofen); other medications for COPD including aclidinium (Tudorza Pressair), ipratropium (Atrovent HFA, in Combivent Respimat), tiotropium (Spiriva, in Stioloto Respimat), and umeclidinium (Incruse Ellipta, in Anoro Ellipta, Trelegy Ellipta); oral glycopyrrolate (Cuvposa, Robinul); or medications for irritable bowel disease, motion sickness, Parkinson's disease, ulcers, or urinary problems. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with glycopyrrolate, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever had glaucoma (an eye disease), urinary retention (inability to empty your bladder completely or at all), prostate or bladder problems, or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using glycopyrrolate, call your doctor.

Skip the missed dose and continue your regular dosing schedule. Do not use the medication more than two times a day or use a double dose to make up for a missed dose.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• nausea
• vomiting
• feeling dizzy or lightheaded
• blurred vision or other vision problems
• painful or red eyes
• constipation
• difficulty urinating

Keep the powder capsules and the nebulizer solution in the blister pack or foil pouch it came in, sealed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Dispose of unused glycopyrrolate vials if not used within 7 days after opening the foil pouch.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Glycopyrrolate oral inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• nausea
• abdominal pain
• back or joint pain
• headache
• extreme tiredness
• swelling of the arms or legs
• sore throat

Some side effects can be serious. If you experience any of these symptoms, stop using glycopyrrolate oral inhalation and call your doctor immediately or get emergency medical treatment:

• sudden shortness of breath immediately after use
• rash; hives; difficulty swallowing or breathing; swelling of the face, throat, tongue, lips, and eyes; hoarseness
• eye pain, red eyes, nausea, vomiting. blurred vision, seeing bright circles around lights or other colored images
• difficult, frequent, painful, or weak urination

Glycopyrrolate oral inhalation may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Lonhala Magnair®
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• Utibron®(as a combination product containing Glycopyrrolate, Indacterol Maleate)®