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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Other
Umeclidinium is a long-acting muscarinic antagonist (LAMA) used for the daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD).
Name
Umeclidinium
Raw Name
UMECLIDINIUM BROMIDE
Category
Other
Salt Form
Bromide
Drug Count
4
Variant Count
5
Last Verified
February 17, 2026
RxCUI
1945039, 1945044, 1945047, 1945048, 2395769, 2395771, 2395774, 2395775, 1539251, 1539885, 1596444, 1596445, 1487519, 1487524, 1487527, 1487528
UNII
JS86977WNV, 7AN603V4JV, 40AHO2C6DG
About Umeclidinium
Umeclidinium is a long-acting muscarinic antagonist (LAMA) used for the daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD).
Detailed information about Umeclidinium
References used for this content
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Umeclidinium.
Umeclidinium was developed to provide sustained bronchodilation (opening of the airways) by inhibiting the action of acetylcholine at muscarinic receptors in the bronchial smooth muscle. It was first approved by the U.S. Food and Drug Administration (FDA) in April 2014 under the brand name Incruse Ellipta. Since its inception, it has become a cornerstone in the management of COPD, either as a monotherapy or in fixed-dose combinations with long-acting beta2-agonists (LABA) like vilanterol, or in triple therapy with inhaled corticosteroids (ICS) like fluticasone furoate.
At the molecular level, umeclidinium works by competitively and reversibly inhibiting the M3 muscarinic receptors located on the smooth muscle cells of the airways. In a healthy respiratory system, the parasympathetic nervous system releases a neurotransmitter called acetylcholine. When acetylcholine binds to M3 receptors, it triggers a cascade that leads to muscle contraction, resulting in bronchoconstriction (narrowing of the airways).
In patients with COPD, the airways are often hyper-reactive or chronically narrowed. By blocking these M3 receptors, umeclidinium prevents acetylcholine from binding, thereby maintaining the smooth muscle in a relaxed state. This pharmacological action results in prolonged bronchodilation, which helps to increase the Forced Expiratory Volume in one second (FEV1) and reduce symptoms such as dyspnea (shortness of breath). Because umeclidinium has a slow dissociation rate from the M3 receptor, its effects last for at least 24 hours, allowing for convenient once-daily dosing.
Understanding how the body processes umeclidinium is essential for clinical management.
Umeclidinium is strictly indicated for the maintenance treatment of COPD. This includes:
It is important to note that umeclidinium is not indicated for the treatment of asthma. While some LAMAs are used off-label or have specific indications for asthma, umeclidinium's clinical trials primarily focused on the COPD population. Healthcare providers may occasionally use it off-label in refractory asthma cases, but this is not a standard FDA-approved use.
Umeclidinium is available almost exclusively as a dry powder for inhalation (DPI). The most common delivery system is the Ellipta inhaler, which provides a pre-metered dose.
> Important: Only your healthcare provider can determine if Umeclidinium is right for your specific condition. It is vital to distinguish between maintenance therapy and rescue therapy to ensure safety during respiratory distress.
For the maintenance treatment of Chronic Obstructive Pulmonary Disease (COPD), the standard adult dosage is as follows:
Umeclidinium is not approved for use in pediatric patients. The safety and effectiveness of this medication in individuals under the age of 18 have not been established. COPD is a disease that primarily affects adults, usually those with a history of smoking or significant environmental exposure to pollutants.
No dosage adjustment is required for patients with renal impairment. Clinical studies have shown that systemic exposure is not significantly altered in patients with severe renal dysfunction (creatinine clearance <30 mL/min).
No dosage adjustment is required for patients with mild to moderate hepatic impairment. Umeclidinium has not been extensively studied in patients with severe hepatic impairment (Child-Pugh Class C), so healthcare providers typically exercise caution in this population.
No dosage adjustment is required based on age. Pharmacokinetic studies have shown that the drug's behavior in patients over 65 is similar to that in younger adults. However, elderly patients may be more sensitive to anticholinergic side effects such as urinary retention or constipation.
Umeclidinium is administered using the Ellipta inhaler. Proper technique is critical for ensuring the medication reaches the small airways of the lungs:
If you miss a dose of umeclidinium, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular schedule. Never take two doses at once to make up for a missed one. This can lead to an increased risk of heart palpitations or blurred vision.
An overdose of umeclidinium is likely to manifest as exaggerated anticholinergic effects. Signs may include:
In the event of a suspected overdose, contact your local poison control center or seek emergency medical attention immediately. While umeclidinium has low systemic absorption, a significant overdose can still impact the cardiovascular and central nervous systems.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or frequency without first consulting a medical professional.
Common side effects are generally mild and often diminish as the body adjusts to the medication. According to clinical trial data, the most frequently reported adverse reactions include:
While rare, some side effects require urgent intervention. Stop taking umeclidinium and call your doctor immediately if you experience:
> Warning: Stop taking Umeclidinium and call your doctor immediately if you experience any of these serious symptoms. Do not wait for the next scheduled dose.
Long-term use of umeclidinium is generally well-tolerated. However, chronic blockade of muscarinic receptors can lead to persistent dry mouth (xerostomia), which may increase the risk of dental cavities and oral thrush. Patients on long-term therapy should maintain excellent oral hygiene and regular dental checkups. There is no evidence currently suggesting that umeclidinium causes bone density loss or significant metabolic changes over several years of use.
No FDA black box warnings currently exist for umeclidinium bromide as a monotherapy. However, it is important to note that many combination products containing umeclidinium (such as those with LABAs) previously carried warnings regarding asthma-related death; however, these were largely removed or modified by the FDA in 2017 based on large-scale safety trials. Always check the specific packaging for combination products.
Report any unusual symptoms or persistent side effects to your healthcare provider to ensure your treatment plan remains safe and effective.
Umeclidinium is intended for the maintenance treatment of COPD only. It is not a rescue inhaler. Patients must have a separate fast-acting bronchodilator (such as albuterol) available at all times to treat acute symptoms or 'attacks.' Using umeclidinium to treat an acute asthma attack or a sudden COPD flare-up can be fatal as the drug does not work quickly enough to open airways in an emergency.
There are currently no FDA black box warnings for Umeclidinium bromide monotherapy. It is considered safe for its intended use when prescribed by a healthcare professional and used according to the provided instructions.
As with other inhaled medicines, umeclidinium can produce paradoxical bronchospasm, which may be life-threatening. If this occurs, the medication should be discontinued immediately, and alternative therapy should be instituted by a physician.
Umeclidinium should be used with extreme caution in patients with narrow-angle glaucoma. Because it is an anticholinergic, it can cause pupillary dilation and increase intraocular pressure. Patients should be instructed to contact their doctor immediately if they experience eye pain, blurred vision, or visual halos.
Caution is advised for patients with urinary retention or prostatic hyperplasia (enlarged prostate). Anticholinergic drugs can decrease the contraction of the bladder's detrusor muscle, making it difficult to initiate or complete urination. This can lead to acute urinary retention, which is a medical emergency.
The Ellipta inhaler contains lactose monohydrate, which may contain trace amounts of milk proteins. Patients with severe hypersensitivity or anaphylactic-level allergies to milk proteins should not use umeclidinium, as it could trigger a severe allergic reaction.
While there are no specific 'black-and-white' lab tests required for umeclidinium (unlike drugs like warfarin or lithium), healthcare providers typically monitor the following:
Umeclidinium is generally not expected to affect the ability to drive or operate machinery. However, if a patient experiences blurred vision or dizziness as a side effect, they should avoid these activities until the symptoms resolve.
There is no direct contraindication between alcohol and umeclidinium. However, alcohol can sometimes worsen the dry mouth associated with anticholinergic use. Additionally, excessive alcohol consumption can impair respiratory drive, which is counterproductive in patients with advanced COPD.
Do not stop taking umeclidinium suddenly without consulting your doctor. While it does not cause a 'withdrawal syndrome' in the traditional sense, stopping the medication will likely result in a return of COPD symptoms, such as increased wheezing and shortness of breath. If you need to stop the medication, your doctor will provide a plan to transition you to a different therapy.
> Important: Discuss all your medical conditions, especially eye or bladder problems, with your healthcare provider before starting Umeclidinium.
Other Anticholinergics: Umeclidinium should not be used in combination with other long-acting muscarinic antagonists (e.g., tiotropium, aclidinium, glycopyrrolate) or short-acting anticholinergics (e.g., ipratropium).
CYP2D6 Inhibitors: Drugs that strongly inhibit the CYP2D6 enzyme (such as paroxetine, fluoxetine, or quinidine) can theoretically increase the systemic exposure of umeclidinium.
Potassium Chloride: Anticholinergics can slow down the movement of the gastrointestinal tract.
There are no known significant food interactions with inhaled umeclidinium. Unlike some oral medications, its absorption from the lungs into the bloodstream is not affected by the presence of food in the stomach. However, staying hydrated is recommended to combat the common side effect of dry mouth.
Umeclidinium is not known to interfere with standard blood or urine laboratory tests. It does not typically cause false positives on drug screenings. However, it may affect the results of certain specialized tests for glaucoma (like tonometry) if the drug has caused pupillary dilation.
Summary of Management Strategy:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, as the 'total anticholinergic load' on your body is a critical safety consideration.
There are specific circumstances where Umeclidinium must never be used because the risks far outweigh any potential benefits:
These are conditions where the drug may be used, but only with extreme caution and frequent monitoring by a healthcare provider:
Patients who have had allergic reactions to other anticholinergic medications (such as tiotropium/Spiriva or ipratropium/Atrovent) should be cautious. While the chemical structures differ, there is a theoretical risk of cross-sensitivity. Always inform your doctor if you have ever had a bad reaction to any 'dry powder' inhaler in the past.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of allergies to dairy or previous eye surgeries, before prescribing Umeclidinium.
Umeclidinium is classified as Pregnancy Category C under the old FDA system (now replaced by the Pregnancy and Lactation Labeling Rule). There are no adequate and well-controlled studies of umeclidinium in pregnant women. Animal studies (rats and rabbits) did not show evidence of teratogenicity (birth defects) at doses significantly higher than the human inhalation dose. However, because animal studies are not always predictive of human response, umeclidinium should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Healthcare providers typically prioritize maintaining stable respiratory function in the mother, as poorly controlled COPD can lead to fetal hypoxia (low oxygen).
It is not known whether umeclidinium is excreted in human milk. However, many drugs are excreted in breast milk, and the effects on the nursing infant are unknown. Because umeclidinium has low systemic bioavailability, the amount reaching the milk is likely very small. Nevertheless, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Umeclidinium is not indicated for use in children. COPD is a disease of adults. The safety and efficacy of umeclidinium for the treatment of asthma in children have not been established, and it is not approved for any pediatric condition.
Based on available data, no overall differences in safety or effectiveness have been observed between patients aged 65 and older and younger adult patients. However, the elderly are generally more susceptible to anticholinergic side effects.
No dose adjustment is required for patients with renal impairment. The drug is primarily cleared via the liver/feces, and clinical trials included patients with varying degrees of renal function without showing a need for modified dosing.
For patients with mild to moderate hepatic impairment, no dose adjustment is necessary. The drug has not been formally studied in patients with severe hepatic impairment (Child-Pugh Class C). In these cases, the healthcare provider will monitor liver enzymes and clinical response closely.
> Important: Special populations, particularly pregnant women and the elderly, require individualized medical assessment to ensure the safest possible treatment outcomes.
Umeclidinium is a long-acting muscarinic antagonist (LAMA). It exerts its pharmacological effect by binding to muscarinic receptors in the bronchial smooth muscle. Specifically, it targets the M3 receptor subtype, which is responsible for mediating bronchoconstriction. By acting as a competitive antagonist, umeclidinium prevents the neurotransmitter acetylcholine from activating these receptors. This leads to a reduction in intracellular calcium and subsequent relaxation of the smooth muscle, resulting in bronchodilation. Its long duration of action is attributed to its slow dissociation kinetics from the M3 receptor compared to the M2 receptor.
The primary pharmacodynamic effect of umeclidinium is the improvement of lung function, measured by the increase in FEV1. The onset of action occurs within 5 to 15 minutes, but the full clinical benefit may not be realized until after several days of consistent dosing. The effect is sustained over a 24-hour period, supporting a once-daily dosing regimen. At doses up to 500 mcg (8 times the recommended dose), no significant effect on the QT interval (a measure of heart rhythm) was observed in healthy volunteers.
| Parameter | Value |
|---|---|
| Bioavailability | ~13% (Inhaled) |
| Protein Binding | ~89% |
| Half-life | ~11 hours |
| Tmax | 5 to 15 minutes |
| Metabolism | Primarily CYP2D6 |
| Excretion | Fecal (92%), Renal (22%) |
Umeclidinium belongs to the therapeutic class of bronchodilators and the pharmacologic class of anticholinergics (specifically LAMAs). It is chemically and functionally related to other medications such as tiotropium bromide and aclidinium bromide. Unlike short-acting muscarinic antagonists (SAMAs) like ipratropium, which require dosing 4 times daily, umeclidinium provides 24-hour coverage.
Medications containing this ingredient
Common questions about Umeclidinium
Umeclidinium is primarily used for the long-term, once-daily maintenance treatment of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD). This includes chronic conditions like emphysema and chronic bronchitis where the airways become narrowed over time. It works by relaxing the muscles around the airways to make breathing easier and reduce daily symptoms like wheezing. It is important to remember that it is a maintenance medication and not a rescue treatment for sudden breathing problems. Your doctor may prescribe it alone or in combination with other respiratory medications to help prevent COPD flare-ups.
The most common side effects reported by patients taking Umeclidinium include nasopharyngitis (sore throat and runny nose), upper respiratory tract infections, and a persistent cough. Some patients also experience joint pain (arthralgia) or a mild change in their sense of taste. Because it is an anticholinergic drug, it can occasionally cause a dry mouth or mild constipation. Most of these side effects are manageable and may improve as your body becomes accustomed to the daily medication. However, if any side effect becomes severe or persistent, you should contact your healthcare provider for advice.
There is no direct chemical interaction between alcohol and Umeclidinium that would make it strictly forbidden to drink. However, both alcohol and Umeclidinium can cause or worsen dry mouth, which may lead to discomfort or dental issues over time. Furthermore, alcohol can sometimes interfere with the quality of sleep and respiratory efficiency, which is a concern for patients with advanced COPD. It is generally best to consume alcohol only in moderation and to stay well-hydrated. Always discuss your alcohol consumption habits with your doctor to ensure they do not interfere with your overall COPD management plan.
The safety of Umeclidinium during pregnancy has not been established through comprehensive human clinical trials. Animal studies have shown that very high doses do not appear to cause birth defects, but these results do not always translate perfectly to humans. Doctors usually only prescribe Umeclidinium to pregnant women if the benefit of keeping the mother's lungs functioning outweighs the potential risks to the developing baby. If you are pregnant or planning to become pregnant, you must discuss your respiratory treatment with your obstetrician and pulmonologist. They will help you weigh the risks and benefits of continuing this medication during your pregnancy.
Umeclidinium begins to work relatively quickly, with some bronchodilation occurring within 5 to 15 minutes after the first inhalation. However, because it is a maintenance medication designed for long-term control, it may take several days of consistent, once-daily use to reach its full therapeutic effect. You should not expect immediate, dramatic relief from a single dose if you are having a severe flare-up. Instead, you will likely notice a gradual improvement in your ability to breathe and a decrease in daily symptoms over the first week of treatment. Consistency is key to ensuring the medication provides 24-hour protection.
You should not stop taking Umeclidinium suddenly without first consulting your healthcare provider. While the drug does not cause physical addiction or a traditional withdrawal syndrome, your COPD symptoms are likely to return or worsen once the medication leaves your system. This could lead to increased shortness of breath, more frequent coughing, and a higher risk of a COPD exacerbation (attack). If you are concerned about side effects or feel the medicine isn't working, your doctor can help you safely transition to a different treatment. Always follow a medically supervised plan when changing your respiratory medications.
If you miss a dose of Umeclidinium, you should take it as soon as you realize you've forgotten it. However, if it is almost time for your next scheduled dose, you should skip the missed dose and simply take the next one at your regular time. You should never take two doses at once or more than one dose in a 24-hour period, as this increases the risk of side effects like a rapid heart rate or blurred vision. To help you remember, try taking your inhaler at the same time every day, such as right after you brush your teeth in the morning.
Weight gain is not a recognized or common side effect of Umeclidinium bromide. Clinical trials have not shown a significant link between this medication and changes in body weight. If you experience rapid or unexplained weight gain while taking this medication, it may be due to other factors, such as other medications (like oral steroids) or a change in your activity level due to COPD symptoms. Sometimes, fluid retention can cause weight gain in patients with heart or lung issues, so it is important to report any sudden changes in weight to your doctor for a proper evaluation.
Umeclidinium can be taken with many other medications, but it should never be combined with other anticholinergic drugs like tiotropium or ipratropium. Combining these can lead to an 'anticholinergic overdose,' causing severe dry mouth, blurred vision, and inability to urinate. It is often safely used alongside other types of inhalers, such as inhaled corticosteroids or long-acting beta-agonists. However, you must provide your doctor with a full list of all your medications, including over-the-counter supplements and cold medicines. This allows your healthcare provider to check for potential interactions and ensure your 'total anticholinergic load' remains safe.
As of 2024 and 2025, Umeclidinium is primarily available under the brand name Incruse Ellipta, and generic versions are not yet widely available in many markets due to patent protections. The Ellipta delivery device itself is also protected by patents, which can delay the entry of generic competitors. However, the availability of generics can change as patents expire and new manufacturers receive regulatory approval. You should check with your pharmacist or insurance provider for the most current information on generic availability and cost-effective alternatives. In some cases, your insurance may prefer one brand of LAMA over another based on their formulary.