Incruse Ellipta (umeclidinium) is a maintenance inhaler designed to help patients with chronic obstructive pulmonary disease (COPD) breathe better and reduce dependency on rescue inhalers. The medication provides a long-acting muscarinic antagonist which relaxes and opens the air passages in the lungs.

Note that Incruse Ellipta is not a rescue inhaler; it should not be used to alleviate sudden, urgent symptoms of impaired breathing; it will provide little benefit. Patients should keep a rescue inhaler on-hand for use as needed.

Also note that this product should not be used to treat asthma. A similar product, Arnuity Ellipta, which contains fluticasone furoate, is a maintenance inhaler marketed towards asthmatics. It contains a different active ingredient than Incruse Ellipta, which utilizes umeclidinium.

Effects of Incruse Ellipta on patients under age 18 are unclear; the medication should not be used in those patients.

Taking Incruse Ellipta

Incruse Ellipta should be taken once per day. It should not be used more or less often; again it is not a rescue inhaler and increasing use during COPD exacerbations will not provide benefit. Likewise if COPD is very mild Incruse Ellipta should still be taken; if the medication is working as it should then exacerbations will be less frequent and should be less severe when they do happen.

Effects from Incruse Ellipta can be difficult to detect; there is no immediate effect as from a rescue inhaler, and it may take some days of consistent use before effects are significant at all. Patients are encouraged to use the inhaler for several months before deciding it doesn't work.

In most cases treatment is long term; the medication is taken for years.

A small percentage of patients will experience little benefit from Incruse Ellipta, with no improved benefits and no reduction of reliance on rescue inhalers. If there is no noticeable improvement of COPD after several months of use, there's no reason to keep using the product.

Using the Inhaler

Each Incruse Ellipta inhaler contains 30 metered doses. The number of doses left is indicated on the inhaler, with some number between 30 and 0. A new inhaler should start with 30, and when it is empty it will say 0.

Prior to using the inhaler the lid at top must be opened; simply slide it down and to the side until the inhaler clicks and the dosage counter changes. A dose is now ready to inhale. Note that if the inhaler is closed at this point the dose will be lost entirely; it cannot be inhaled as a double-dose if the inhaler is opened again, nor can it be retrieved for use any other way.

Once the inhaler is opened and the click is heard, hold the inhaler upright or some of the powdered medication may be lost.

Now that the inhaler is ready to use, exhale fully. Move the mouthpiece of the inhaler---that was uncovered with the lid---to your mouth and breath in slowly and deeply, holding your breath for as long as comfortable after finished inhaling. Some users may taste or feel the powdered medication, others do not; either way, do not take an additional dose. Take care to avoid blocking the air vents while inhaling.

Resume breathing normally after taking the dose. Close the inhaler when finished. It can be dusted off with a dry cloth or tissue if powder builds up on the inhaler, but do not get it wet. These inhalers do not require regular cleaning.

Rinsing the mouth out after using Incruse Ellipta, or any inhaled powder, can prevent infection and other issues involving the mouth and throat.

Potential Side Effects

There are no true contraindications to Incruse Ellipta other than hypersensitivity to any of the ingredients in it. However, some patients are at increased risk of serious side effects, and a doctor may decide it is not the ideal choice. Be sure the prescribing doctor is aware if there is any history of:

• Heart problems
• Prostate or bladder problems
• Difficulty urinating
• Glaucoma

Not everyone will experience side effects from this product, but some do even when taken with meticulous attention to use instructions. Relatively common side effects include:

• Pain in mouth or throat
• Tooth pain
• Muscle pain
• Joint pain
• Stomach discomfort
• Runny or stuffy nose
• Taste changes

More rare, but also more serious, side effects warrant medical attention:

• Upper respiratory tract infection
• Rapid or irregular heartbeat
• Unexplained or easy bruising
• Difficulty urinating
• Frequent urination
• Painful urination
• Blurred vision
• Eye pain
• Other vision changes

The above, particularly if caught early, can almost certainly be reversed if treatment ends.

Other medications can interact with Incruse Ellipta; be sure the prescribing doctor is aware of all other medications being taken, and double-check with a doctor before adding new medications. Anticholinergics are of particular concern with Incruse Ellipta.