Aclidinium Bromide (Eklira Genuair)

How it works

It competitively and reversibly blocks acetylcholine at muscarinic receptors on airway smooth muscle, producing sustained bronchodilation.

Prescribing in practice

• It is for regular maintenance and not for relief of acute bronchospasm, which still requires a short-acting reliever.
• Use with caution in symptomatic prostatic hyperplasia, bladder-outflow obstruction or narrow-angle glaucoma owing to antimuscarinic effects.
• It is delivered by a dry-powder inhaler (Genuair), so correct device technique should be confirmed.

Monitoring

Monitor symptom control and inhaler technique at review, and check for antimuscarinic adverse effects such as dry mouth or urinary retention.

Counselling the patient

• Use the inhaler regularly as prescribed, not for sudden breathlessness.
• Report eye pain, blurred vision, or difficulty passing urine.
• Rinse the mouth if dryness occurs and demonstrate your inhaler technique at reviews.

Evidence & guidelines

NICE guidance positions LAMAs such as aclidinium within COPD maintenance bronchodilator pathways.