ICS + LABA + LAMA triple inhaler
Beclometasone with formoterol and glycopyrronium
Brand names: Trimbow
Adult dose
Dose: 2 inhalations BD
Route: Inhaled (pMDI)
Frequency: BD
Clinical pearls
- NICE NG115 COPD: triple therapy for symptomatic COPD with exacerbations on ICS/LABA or LABA/LAMA
- NICE NG80 asthma: triple therapy step-up
- MHRA: brand-prescribing for inhalers
Contraindications
- Hypersensitivity
- Untreated angle-closure glaucoma
- Severe urinary retention
Side effects
- Pneumonia (COPD)
- Oral candidiasis
- Tremor
- Tachycardia
- Hypokalaemia
- Antimuscarinic effects
Interactions
- Beta-blockers
- QT-prolonging
- Antimuscarinics
- CYP3A4 inhibitors
Monitoring
- Symptom control
- PEFR
- Inhaler technique
- Pneumonia signs
Reference: BNF; NICE NG115; NICE NG80; GOLD; https://bnf.nice.org.uk/drugs/beclometasone-with-formoterol-and-glycopyrronium/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024