Mometasone with glycopyrronium and indacaterol

How it works

Mometasone suppresses airway inflammation, indacaterol relaxes bronchial smooth muscle via beta-2 receptors and glycopyrronium produces additional bronchodilation by blocking muscarinic receptors.

Prescribing in practice

• This is a maintenance preventer only and must not be used to relieve acute bronchospasm; patients still need a separate reliever inhaler.
• Counsel on rinsing the mouth after use to reduce oral candidiasis and hoarseness from the corticosteroid component, and review inhaler technique.
• Use the antimuscarinic component with care in significant cardiovascular disease, narrow-angle glaucoma or urinary retention.

Monitoring

Monitor asthma control, inhaler technique, and for oral candidiasis and antimuscarinic effects such as dry mouth or urinary symptoms.

Counselling the patient

• This inhaler prevents attacks and is not for sudden breathlessness; keep your reliever to hand.
• Rinse your mouth and spit out after each dose.
• Use it once daily at the same time each day, even when you feel well.

Evidence & guidelines

Trials and the SPC support once-daily inhaled triple therapy for asthma uncontrolled on an inhaled corticosteroid and long-acting beta-2 agonist.