LAMA Pregnancy: Limited data in pregnant women; animal studies show no direct/indirect reproductive toxicity. Use during pregnancy only if the expected benefit to the mother justifies the potential risk to the foetus.

Umeclidinium

Brand names: Incruse Ellipta

Umeclidinium is a long-acting muscarinic antagonist (LAMA) bronchodilator used as maintenance treatment of chronic obstructive pulmonary disease (COPD).

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 55 micrograms (one inhalation)

Route: Inhalation (oral inhalation powder, Ellipta inhaler)

Frequency: Once daily, at the same time each day

Max: One inhalation (55 micrograms) once daily

Incruse Ellipta, maintenance treatment of COPD. Not for relief of acute symptoms/rescue therapy. If a dose is missed, inhale the next dose at the usual time the next day; do not double dose. No relevant use in the paediatric population (under 18 years) for COPD.

Dose adjustments

Renal

No dose adjustment required in patients with renal impairment.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients

Side effects

Nasopharyngitis (6%)
Upper respiratory tract infection (5%)
Urinary tract infection, sinusitis (common)
Headache, cough, oropharyngeal pain (common)
Tachycardia, constipation (common)

Interactions

Other long-acting muscarinic antagonists (or products containing umeclidinium): co-administration not recommended (may potentiate antimuscarinic adverse reactions)
CYP2D6: umeclidinium is a CYP2D6 substrate, but no clinically relevant interaction expected with CYP2D6 inhibitors

Clinical monograph

How it works

It blocks muscarinic M3 receptors on airway smooth muscle, inhibiting acetylcholine-mediated bronchoconstriction to produce sustained bronchodilation.

Prescribing in practice

It is a maintenance bronchodilator only and is not suitable for the relief of acute bronchospasm; patients must retain a short-acting reliever inhaler.
Use with caution in patients with narrow-angle glaucoma or significant urinary retention or bladder outflow obstruction owing to its antimuscarinic effects.
It is available as a dry powder inhaler and as a fixed-dose combination with a long-acting beta-2 agonist; avoid duplicating LAMA therapy.

Monitoring

Monitor symptom control, exacerbation frequency and inhaler technique, and watch for antimuscarinic effects such as dry mouth, worsening glaucoma or urinary retention.

Counselling the patient

This inhaler is for regular daily use to prevent symptoms, not for sudden breathlessness; keep your reliever inhaler with you.
Report blurred vision, eye pain, or difficulty passing urine.
Rinse your mouth and check your inhaler technique to get the full benefit.

Evidence & guidelines

NICE guidance on COPD supports long-acting bronchodilators including LAMAs for maintenance treatment to reduce symptoms and exacerbations.

Reference: NICE NG115; GOLD; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways