mometasone/glycopyrrolate (glycopyrronium)/ indacaterol

Action and Spectrum

Actions and Spectrum 

mometasone acts as an anti-inflammatory agent, primarily used to reduce inflammation in the airways. It helps control and prevent symptoms in conditions such as asthma and chronic obstructive pulmonary disease (COPD) by decreasing swelling and mucus production in the air passages.  

glycopyrrolate functions as a bronchodilator, which means it relaxes and widens the airways in the lungs. By blocking the action of acetylcholine, a neurotransmitter that causes smooth muscle contraction in the airways. 

indacaterol acts as a bronchodilator by stimulating beta2-adrenergic receptors in the airways. This stimulation relaxes the smooth muscles in the bronchioles, leading to bronchodilation and improved airflow.  

Drug Interaction

Adverse Reaction

Frequency defined  

<1% 

Xerostomia 

Hyperglycemia 

Dysuria 

Pruritus 

Candidiasis 

Skin rash 

1-10% 

Musculoskeletal pain 

Cough  

Urinary tract infection  

Tachycardia 

Gastroenteritis  

Headache 

Hypersensitivity reaction  

Muscle spasm   

Oropharyngeal pain  

Fever

Black Box Warning

Black Box Warning 

None

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity or allergy to mometasone/ glycopyrrolate/indacaterol drugs or any of its components.  

Caution: 

• Prolonged use of mometasone may increase the risk of Glaucoma and cataracts so caution should be taken.  
• Caution should be taken in patients with conditions like ulcerative colitis while using glycopyrrolate drug. 
• Caution in patients with heart conditions or arrhythmias when using indacaterol drug.  

Pregnancy / Lactation

Pregnancy consideration: 

Pregnancy category: N/A 

Lactation: Excretion into human milk is unknown  

Pregnancy Categories:         

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.  

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women. 

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 

Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology  

mometasone acts locally in the airways. It binds to glucocorticoid receptors, leading to the activation or repression of various genes involved in the inflammatory response. 

glycopyrrolate works by blocking the action of acetylcholine at muscarinic receptors on the smooth muscles of the airways.  

indacaterol binds to and stimulates beta2-adrenergic receptors. This receptor leads to relaxation of the bronchial smooth muscles, resulting in bronchodilation. In 

Pharmacodynamics 

mometasone inhibits the production of inflammatory cytokines and chemokines, suppresses the migration and activation of inflammatory cells, and reduces the synthesis of inflammatory mediators. 

glycopyrrolate inhibits the actions of acetylcholine and it promotes bronchoconstriction and mucus secretion.  

indacaterol stimulates the receptors, leading to the activation of adenylate cyclase and increased intracellular levels of cyclic adenosine monophosphate (cAMP).  

Pharmacokinetics 

Absorption   

mometasone/glycopyrrolate/indacaterol all are administered via inhalation which ensures local delivery to the lungs. 

Distribution 

mometasone/glycopyrrolate/indacaterol are distributed through the bloodstream to various tissues.  

Metabolism 

mometasone undergoes extensive hepatic metabolism while glycopyrrolate/indacaterol undergoes limited metabolism in the liver.  

Elimination and excretion 

mometasone/glycopyrrolate/indacaterol all are excreted mainly through the renal route in urine and feces. 

Adminstartion

Administration 

mometasone is available in various formulations, including inhalers and nasal sprays. While glycopyrrolate/indacaterol are administered via inhalation and they are usually available as a dry powder inhaler (DPI) or a solution for nebulization. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: mometasone/glycopyrrolate (glycopyrronium)/indacaterol  

Why do we use mometasone/glycopyrrolate (glycopyrronium)/indacaterol? 

mometasone/glycopyrrolate/indacaterol each of these drugs specifically uses for the management of various respiratory conditions.  

mometasone/glycopyrrolate/indacaterol inhalers are used for maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD).