Consider combination umeclidinium with vilanterol (Anoro Ellipta®) as first choice in patients with moderate to very severe COPD who are breathless but not prone to exacerbations or not suitable/unwilling to take inhaled corticosteroid. The Spiolto Respimat® and the Duaklir Genuair® offer alternative devices.
PREFERRED: Dry Powder Inhaler (DPI) (Inhalation powder)These are more environmentally friendly than MDIs and should be considered first line providing that the patient shows good inhaler technique with the chosen device.
COPD: by inhalation of powder, 1 puff once daily.
PREFERRED: Soft Mist Inhaler (SMI)These are more environmentally friendly than MDIs and should be considered first line providing that the patient shows good inhaler technique with the chosen device.
COPD: by aerosol inhalation, 2 puffs once daily.
PREFERRED: Dry Powder Inhaler (DPI) (Inhalation powder)These are more environmentally friendly than MDIs and should be considered first line providing that the patient shows good inhaler technique with the chosen device.
COPD: by inhalation of powder, 1 puff twice daily.
ALTERNATIVE: less environmentally friendly
Metered dose inhalers (MDI) (Pressurised inhalation). To be considered in those patients who are unable to use a DPI or SM.
Can be used via a spacer device.
COPD: As per SMC 2652: as a maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD).
Guideline: COPD (Chronic Obstructive Pulmonary Disease) (Guidelines)
TAM (Treatments and Medicines) NHS Highland