Breztri Side Effects: What To Know About Heart Palpitations and Pneumonia Risk With the COPD Inhaler
Plus find out why you should let your doctor know if you have glaucoma before starting this Rx
Key Takeaways
- Breztri combines three medications in one inhaler to treat COPD symptoms.
- The inhaler is effective, but can lead to rare side effects like increased risk of pneumonia.
- Breztri and Trelegy work similarly, but Breztri's twice-daily dose may help nighttime symptoms.
If you have chronic obstructive pulmonary disease (COPD)—an umbrella term for several lung diseases, including emphysema, chronic bronchitis and some forms of asthmatic bronchitis—you know what a game-changer an effective inhaler can be. One option gaining attention is Breztri, a “triple therapy” inhaler that combines three medications in one device. We asked a top pulmonologist to explain how effective it is and put Breztri’s potential side effects into perspective.
What is the Breztri inhaler?
The Breztri Aerosphere inhaler is a triple therapy medication, meaning it has three active ingredients, and is often recommended for patients with COPD who don’t respond to double therapy, explains E. Neil Schachter, MD, professor of pulmonary medicine at the Icahn School of Medicine at Mount Sinai.
Those three ingredients include an inhaled corticosteroid (budesonide), an anticholinergic medicine (glycopyrrolate) and a long-acting beta-2 adrenergic agonist (formoterol fumarate).
Woman's World Answers
How helpful is Breztri? “We’ve found that these triple therapy regimens are very effective,” he observes. “There are two major triple therapy inhalers out there: Breztri and Trelegy.” The ultimate endorsement comes from his patients: “They often say to me, ‘I breathe much better since I’ve been using these inhalers.’”
How Breztri is used to treat COPD
To understand how Breztri fits into COPD treatment, Dr. Schachter explains that there are two main medication categories. Controler medications, like Breztri (taken twice daily) and Trelegy (taken once daily), are used to stabilize the disease and reduce the number of COPD exacerbations or flare-ups. Their effects generally last for 24 hours when taken as directed.
“Rescue medications, on the other hand, are short-acting bronchodilators that work within about 10 minutes, and whose effects are usually gone after about four hours,” he says. “They can be used up to four times a day to relieve sudden symptoms or prevent airway tightening when you know you’ll be in a triggering situation.”
Now let’s look at how Breztri works and a few potential side effects.
Breztri side effects you need to know
While Breztri is effective, it can cause some side effects, though they’re relatively rare. “You’re dealing with three separate drugs in Breztri (and Trelegy), and each one can affect people differently,” notes Dr. Schachter. Here’s what to know about each of the three components:
The ingredient: Long-acting beta agonist
The side effect: Heart palpitations, nervousness
This component stimulates the nervous system to relax the airway muscles. But some people experience a rapid heart rate, irregular heartbeat or palpitations (sometimes even chest pain) when treated with a beta agonist. “Beta agonists can also make you feel jittery or upset your sleep,” Dr. Schachter says, emphasizing that this is in general a relatively infrequent reaction with the longer acting beta agonists.
“Patients taking beta blocking medications for heart disease should consult their cardiologists.”
The ingredient: Anticholinergic
The side effect: Increased eye pressure and difficulty urinating (in men with prostate
enlargement)
The anticholinergic in Breztri helps stabilize the airway, but can also increase eye pressure, Dr. Schachter explains. “So if you have glaucoma, it’s important to discuss this medicine with your ophthalmologist.”
“In rare cases, these drugs can also worsen symptoms in men with an enlarged prostate, making it more difficult to urinate,” he adds.
The ingredient: Corticosteroid
The side effect: Slightly increased pneumonia risk
When you’re inhaling steroids, you increase the chances of getting an infection, Dr. Schachter points out. In general these are local infections of the upper airway, such as oral thrush that can be avoided by gargling and rinsing after use. Less common are infections of the lower airway, that can increase the chance of developing pneumonia.
Breztri vs. Trelegy: Which is right for you?
How does Breztri compare to Trelegy, the other major triple-therapy inhaler? They use the same three ingredients but different compounds, which essentially work in the same way, Dr. Schachter explains. “A key difference is dosing: Breztri is used twice daily versus Trelegy once daily. For people with more nighttime symptoms, the twice-daily option may work better because they can take that second dose closer to bedtime.”
“On the other hand, some patients prefer the once-a-day dosing and the Trelegy device which requires less coordination. Finally, one is a liquid aerosol (Breztri) and the other a powder (Trelegy), which is a factor which some patients consider important.”
The bottom line on Breztri side effects
Both Breztri and Trelegy represent great advancements in the treatment of COPD. While side effects are rare, talk to your doctor to determine which option is best for you, especially if you have conditions like glaucoma or heart disease that may be affected by the medication.
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