Aclidinium belongs to the class of medications called long-acting bronchodilators. It is used as long-term maintenance to keep the airways open for people with chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.

Aclidinium works by relaxing the muscles that surround the airways. This opens the air passages and makes breathing easier.

Aclidinium should not be used as a rescue medication to relieve sudden attacks of COPD symptoms such as wheezing or shortness of breath. Consult your doctor or pharmacist for advice about rescue medications that are appropriate for you.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended dose of aclidinium is one dose inhaled 2 times daily.

Have your doctor or pharmacist explain how to use the inhaler and read the instructions carefully before using the inhaler. If you have any questions about how to use the inhaler, check with your health care professional.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. To receive the most benefit from this medication, it must be used regularly. Do NOT use this medication to treat episodes of shortness of breath.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, in the sealed pouch, until it is needed. Once opened, protect it from light and moisture. Keep it out of the sight and reach of children. Discard any remaining medication 90 days after opening the pouch.

Each inhalation dose contains 400 µg aclidinium bromide which corresponds to a delivered dose (the dose leaving the mouthpiece) of 375 µg aclidinium bromide equivalent to 322 µg aclidinium. Nonmedicinal ingredients: lactose monohydrate.

Do not use this medication if you are allergic to aclidinium or any ingredients of the medication.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• cough
• diarrhea
• dizziness
• dry mouth
• headache
• hoarseness
• irritated nose or throat
• itchy skin
• mouth or tooth infection
• nausea
• rash
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision
• falls
• fast heartbeat
• pain or stiffness in joints
• signs of heart problems (e.g., fast, irregular heartbeat or pulse, chest pain, sudden weight gain, difficulty breathing)
• sinus inflammation
• symptoms of glaucoma (e.g., blurred vision, seeing halos of bright colours around lights, red eyes, increased pressure in your eyes, eye pain or discomfort)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• thrush (fungal infection in the mouth; white patchy spots in the mouth and throat)
• urinary tract problems (e.g., difficulty starting to pass urine, pain when urinating, frequent need to urinate)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• sudden difficulty breathing with cough or wheezing immediately after using aclidinium
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy: In rare cases, immediate allergic reactions may occur after using aclidinium, causing hives, swelling around the throat and tongue, rash, and worsening of breathing problems. If this occurs, seek emergency medical help at once.

Glaucoma: Aclidinium may cause symptoms of glaucoma (increased pressure in the eyes), such as blurred vision or eye pain or pressure to become worse. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart conditions: The safety and effectiveness of this medication have not been determined for people with heart conditions. If you have a history of heart attack, angina or irregular heartbeat, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Reduced response: When symptoms of COPD are not controlled by regular use of the treatment recommended by your doctor, it may be a sign that your COPD is worsening. If you are using your short-acting bronchodilator more than usual or you find that it is not working for as long as it used to, contact your doctor. Do not use aclidinium more than twice per day.

Smoking: If you smoke, discuss with your doctor or pharmacist the benefits of stopping smoking. Smoking contributes to the symptoms of COPD. People who stop smoking often see a significant improvement in their breathing symptoms.

Urinary tract problems: This medication can cause the symptoms of some urinary tract problems to become worse. If you have an enlarged prostate or other condition that causes urination to be difficult, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if aclidinium passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under the age of 18 years.

There may be an interaction between aclidinium and any of the following:

• amantadine
• amoxapine
• antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• atropine
• azelastine
• belladonna
• benztropine
• botulinum toxin
• cannabis
• cyclobenzaprine
• darifenacin
• dimenhydrinate
• disopyramide
• domperidone
• donepezil
• fesoterodine
• flavoxate
• galantamine
• glucagon
• glycopyrrolate
• ipratropium
• metoclopramide
• mirabegron
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
• orphenadrine
• oxybutynin
• potassium chloride
• pramlintide
• quinidine
• rivastigmine
• scopolamine
• secretin
• solifenacin
• thiazide diuretics (water pills; e.g., hydrochlorothiazide, indapamide)
• tiotropium
• tolterodine
• topiramate
• tramadol
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• trospium
• umeclidinium

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.