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Why is Breztri not for asthma?

Medically reviewed by Carmen Pope, BPharm. Last updated on Jan 15, 2025.

Official Answer by Drugs.com

Breztri is not used for asthma because it was made specifically to help people with COPD, which is a different lung condition. When scientists tested Breztri, they only looked at how well it worked for COPD, not asthma. Even though asthma and COPD both affect breathing, they need different kinds of treatments. The mix of medicines in Breztri has been shown to work for COPD, but it might not be the best choice for controlling asthma symptoms. That's why doctors don't prescribe Breztri for asthma - they have other medicines that work better for people with asthma.

Research has shown that one of the ingredients in Breztri, glycopyrrolate, is more useful for COPD than asthma because its mechanism of action involves blocking the effects of acetylcholine. While acetylcholine contributes to asthma symptoms, it's not considered a primary cause of the disease. In COPD, cholinergic mechanisms play a more dominant role in airway obstruction, which is why anticholinergics are more commonly used as primary treatments.

Asthma treatment guidelines, such as those from the Global Initiative for Asthma (GINA), recommend different medication combinations and stepwise approaches for the management of asthma, which does not include the specific triple therapy formulation in Breztri.

What is Breztri?

Breztri is a combination inhaler that contains 3 ingredients: budesonide (a corticosteroid), glycopyrrolate (a long-acting muscarinic antagonist), and formoterol (a long-acting beta agonist). Breztri is also known as Breztri aerosphere.

Breztri is only approved for use in adults with COPD (chronic obstructive pulmonary disease.

Breztri is not a rescue inhaler and cannot help if you have sudden breathing problems. Breztri is used twice a day as maintenance treatment for COPD. You should always keep a rescue inhaler, such as albuterol, with you while using Breztri.

Related questions

How does Breztri work?

Each of the 3 ingredients in Breztri has a different mechanism of action.

References
  • Breztri Prescribing Information. https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/9d44f9af-438a-448b-bb5c-dae506e17e49/9d44f9af-438a-448b-bb5c-dae506e17e49_viewable_rendition__v.pdf
  • Breztri Package Insert. https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/9d44f9af-438a-448b-bb5c-dae506e17e49/9d44f9af-438a-448b-bb5c-dae506e17e49_pi_med_guide_rendition__c.pdf

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Can severe asthma lead to COPD?

Severe and poorly controlled asthma can lead to damaged lungs which may increase the risk of developing chronic obstructive pulmonary disease (COPD). Symptoms of asthma and COPD may frequently co-exist in smokers and the elderly. Continue reading

How is severe asthma treated?

Severe asthma is treated by using higher doses of inhaled corticosteroids or using inhaled corticosteroids more frequently; taking oral corticosteroids or being given corticosteroid injections; with continuous inhaled nebulizers; using ipratropium bromide aerosols; taking long-acting beta-agonists (LABAs) such as albuterol or formoterol, which help keep the airways open for about 12 hours; leukotriene receptor antagonists (LTRAs), such as montelukast or zafirlukast; slow-release theophylline; long-acting muscarinic receptor antagonists (LAMAs) such as tiotropium bromide or glycopyrronium bromide; with biologics such as omalizumab, mepolizumab, reslizumab, benralizumab, or dupilumab.

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What is considered severe asthma?

Severe asthma is when you require medium to high-dose inhaled corticosteroids combined with other longer-acting medications. Severe asthma can also be defined as having a peak expiratory flow rate (PEF or PEFR) less than 50% of your personal best. This shows severe narrowing of your large airways and is considered a medical emergency and you should get help right away. Your symptoms may include coughing, being very short of breath, wheezing while breathing in and out, or retractions (this is when you can see the muscles between the ribs working hard to keep you breathing). Walking and talking may also be difficult. Continue reading

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