What was Seebri (glycopyrrolate)?
Seebri Neohaler was a brand name for the medication glycopyrrolate, a long-acting muscarinic antagonist (LAMA) used for the long-term maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults. It was administered via a dry-powder inhaler (the Neohaler) once daily to help relax the muscles in the lungs and widen the airways, making breathing easier.
- Mechanism of Action: As an anticholinergic, glycopyrrolate works by blocking the action of acetylcholine, a neurotransmitter that can cause the airways to constrict. By blocking this action, the medication allows the airways to open up.
- Indication: It was prescribed for the maintenance therapy of COPD, including chronic bronchitis and emphysema, but was not intended for the relief of acute symptoms or as a rescue inhaler.
- Manufacturer History: Originally developed by Novartis, the U.S. commercial rights for the Seebri Neohaler were out-licensed to Sunovion Pharmaceuticals in late 2016.
The discontinuation of Seebri in the U.S.
In early 2020, Sunovion announced its decision to discontinue the Seebri Neohaler, along with two other related inhalers, Arcapta Neohaler and Utibron Neohaler. The company ceased shipping the products on March 31, 2020, and the FDA officially withdrew its approval in June 2020.
This decision was driven by commercial strategy rather than any issues regarding the medication's safety or efficacy. The move allowed Sunovion to focus its respiratory business on other products in its portfolio. Patients who were using Seebri Neohaler at the time were advised to contact their healthcare providers to transition to an alternative treatment.
What to use instead: Alternatives for Seebri
For patients who relied on Seebri, numerous effective alternatives for managing COPD are available. The best option will depend on your specific needs, the severity of your condition, and your doctor's recommendation. Here are some of the medication categories that serve as viable replacements:
Other long-acting muscarinic antagonists (LAMAs)
These medications belong to the same class as Seebri and offer similar benefits by relaxing the airways. They include:
- Spiriva (tiotropium): Available as a HandiHaler dry-powder inhaler or a Respimat soft mist inhaler.
- Incruse Ellipta (umeclidinium): A once-daily dry-powder inhaler.
- Lonhala Magnair (glycopyrrolate): This is the same active ingredient as Seebri but delivered via a nebulized solution, which may be more suitable for some patients.
- Tudorza Pressair (aclidinium): A twice-daily dry-powder inhaler.
Combination LAMA/LABA inhalers
For some patients, a combination of a LAMA and a long-acting beta-agonist (LABA) can provide more comprehensive symptom relief. These include products that still contain glycopyrrolate, such as:
- Breztri Aerosphere (budesonide/glycopyrrolate/formoterol): A triple therapy combination inhaler.
- Utibron Neohaler (indacaterol/glycopyrrolate): While discontinued in the U.S. in the same announcement as Seebri, other LAMA/LABA combinations are available, including those that do not use the Neohaler device.
- Stiolto Respimat (tiotropium/olodaterol): A soft mist inhaler.
Combination LAMA/LABA/ICS inhalers
For patients with more severe COPD or frequent exacerbations, a triple therapy combining a LAMA, a LABA, and an inhaled corticosteroid (ICS) may be recommended.
- Trelegy Ellipta (fluticasone furoate/umeclidinium/vilanterol): A once-daily dry-powder inhaler.
Comparison of COPD Inhalers (LAMA & Combos)
| Medication Name | Active Ingredient(s) | Inhaler Type | Dosing Frequency | Notes |
|---|---|---|---|---|
| Seebri Neohaler | Glycopyrrolate | Dry-powder (Neohaler) | Once-daily | Discontinued in U.S. |
| Spiriva | Tiotropium | Dry-powder (HandiHaler) or soft mist (Respimat) | Once-daily | Long-standing LAMA standard |
| Incruse Ellipta | Umeclidinium | Dry-powder (Ellipta) | Once-daily | LAMA with a once-daily regimen |
| Breztri Aerosphere | Budesonide/Glycopyrrolate/Formoterol | Metered-dose (Aerosphere) | Twice-daily | Triple therapy for advanced COPD |
| Lonhala Magnair | Glycopyrrolate | Nebulized solution | Twice-daily | Glycopyrrolate via nebulizer |
| Trelegy Ellipta | Fluticasone/Umeclidinium/Vilanterol | Dry-powder (Ellipta) | Once-daily | Triple therapy for severe COPD |
What to do if you were using Seebri
If you were a patient on Seebri, the primary and most important step is to consult your healthcare provider. Do not stop your medication abruptly without guidance. Your doctor will assess your current condition and help you determine the most appropriate alternative treatment. They will consider factors such as your specific symptoms, the severity of your COPD, and your preference for different inhaler types.
While the Neohaler device itself is no longer available, the active ingredient, glycopyrrolate, is still used in other products like Lonhala Magnair and Breztri Aerosphere. This may be a suitable option for some patients, while others might transition to a different LAMA or combination therapy.
Conclusion
The discontinuation of the Seebri Neohaler in the United States was a business-driven decision by Sunovion, not a result of safety concerns. While the specific brand is no longer available, multiple equally effective and well-regarded treatment options exist for patients with COPD. Individuals affected by the discontinuation should prioritize a discussion with their healthcare provider to find a safe and appropriate medication replacement. The active ingredient, glycopyrrolate, continues to be available in other forms and combination products, ensuring a continuity of care for those who benefited from it. A detailed list of alternative medications and their application can be further explored on trusted health websites, such as Drugs.com.
