Ultibro Breezhaler

indacaterol / glycopyrronium bromide

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This is a summary of the European public assessment report (EPAR) for Ultibro Breezhaler. It explains how the European Medicines Agency assessed the medicine to recommend its authorisation in the European Union (EU) and its conditions of use. It is not intended to provide practical advice on how to use Ultibro Breezhaler.

For practical information about using Ultibro Breezhaler, patients should read the package leaflet or contact their doctor or pharmacist.

What is Ultibro Breezhaler and what is it used for?

Ultibro Breezhaler is a medicine that contains two active substances, indacaterol (85 micrograms) and glycopyrronium (43 micrograms). It is used as maintenance (regular) treatment to relieve symptoms of chronic obstructive pulmonary disease (COPD) in adults. COPD is a long-term disease in which the airways and air sacs inside the lungs become damaged or blocked, leading to difficulty breathing air in and out of the lungs.

How is Ultibro Breezhaler used?

Ultibro Breezhaler is available as capsules containing a powder for inhalation and can only be obtained with a prescription.

The recommended dose is one inhalation once a day of the powder content of a single capsule. It is taken at the same time each day using the Ultibro Breezhaler device. The contents of the capsules must not be inhaled using any other device.

In patients with severely reduced kidney function Ultibro Breezhaler should only be used after a careful benefit-risk assessment.

How does Ultibro Breezhaler work?

The active substances in Ultibro Breezhaler, indacaterol and glycopyrronium, work in different ways to widen the airways and improve breathing in COPD.

Indacaterol is a long-acting beta-2 agonist. It works by attaching to beta-2-adrenergic receptors found in the muscles of many organs including the airways of the lungs. When inhaled, indacaterol reaches the receptors in the airways and activates them. This causes the muscles of the airways to relax.

Glycopyrronium is a muscarinic-receptor antagonist. It works by blocking some receptors called muscarinic receptors, which control the contraction of muscles. When glycopyrronium is inhaled, it causes the muscles of the airways to relax.

The combined action of the two active substances helps to keep the airways open and allows the patient to breathe more easily. Muscarinic receptor antagonists and long-acting beta-2-adrenergic agonists are commonly combined in the management of COPD.

What benefits of Ultibro Breezhaler have been shown in studies?

Ultibro Breezhaler has been studied in two main studies involving a total of 2,667 patients with COPD. While one study compared the effects of Ultibro Breezhaler with those of placebo (a dummy inhalation), or indacaterol or glycopyrronium alone, the other study compared Ultibro Breezhaler with fluticasone plus salmeterol, a standard treatment for COPD. In both studies, the main measure of effectiveness was how Ultibro Breezhaler improved patients’ forced expiratory volumes (FEV1, the maximum volume of air a person can breathe out in one second) after 26 weeks of treatment.

The first study showed that treatment with Ultibro Breezhaler was more effective than placebo and increased FEV1 by an average of 200 ml more. Ultibro Breezhaler also increased FEV1 by 70 ml more than indacaterol alone and 90 ml more than glycopyrronium alone. In the second study the average increase in FEV1 was 140 ml more with Ultibro Breezhaler treatment than with treatment with fluticasone and salmeterol.

A third study studied the effects of Ultibro Breezhaler on the rate of exacerbations (flare-ups) patients experienced during 64 weeks of treatment when compared with treatment with glycopyrronium or tiotropium (other treatments for COPD). The reduction in the rate of exacerbations was 10 to 12% higher with Ultibro Breezhaler than with tiotropium and glycopyrronium.

What are the risks associated with Ultibro Breezhaler?

The most common side effects with Ultibro Breezhaler (which may affect more than 1 in 10 people) are upper-respiratory-tract infections (colds).

For the full list of all side effects reported with Ultibro Breezhaler, see the package leaflet.

Why is Ultibro Breezhaler approved?

The Agency’s Committee for Medicinal Products for Human Use (CHMP) decided that Ultibro Breezhaler’s benefits are greater than its risks and recommended that it be approved for use in the EU. The effects of Ultibro Breezhaler when used to relieve symptoms of COPD were clinically meaningful. However, the CHMP considered that its effects on reducing the rate of exacerbations were too small to recommend the use for reducing exacerbations. Regarding its safety, Ultibro Breezhaler is comparable to indacaterol and glycopyrronium used as separate medicines. Side effects seen in studies were generally benign and were considered manageable.

What measures are being taken to ensure the safe and effective use of Ultibro Breezhaler?

A risk-management plan has been developed to ensure that Ultibro Breezhaler is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Ultibro Breezhaler, including the appropriate precautions to be followed by healthcare professionals and patients.

Other information about Ultibro Breezhaler

The European Commission granted a marketing authorisation valid throughout the European Union for Ultibro Breezhaler on 19 September 2013.

For more information about treatment with Ultibro Breezhaler, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Name Language First published Last updated
Ultibro Breezhaler : EPAR - Summary for the public BG = bălgarski 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public ES = español 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public CS = čeština 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public DA = dansk 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public DE = Deutsch 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public ET = eesti keel 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public EL = elliniká 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public EN = English 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public FR = français 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public IT = italiano 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public LV = latviešu valoda 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public LT = lietuvių kalba 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public HU = magyar 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public MT = Malti 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public NL = Nederlands 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public PL = polski 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public PT = português 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public RO = română 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public SK = slovenčina 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public SL = slovenščina 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public FI = suomi 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public SV = svenska 2013-10-03  
Ultibro Breezhaler : EPAR - Summary for the public HR = Hrvatski 2013-10-03  

This EPAR was last updated on 10/11/2015 .

Authorisation details

Product details

Product details for Ultibro Breezhaler
NameUltibro Breezhaler
Agency product numberEMEA/H/C/002679
Active substance

indacaterol / glycopyrronium bromide

International non-proprietary name (INN) or common name

indacaterol / glycopyrronium bromide

Therapeutic area Pulmonary Disease, Chronic Obstructive
Anatomical therapeutic chemical (ATC) code R03AL04
Additional monitoring

This medicine is under additional monitoring. This means that it is being monitored even more intensively than other medicines. For more information, see medicines under additional monitoring.

Publication details

Publication details for Ultibro Breezhaler
Marketing-authorisation holder

Novartis Europharm Ltd

Revision4
Date of issue of marketing authorisation valid throughout the European Union19/09/2013

Contact address:

Novartis Europharm Ltd
Frimley Business Park
Camberley
GU16 7SR
United Kingdom

Product information

Product information

09/10/2015  Ultibro Breezhaler -EMEA/H/C/002679 -IB/0010/G

Name Language First published Last updated
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - Product Information HR = Hrvatski 2013-10-03 2015-11-10

Contents

  • Annex I - Summary of product characteristics
  • Annex IIA - Manufacturing-authorisation holder responsible for batch release
  • Annex IIB - Conditions of the marketing authorisation
  • Annex IIIA - Labelling
  • Annex IIIB - Package leaflet

Please note that the size of the above document can exceed 50 pages.

You are therefore advised to be selective about which sections or pages you wish to print.


Name Language First published Last updated
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10
Ultibro Breezhaler : EPAR - All Authorised presentations HR = Hrvatski 2013-10-03 2015-11-10

Pharmacotherapeutic group

Adrenergics in combination with anticholinergic

Therapeutic indication

Ultibro Breezhaler is indicated as a maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD).

Assessment History

Changes since initial authorisation of medicine

Initial marketing-authorisation documents

Name Language First published Last updated
Ultibro Breezhaler : EPAR - Public assessment report HR = Hrvatski 2013-10-03  
CHMP summary of positive opinion for Ultibro Breezhaler HR = Hrvatski 2013-07-26  

Authorised

This medicine is approved for use in the European Union