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Enurev Breezhaler (glycopyrronium bromide) – Package leaflet - R03BB06

Updated on site: 06-Oct-2017

Medication nameEnurev Breezhaler
ATC CodeR03BB06
Substanceglycopyrronium bromide
ManufacturerNovartis Europharm Ltd

Package leaflet: Information for the user

Enurev Breezhaler 44 micrograms inhalation powder, hard capsules glycopyrronium

(as glycopyrronium bromide)

This medicine is subject to additional monitoring. This will allow quick identification of new safety information. You can help by reporting any side effects you may get. See the end of section 4 for how to report side effects.

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

-Keep this leaflet. You may need to read it again.

-If you have any further questions, ask your doctor, pharmacist or nurse.

-This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1.What Enurev Breezhaler is and what it is used for

2.What you need to know before you use Enurev Breezhaler

3.How to use Enurev Breezhaler

4.Possible side effects

5.How to store Enurev Breezhaler

6.Contents of the pack and other information

1.What Enurev Breezhaler is and what it is used for

What Enurev Breezhaler is

This medicine contains an active substance called glycopyrronium bromide. This belongs to a group of medicines called bronchodilators.

What Enurev Breezhaler is used for

This medicine is used to make breathing easier for adult patients who have breathing difficulties due to a lung disease called chronic obstructive pulmonary disease (COPD).

In COPD the muscles around the airways tighten. This makes breathing difficult. This medicine blocks the tightening of these muscles in the lungs, making it easier for air to get in and out of the lungs.

If you use this medicine once a day, it will help to reduce the effects of COPD on your everyday life.

2. What you need to know before you use Enurev Breezhaler

Do not use Enurev Breezhaler

-if you are allergic to glycopyrronium bromide or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor before using Enurev Breezhaler, if any of the following applies to you:

-you have kidney problems.

-you have an eye problem called narrow-angle glaucoma.

-you have difficulty passing urine.

During treatment with Enurev Breezhaler, stop taking this medicine and tell your doctor immediately:

-if you experience tightness of the chest, coughing, wheezing or breathlessness immediately after using Enurev Breezhaler (signs of bronchospasm).

-if you experience difficulties in breathing or swallowing, swelling of the tongue, lips or face, skin rash, itching and hives (signs of allergic reaction).

-if you experience eye pain or discomfort, temporary blurring of vision, visual halos or coloured images in association with red eyes. These may be signs of an acute attack of narrow-angle glaucoma.

Enurev Breezhaler is used as a maintenance treatment for your COPD. Do not use this medicine to treat a sudden attack of breathlessness or wheezing.

Children and adolescents

Do not give this medicine to children or adolescents below the age of 18 years.

Other medicines and Enurev Breezhaler

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines similar to Enurev Breezhaler used for your lung disease, such as ipratropium, oxitropium or tiotropium (so called anticholinergics).

No specific side effects have been reported when Enurev Breezhaler has been used together with other medicines used to treat COPD such as reliever inhalers (e.g. salbutamol), methylxanthines (e.g. theophylline) and/or oral and inhaled steroids (e.g. prednisolone).

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

There are no data from the use of this medicine in pregnant women and it is not known whether the active substance of this medicine passes into human milk.

Driving and using machines

It is unlikely that this medicine will affect your ability to drive and use machines.

Enurev Breezhaler contains lactose

This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

3.How to use Enurev Breezhaler

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

How much Enurev Breezhaler to use

The usual dose is to inhale the content of one capsule each day.

You only need to inhale once a day because the effect of this medicine lasts for 24 hours. Do not use more than your doctor tells you to use.

Elderly people

You can use this medicine if you are aged 75 years and over at the same dose as for other adults.

When to inhale Enurev Breezhaler

Use this medicine at the same time each day. This will also help you to remember to use it.

You can inhale this medicine anytime before or after food or drink.

How to inhale Enurev Breezhaler

-In this pack, you will find an inhaler and capsules (in blisters) that contain the medicine as inhalation powder. Only use the capsules with the inhaler provided in this pack (Enurev Breezhaler inhaler). The capsules should remain in the blister until you need to use them.

-Do not push the capsule through the foil.

-When you start a new pack, use the new Enurev Breezhaler inhaler that is supplied in the pack.

-Dispose of each inhaler after 30 days of use.

-Do not swallow the capsules.

-Please read the instructions at the end of this leaflet for more information on how to use the inhaler.

If you use more Enurev Breezhaler than you should

If you have inhaled too much of this medicine or if someone else accidentally uses your capsules, you must immediately either tell your doctor or go to the nearest emergency unit. Show the pack of Enurev Breezhaler. Medical attention may be needed.

If you forget to use Enurev Breezhaler

If you forget to inhale a dose, take one as soon as possible. However, do not take two doses on the same day. Then take the next dose as usual.

How long to continue your treatment with Enurev Breezhaler

-Keep using this medicine for as long as your doctor tells you.

-COPD is a long-term disease and you should use this medicine every day and not only when

you have breathing problems or other symptoms of COPD.

If you have questions about how long to continue your treatment with this medicine, talk to your doctor or pharmacist.

If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.

4.Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some side effects may be serious but are uncommon

(may affect up to 1 in 100 people)

Irregular heart beat

High level of blood sugar (hyperglycaemia: typical symptoms include excessive thirst or hunger and frequent urination)

Rash, itching, hives, difficulty breathing or swallowing, dizziness (possible signs of allergic reaction)

Swelling mainly of the tongue, lips, face or throat (possible signs of angioedema)

If you get any of these side effects, tell your doctor immediately.

Some side effects may be serious, but the frequency of these side effects is not known

(frequency cannot be estimated from the available data)

Difficulty breathing with wheezing or coughing (signs of paradoxical bronchospasm)

Some side effects are common

(may affect up to 1 in 10 people)

Dry mouth

Difficulty sleeping

Runny or stuffy nose, sneezing, sore throat

Diarrhoea or stomach ache

Musculoskeletal pain

Some side effects are uncommon

(may affect up to 1 in 100 people)

Difficulty and pain when passing urine

Painful and frequent urination




Cough with sputum

Dental caries

Feeling of pressure or pain in the cheeks and forehead

Nose bleeds

Pain in arms or legs

Pain in muscles, bones or joints of the chest

Stomach discomfort after meals

Throat irritation




Voice alteration (hoarseness)



Some elderly patients above 75 years of age experienced headache (frequency common) and urinary tract infection (frequency common).

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects

not listed in this leaflet. You can also report side effects directly via the national reporting system

listed in Appendix V. By reporting side effects you can help provide more information on the safety of

this medicine.

5.How to store Enurev Breezhaler

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and blister after “EXP”. The expiry date refers to the last day of that month.

Do not store above 25°C.

Store the capsules in the original blister in order to protect from moisture. Do not remove from the blister until immediately before use.

Each inhaler should be disposed of after 30 days of use.

Do not use this medicine if you notice that the pack is damaged or shows signs of tampering.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Enurev Breezhaler contains

-The active substance is glycopyrronium bromide. Each capsule contains 63 micrograms of glycopyrronium bromide (equivalent to 50 micrograms glycopyrronium). The delivered dose (the dose that leaves the mouthpiece of the inhaler) is equivalent to 44 micrograms of glycopyrronium.

-The other ingredients of the inhalation powder are lactose monohydrate and magnesium stearate.

What Enurev Breezhaler looks like and contents of the pack

Enurev Breeyhaler 44 micrograms inhalation powder, hard capsules are transparent and orange and contain a white powder. They have the product code “GPL50” printed in black above and a company

logo () printed in black below a black bar.

Each pack contains a device called an inhaler, together with capsules in blisters. Each blister strip contains either 6 or 10 hard capsules.

The following pack sizes are available:

Packs containing 6x1, 10x1, 12x1 or 30x1 hard capsules, together with one inhaler.

Multipacks containing 90 (3 packs of 30x1) hard capsules and 3 inhalers. Multipacks containing 96 (4 packs of 24x1) hard capsules and 4 inhalers. Multipacks containing 150 (15 packs of 10x1) hard capsules and 15 inhalers. Multipacks containing 150 (25 packs of 6x1) hard capsules and 25 inhalers.

Not all pack sizes may be available in your country.

Marketing Authorisation Holder

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom


Novartis Pharma GmbH

Roonstraße 25

D-90429 Nuremberg


For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:



Novartis Pharma N.V.

Novartis Pharma Services Inc.

Tél/Tel: +32 2 246 16 11

Tel: +370 5 269 16 50



Novartis Bulgaria EOOD

Novartis Pharma N.V.

Тел.: +359 2 489 98 28

Tél/Tel: +32 2 246 16 11

Česká republika


Novartis s.r.o.

Novartis Hungária Kft.

Tel: +420 225 775 111

Tel.: +36 1 457 65 00



Novartis Healthcare A/S

Novartis Pharma Services Inc.

Tlf: +45 39 16 84 00

Tel: +356 2122 2872



Novartis Pharma GmbH

Novartis Pharma B.V.

Tel: +49 911 273 0

Tel: +31 26 37 82 111



Novartis Pharma Services Inc.

Novartis Norge AS

Tel: +372 66 30 810

Tlf: +47 23 05 20 00



Novartis (Hellas) A.E.B.E.

Novartis Pharma GmbH

Τηλ: +30 210 281 17 12

Tel: +43 1 86 6570



Ferrer Internacional, S.A.

Novartis Poland Sp. z o.o.

Tel: +34 93 600 37 00

Tel.: +48 22 375 4888



Novartis Pharma S.A.S.

Novartis Farma - Produtos Farmacêuticos, S.A.

Tél: +33 1 55 47 66 00

Tel: +351 21 000 8600



Novartis Hrvatska d.o.o.

Novartis Pharma Services Romania SRL

Tel. +385 1 6274 220

Tel: +40 21 31299 01



Novartis Ireland Limited

Novartis Pharma Services Inc.

Tel: +353 1 260 12 55

Tel: +386 1 300 75 50


Slovenská republika

Vistor hf.

Novartis Slovakia s.r.o.

Sími: +354 535 7000

Tel: +421 2 5542 5439



Novartis Farma S.p.A.

Novartis Finland Oy

Tel: +39 02 96 54 1

Puh/Tel: +358 (0)10 6133 200



Novartis Pharma Services Inc.

Novartis Sverige AB

Τηλ: +357 22 690 690

Tel: +46 8 732 32 00


United Kingdom

Novartis Pharma Services Inc.

Novartis Pharmaceuticals UK Ltd.

Tel: +371 67 887 070

Tel: +44 1276 698370

This leaflet was last revised in

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency website: http://www.ema.europa.eu

Instructions for use of Enurev Breezhaler inhaler

Please read the following instructions carefully to learn how to use this medicine.

Only use the Enurev Breezhaler inhaler contained in this pack. Do not use Enurev Breezhaler capsules with any other inhaler, and do not use Enurev Breezhaler inhaler to take any other capsule medicine.

Do not push the capsule through the foil to remove it from the blister.

When you start a new pack, only use the new Enurev Breezhaler inhaler that is supplied in the pack.

Each inhaler should be disposed of after 30 days of use. Ask your pharmacist how to dispose of medicines and inhalers no longer required.

Do not swallow the capsules. The powder in the capsules is for you to inhale.

Your Enurev Breezhaler pack

One Enurev Breezhaler pack contains:

-one Enurev Breezhaler inhaler

-one or more blister strips, each containing either 6 or 10 Enurev Breezhaler capsules to be used in the inhaler.







Capsule chamber


Blister strip

Inhaler base

How to use your inhaler

Pull off the cap.

Open inhaler:

Hold the base of the inhaler firmly and tilt the mouthpiece. This opens the inhaler.

Prepare capsule:

Separate a single blister from the blister strip by tearing along the perforation.

Peel away the protective backing to expose the capsule.

Do not push capsule through foil.

Remove a capsule:

Capsules should always be stored in the blister and only removed immediately before use.

With dry hands, remove capsule from the blister. Do not swallow the capsule.

Insert capsule:

Place the capsule into the capsule chamber.

Never place a capsule directly into the mouthpiece.

Close the inhaler:

Close the inhaler until you hear a “click”.

Pierce the capsule:

Hold the inhaler upright with the mouthpiece pointing up.

Pierce the capsule by firmly pressing together both side buttons at the same time.

Do this only once.

You should hear a “click” as the capsule is being pierced.

Release the side buttons fully.

Breathe out:

Before placing the mouthpiece in your mouth, breathe out fully.

Do not blow into the mouthpiece.

Inhale the medicine:

To breathe the medicine deeply into your airways:

Hold the inhaler as shown in the picture. The side buttons should be facing left and right. Do not press the side buttons.

Place the mouthpiece in your mouth and close your lips firmly around it.

Breathe in rapidly but steadily, as deeply as you can. Do not press the side buttons.


As you breathe in through the inhaler, the capsule spins around in the chamber and you should hear a whirring noise. You will experience a sweet flavour as the medicine goes into your lungs.

If you do not hear a whirring noise:

The capsule may be stuck in the capsule chamber. If this happens:

Open the inhaler and carefully loosen the capsule by tapping the base of the inhaler.

Do not press the side buttons.

Inhale the medicine again by repeating steps 9 and 10.

Hold breath:

After you have inhaled the medicine:

Hold your breath for at least 5-10 seconds or as long as you comfortably can while taking the inhaler out of your mouth.

Then breathe out.

Open the inhaler to see if any powder is left in the capsule.

If there is powder left in the capsule:Close the inhaler.

Repeat steps 9 to 12.

Most people are able to empty the capsule with one or two inhalations.

Additional information

Some people occasionally cough briefly soon after inhaling a medicine. If you do, don’t worry. As long as the capsule is empty, you have received enough of your medicine.

After you have finished taking your daily dose of Enurev Breezhaler:

Open the mouthpiece again, and remove the empty capsule by tipping it out of the capsule chamber. Put the empty capsule in your household waste.

Close the inhaler and replace the cap.

Do not store the capsules in the Enurev

Breezhaler inhaler.

Additional information

Occasionally, very small pieces of the capsule can get past the screen and enter your mouth. If this happens, you may be able to feel these pieces on your tongue. It is not harmful if these pieces are swallowed or inhaled. The chances of the capsule shattering will be increased if the capsule is pierced more than once (step 7).

How to clean your inhaler

Never wash your inhaler with water. If you want to clean your inhaler, wipe the mouthpiece inside and outside with a clean, dry, lint-free cloth to remove any powder residue. Keep the inhaler dry.


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