Glycopyrrolate is a long term medication used to treat ongoing lung disease such as chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It must be used regularly to reduce and prevent symptoms such as shortness of breath and wheezing. This may lead to a decrease in time lost from work due to COPD. This medication belongs to a class of drugs known as anticholinergics. It works by relaxing the muscles around the airways so that they open up and you can breathe more easily.

Glycopyrrolate does not work right away and should not be used to relieve sudden breathing problems. If wheezing or sudden shortness of breath occurs, use your quick-relief inhaler as prescribed.

Read the Patient Information Leaflet provided by your pharmacist before you start using glycopyrrolate and each time you get a refill. Follow the illustrated directions for the proper use of this medication. If you have any questions, ask your doctor or pharmacist.

Do not swallow these capsules. Use only the special inhaler that comes with the medication to inhale the powder in the capsules. Inhale this medication by mouth as directed by your doctor, usually once or twice daily, depending on the brand that you use.

Leave the capsule sealed in the blister packet until just before use. Dry your hands before touching the capsules. Do not push the capsule through the foil. Follow the instructions for loading the capsule into the inhaler and for piercing it. Inhale rapidly and deeply through the mouthpiece. You should hear a whirring noise as you inhale the medication. You will also have a sweet taste from the medicine. Hold your breath for at least 5 to 10 seconds. Open the inhaler to see if any powder is left in the capsule. If there is, close the inhaler and inhale again. Inhale all of the powder from each capsule. Do not blow into the mouthpiece at any time.

Avoid getting this medication into your eyes. It may cause eye pain/irritation, temporary blurred vision, and other vision changes.

If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time(s) each day. Do not increase your dose or use this drug more often than prescribed, or stop using it without first consulting your doctor.

Do not wash the inhaler with water. You may wipe the mouthpiece inside and outside with a clean, dry, lint-free cloth.

Learn which of your inhalers you should use every day and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, waking up at night with trouble breathing, if you use your quick-relief inhaler more often, or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away.

Tell your doctor if your symptoms do not get better or if they get worse.

Dry mouth, dry/sore throat, or runny/stuffy nose may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• difficult/painful urination
• fast/irregular heartbeat

Get medical help right away if you have any very serious side effects, including:

• eye pain/swelling/redness
• vision changes (such as seeing rainbows around lights at night, blurred vision)

Rarely, glycopyrrolate may cause worsening of breathing problems (paradoxical bronchospasm) that may be severe. If this occurs, get medical attention right away.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using glycopyrrolate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as milk proteins), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• personal or family history of glaucoma (angle-closure type)
• kidney disease
• problems with urination (such as urinary tract blockage, enlarged prostate)

This drug may cause blurred vision. Do not drive, use machinery, or do anything that needs clear vision until you are sure you can perform such activities safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to certain effects of this drug, especially headache and burning/painful/frequent/urgent urination.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

This medication will not work and may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Do not share this medication with others.

If you smoke, quitting is the most important step you can take to treat COPD. Talk with your doctor or pharmacist about programs and products that can help you quit.

Because the flu virus can worsen breathing problems, ask your doctor or pharmacist if you should have a flu shot every year.

Lab and/or medical tests (such as lung function) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Store the capsules and the inhaler in a dry place at room temperature away from heat and moisture. Do not store in the bathroom. Discard the inhaler after 30 days of use. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).