ATC Group: R03AL Adrenergics in combination with anticholinergics

Aclidinium is a long-acting muscarinic antagonist (also known as an anticholinergic) and formoterol is a long-acting β₂-adrenergic agonist. The combination of these substances with different mechanisms of action results in additive efficacy compared to that achieved with either component alone. Relaxation of both central and peripheral airways with combination treatment may contribute to the beneficial effects of aclidinium/formoterol combination on lung function.

Combination of two bronchodilators: glycopyrronium, a long-acting muscarinic antagonist (also referred to as an anticholinergic), and formoterol, a long-acting β₂-adrenergic agonist with a rapid onset of action.

Fixed dose combination containing a long acting muscarinic receptor antagonist, tiotropium and a long acting beta₂-adrenergic agonist, olodaterol (LAMA/LABA). The two active ingredients provide additive bronchodilation due to their different mode of action. Since muscarinic receptors appear to be more prominent in the central airways while β₂ adrenoceptors have a higher expression level in the peripheral airways, a combination of tiotropium and olodaterol should provide optimal bronchodilatation in all regions of the lungs.

Vilanterol is a selective long-acting, beta₂-adrenergic agonist (LABA). The pharmacologic effects of beta₂-adrenoceptor agonist active substances, including vilanterol, are at least in part attributable to stimulation of intracellular adenylate cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3',5'-adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.

Umeclidinium/vilanterol is a combination inhaled long-acting muscarinic receptor antagonist/long-acting beta₂-adrenergic agonist (LAMA/LABA). Following oral inhalation both compounds act locally on airways to produce bronchodilation by separate mechanisms.