Incruse Ellipta
Long-Acting Muscarinic Antagonist (LAMA) Inhaler for COPD
Quick Facts About Incruse Ellipta
Key Takeaways About Incruse Ellipta
- Once-daily COPD maintenance: Incruse Ellipta provides 24-hour bronchodilation with a single daily inhalation, helping to improve airflow and reduce breathlessness in COPD patients
- Not a rescue inhaler: This medicine does not work fast enough to relieve sudden breathing problems – always keep a short-acting bronchodilator (such as salbutamol) available for acute symptoms
- Simple Ellipta device: The inhaler is ready to use with no assembly required – just open the cover, inhale the dose, and close it again
- Do not combine with other LAMAs: Avoid using Incruse Ellipta together with other long-acting anticholinergic inhalers such as tiotropium (Spiriva), as this increases the risk of side effects without additional benefit
- Watch for eye and urinary symptoms: Seek immediate medical attention if you develop eye pain, blurred vision, or difficulty urinating, as these may indicate serious complications (acute glaucoma or urinary retention)
What Is Incruse Ellipta and What Is It Used For?
Incruse Ellipta is a once-daily inhaled bronchodilator used for the long-term maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults. It contains umeclidinium, a long-acting muscarinic antagonist (LAMA) that keeps the airways open for 24 hours by blocking the nerve signals that cause airway muscles to tighten.
Incruse Ellipta contains the active substance umeclidinium (as bromide), which belongs to a class of medicines called long-acting muscarinic antagonists, also known as long-acting anticholinergics or LAMAs. These medicines work as bronchodilators, meaning they open up the airways in the lungs to make breathing easier. Umeclidinium specifically targets and blocks muscarinic M3 receptors on the smooth muscle cells lining the bronchial airways.
The medicine is used to treat chronic obstructive pulmonary disease (COPD) in adults. COPD is a progressive, long-term condition in which the airways and air sacs in the lungs become damaged and narrowed over time. This damage leads to breathing difficulties that gradually worsen. The condition is most commonly caused by long-term exposure to cigarette smoke, but can also result from occupational dust, chemical fumes, or air pollution. COPD encompasses both chronic bronchitis and emphysema.
In COPD, the muscles around the airways can tighten (bronchospasm), making the airways even narrower and further restricting airflow. The neurotransmitter acetylcholine, released by nerves in the airway wall, binds to muscarinic receptors on smooth muscle cells and causes this contraction. Umeclidinium works by blocking these muscarinic receptors, preventing acetylcholine from triggering muscle contraction. This allows the airway muscles to relax and the airways to remain open, reducing airflow obstruction and making it easier to breathe.
When used regularly as prescribed, Incruse Ellipta helps to control breathing difficulties throughout both day and night, and reduces the impact of COPD on daily activities. Clinical trials have demonstrated that umeclidinium provides statistically significant and clinically meaningful improvements in trough forced expiratory volume in one second (FEV1) – the standard measurement of lung function – compared with placebo over 12 to 24 weeks of treatment.
Incruse Ellipta must not be used to relieve a sudden attack of breathlessness or wheezing. If you experience a sudden worsening of your symptoms, you must use a short-acting rescue inhaler (such as salbutamol/albuterol). Contact your doctor if you do not have a rescue inhaler available.
Incruse Ellipta was first approved by the European Medicines Agency (EMA) in April 2014 and by the US Food and Drug Administration (FDA) in April 2014. It is manufactured by GlaxoSmithKline and delivered through the innovative Ellipta dry powder inhaler device, which is designed for simplicity – the inhaler comes pre-loaded and ready to use with no assembly, priming, or shaking required.
What Should You Know Before Using Incruse Ellipta?
Before using Incruse Ellipta, tell your doctor about all your medical conditions, especially if you have asthma, heart problems, narrow-angle glaucoma, enlarged prostate, difficulty urinating, or severe liver disease. Incruse Ellipta is not approved for treating asthma.
Contraindications
You should not use Incruse Ellipta if any of the following apply:
- Allergy to umeclidinium or any of the other ingredients in the product (lactose monohydrate and magnesium stearate) – allergic reactions can include itching, rash (hives), redness, swelling, wheezing, or difficulty breathing
- Allergy to milk proteins – Incruse Ellipta contains lactose (derived from milk), so patients with severe milk allergy should not use this medicine
If you think any of these apply to you, do not use this medicine until you have spoken with your doctor.
Warnings and Precautions
Talk to your doctor before using Incruse Ellipta if you have or have had any of the following conditions:
- Asthma – Incruse Ellipta is not indicated for asthma and should not be used to treat it. Asthma requires different treatment approaches, typically including inhaled corticosteroids
- Heart problems – antimuscarinic medicines can affect heart rate and rhythm. Patients with significant cardiovascular disease were excluded from clinical trials, so the safety profile in these patients is not well established
- Narrow-angle glaucoma – anticholinergic medicines can increase intraocular pressure and may precipitate or worsen acute narrow-angle glaucoma. If you have this condition or are at risk, extra monitoring is necessary
- Enlarged prostate (benign prostatic hyperplasia), difficulty urinating, or bladder-neck obstruction – anticholinergic medicines can worsen urinary retention, making it harder to pass urine
- Severe liver disease (hepatic impairment) – the effects of umeclidinium have not been studied in patients with severe hepatic impairment, and dose adjustments may be warranted
Paradoxical Bronchospasm
In rare cases, using an inhaled bronchodilator may cause the opposite of the intended effect – a sudden tightening of the airways immediately after inhalation. This is known as paradoxical bronchospasm. If you feel tightness in your chest, start coughing, develop wheezing, or become breathless immediately after using Incruse Ellipta, stop using the medicine and seek medical attention immediately. This is a potentially serious condition that requires urgent treatment.
Eye Problems During Treatment
If you develop eye pain or discomfort, temporary blurred vision, or see visual halos or coloured spots combined with red eyes during treatment with Incruse Ellipta, stop using this medicine and seek medical attention immediately. These may be signs of acute narrow-angle glaucoma, a medical emergency that requires prompt treatment to prevent permanent vision loss. Although this complication is rare, patients using anticholinergic inhalers should be aware of these warning signs.
Pregnancy and Breastfeeding
The safety of Incruse Ellipta during pregnancy has not been established in humans. If you are pregnant, think you might be pregnant, or are planning to become pregnant, consult your doctor before using this medicine. Your doctor will weigh the potential benefits against the possible risks and may recommend an alternative treatment. Do not use Incruse Ellipta during pregnancy unless your doctor specifically advises you to do so.
It is not known whether umeclidinium or its metabolites pass into breast milk. If you are breastfeeding, you must consult your doctor before using Incruse Ellipta. Your doctor will consider the benefit of breastfeeding for your child and the benefit of treatment for you to help decide whether you should continue breastfeeding or use this medicine. Do not use this medicine while breastfeeding unless your doctor tells you that you can.
Children and Adolescents
Incruse Ellipta is not indicated for use in children or adolescents under 18 years of age. COPD is primarily an adult disease, and the safety and efficacy of umeclidinium has not been established in paediatric populations.
Driving and Operating Machinery
Incruse Ellipta is not expected to affect your ability to drive or operate machinery. However, if you experience dizziness or blurred vision after using the inhaler, you should avoid driving or operating machinery until the symptoms have resolved.
Lactose Content
Incruse Ellipta contains lactose monohydrate as an excipient. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before using this medicine. The amount of lactose in each dose is very small, and most people with lactose intolerance can use the inhaler without problems. However, patients with severe milk protein allergy should avoid this medicine.
How Does Incruse Ellipta Interact with Other Drugs?
The most important drug interaction to be aware of is with other long-acting anticholinergic (antimuscarinic) medicines such as tiotropium, ipratropium, aclidinium, or glycopyrronium. You must not use Incruse Ellipta together with these medicines, as combining them increases the risk of anticholinergic side effects without providing additional clinical benefit.
Tell your doctor or pharmacist about all other medicines you are taking, have recently taken, or might take. This includes prescription medicines, over-the-counter products, and herbal supplements. If you are unsure what your medicines contain, speak to your doctor or pharmacist before using Incruse Ellipta.
Umeclidinium is metabolised primarily by the cytochrome P450 enzyme CYP2D6 and is also a substrate of the P-glycoprotein (P-gp) transporter. Clinically relevant pharmacokinetic interactions with common medications are considered unlikely due to the low systemic exposure following inhalation. However, it is important to inform your healthcare team about all medicines you use.
| Interacting Medicine | Type | Effect | Clinical Advice |
|---|---|---|---|
| Tiotropium (Spiriva) | Pharmacodynamic | Additive anticholinergic effects; increased risk of side effects including dry mouth, urinary retention, constipation, and tachycardia | Do not use together. Choose one LAMA only. |
| Ipratropium (Atrovent) | Pharmacodynamic | Overlapping anticholinergic mechanism; risk of increased side effects | Avoid concurrent use with short-acting anticholinergics. |
| Aclidinium (Tudorza) | Pharmacodynamic | Duplicate LAMA therapy; no added benefit with increased anticholinergic burden | Do not use two LAMAs concurrently. |
| Glycopyrronium (Seebri) | Pharmacodynamic | Duplicate LAMA therapy; additive anticholinergic side effects | Do not use two LAMAs concurrently. |
| Ketoconazole / strong CYP2D6 inhibitors | Pharmacokinetic | May increase systemic exposure to umeclidinium | Use with caution; monitor for increased side effects. |
| Verapamil / P-gp inhibitors | Pharmacokinetic | May slightly increase umeclidinium plasma levels | No dose adjustment generally needed; monitor if symptoms arise. |
Medicines That Can Be Used Alongside Incruse Ellipta
Incruse Ellipta may be safely used in combination with several other COPD therapies, including:
- Inhaled corticosteroids (ICS) such as fluticasone, budesonide, or beclomethasone – to reduce airway inflammation
- Long-acting beta2-agonists (LABAs) such as salmeterol, formoterol, vilanterol, or indacaterol – to provide additional bronchodilation through a different mechanism
- Short-acting beta2-agonists (SABAs) such as salbutamol/albuterol – for rescue use during acute symptoms
- Phosphodiesterase-4 inhibitors such as roflumilast – for patients with severe COPD and frequent exacerbations
- Oral mucolytics such as carbocisteine or N-acetylcysteine – to help thin and clear mucus
According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 guidelines, patients who remain symptomatic on a single long-acting bronchodilator may benefit from stepping up to a LAMA + LABA combination. If you are using Incruse Ellipta alone and your symptoms are not adequately controlled, your doctor may switch you to a combination inhaler containing both a LAMA and a LABA (such as umeclidinium/vilanterol, sold as Anoro Ellipta).
What Is the Correct Dosage of Incruse Ellipta?
The recommended dose of Incruse Ellipta is one inhalation of 55 micrograms (mcg) of umeclidinium once daily, at the same time each day. The inhaler delivers a pre-metered dose – simply open the cover, inhale, and close. Do not exceed the recommended dose.
Always use Incruse Ellipta exactly as your doctor has prescribed. Check with your doctor or pharmacist if you are unsure. The medicine should be taken at the same time each day to maintain consistent bronchodilation throughout the 24-hour dosing period.
Adults
Standard Adult Dose
55 mcg umeclidinium – one inhalation once daily
Take at the same time every day. The effect lasts for 24 hours, so you only need to inhale once per day. Do not use more than your doctor recommends.
Elderly Patients
Elderly Dose (65 years and older)
55 mcg umeclidinium – one inhalation once daily
No dose adjustment is required in elderly patients. Clinical trials included a significant proportion of patients aged 65 years and older, and no meaningful differences in efficacy or safety were observed compared with younger adults.
Renal and Hepatic Impairment
Patients with Kidney or Liver Disease
Renal impairment: No dose adjustment is required for patients with mild, moderate, or severe kidney impairment, as umeclidinium has minimal renal excretion.
Hepatic impairment (mild to moderate): No dose adjustment is needed. Severe hepatic impairment: Incruse Ellipta has not been studied in this population. Use with caution and under close medical supervision.
Children and Adolescents
Under 18 Years
Incruse Ellipta is not indicated for use in children and adolescents under 18 years. COPD is a disease that typically affects adults with a history of smoking or long-term exposure to inhaled irritants.
How to Use the Ellipta Inhaler
The Ellipta inhaler is a simple, pre-loaded dry powder inhaler that does not require shaking, priming, or assembly. Follow these steps for each dose:
- Open the cover: Slide the cover down fully until you hear a click. This loads one dose. The dose counter will count down by 1. If it does not, the inhaler will not deliver medicine – take it to your pharmacist for advice.
- Breathe out: Hold the inhaler away from your mouth and breathe out as much as is comfortable. Do not breathe out into the inhaler.
- Inhale the dose: Place the mouthpiece between your lips and seal your lips firmly around it. Do not block the air vents with your fingers. Take one long, steady, deep breath in through your mouth.
- Hold your breath: Remove the inhaler from your mouth and hold your breath for at least 3–4 seconds. Then breathe out slowly and gently.
- Close the inhaler: Slide the cover up as far as it goes to close the mouthpiece. If you wish to clean the mouthpiece, use a dry tissue before closing.
You may not taste or feel the medicine when using the Ellipta inhaler – this is normal and does not mean you have not received your dose. The dry powder is delivered in very small quantities, and if you heard the click and the dose counter counted down, you have received the correct dose.
Missed Dose
If you forget to take a dose of Incruse Ellipta:
- Do not inhale a double dose to make up for the missed one
- Simply take your next dose at the usual time
- If you develop wheezing or breathlessness, use your short-acting rescue inhaler (such as salbutamol) and then contact your doctor
Overdose
If you accidentally use too much Incruse Ellipta, contact your doctor or pharmacist immediately for advice, as you may need medical attention. Take the inhaler, its packaging, or this information with you. Symptoms of overdose may include a faster than normal heartbeat, visual disturbances, and dry mouth. In clinical studies, single doses up to 500 mcg (approximately 9 times the recommended dose) showed increased heart rate and dose-related systemic anticholinergic effects.
Stopping Treatment
Continue using Incruse Ellipta for as long as your doctor recommends. It will only help you while you are using it regularly. Do not stop without consulting your doctor, even if you feel better, as your COPD symptoms may worsen. If you have any questions about how long to continue using Incruse Ellipta, speak to your doctor, pharmacist, or nurse.
What Are the Side Effects of Incruse Ellipta?
Like all medicines, Incruse Ellipta can cause side effects, although not everyone will experience them. The most common side effects include faster heart rate, urinary tract infection, common cold, upper respiratory tract infection, cough, sinusitis, headache, constipation, and mouth and throat pain.
Most side effects are mild to moderate and tend to diminish as your body adjusts to the medicine. However, some side effects require immediate medical attention. Understanding the frequency categories will help you assess the likelihood of experiencing any particular effect.
Allergic Reactions – Seek Immediate Medical Help
If you experience any of the following symptoms after using Incruse Ellipta, stop taking this medicine and seek medical attention immediately:
- Itching, skin rash (hives/urticaria), or redness (uncommon – may affect up to 1 in 100 people)
- Wheezing, coughing, or difficulty breathing; sudden feeling of weakness or faintness that may lead to collapse or loss of consciousness (rare – may affect up to 1 in 1,000 people). These may be signs of a severe allergic reaction (anaphylaxis)
Side Effects by Frequency
Common
May affect up to 1 in 10 people
- Faster heart rate (tachycardia)
- Painful and frequent urination (may be signs of urinary tract infection)
- Common cold (nasopharyngitis)
- Upper respiratory tract infection
- Cough
- Feeling of pressure or pain in cheeks or forehead (sinusitis)
- Headache
- Constipation
- Mouth and throat pain (oropharyngeal pain)
Uncommon
May affect up to 1 in 100 people
- Irregular heartbeat (atrial fibrillation, supraventricular tachycardia)
- Sore throat (pharyngitis)
- Dry mouth
- Altered taste (dysgeusia)
- Hoarseness (dysphonia)
- Itching or skin rash (allergic reaction)
Rare
May affect up to 1 in 1,000 people
- Eye pain
- Wheezing, coughing, or difficulty breathing immediately after inhalation (paradoxical bronchospasm)
- Sudden feeling of weakness or faintness (may lead to collapse or loss of consciousness – signs of severe allergic reaction)
Not Known
Frequency cannot be estimated from available data
- Worsened vision or eye pain due to increased eye pressure (possible signs of glaucoma)
- Blurred vision
- Increased measured eye pressure
- Difficulty and pain when passing urine (signs of bladder obstruction or urinary retention)
- Dizziness
Stop using Incruse Ellipta and seek emergency medical care if you experience: sudden tightness in the chest, wheezing, or breathlessness immediately after inhalation (paradoxical bronchospasm); eye pain, blurred vision, or seeing halos with red eyes (acute glaucoma); or signs of a severe allergic reaction such as swelling of the face, lips, tongue, or throat with difficulty breathing.
Reporting Side Effects
It is important to report suspected side effects after a medicine has been authorised. This allows ongoing monitoring of the medicine's benefit-risk balance. Healthcare professionals and patients are encouraged to report any suspected adverse reactions to their national medicines regulatory authority.
How Should You Store Incruse Ellipta?
Store Incruse Ellipta in the sealed foil tray until first use. Once opened, use within 6 weeks. Store at or below 30°C. Keep out of sight and reach of children.
Proper storage of Incruse Ellipta is essential to ensure the medicine remains effective throughout its use. The Ellipta inhaler contains a blister strip with pre-metered doses of dry powder that must be protected from moisture and extreme temperatures.
- Before first use: Keep the inhaler in the sealed foil tray to protect it from moisture. Do not remove the inhaler until you are ready to start using it.
- After opening the tray: The inhaler can be used for up to 6 weeks from the date you open the foil tray. Write the discard date on the label of the inhaler in the space provided. After this date, the inhaler should no longer be used.
- Temperature: Store at or below 30°C (86°F). If the inhaler has been stored in a refrigerator, allow it to reach room temperature for at least one hour before use.
- Use before expiry: Do not use after the expiry date (EXP) printed on the packaging, tray, and inhaler. The expiry date refers to the last day of that month.
- Desiccant: The foil tray contains a desiccant sachet to reduce moisture. Discard the desiccant – do not open, eat, or inhale it.
- Disposal: Do not throw medicines away via household waste or wastewater. Ask your pharmacist how to dispose of medicines you no longer use. These measures help to protect the environment.
Keep Incruse Ellipta out of the sight and reach of children. The dose counter on the inhaler shows how many doses remain. It counts down from either 30 (one month supply) or 7 (one week supply) to 0, when the inhaler is empty and should be disposed of.
What Does Incruse Ellipta Contain?
Each delivered dose of Incruse Ellipta provides 55 micrograms of umeclidinium (equivalent to 65 micrograms of umeclidinium bromide). The other ingredients are lactose monohydrate and magnesium stearate.
Understanding what your medicine contains is important, particularly if you have allergies or sensitivities. The active and inactive ingredients of Incruse Ellipta are listed below:
Active Ingredient
The active substance is umeclidinium (as bromide). Each single inhalation provides a delivered dose (the dose that leaves the mouthpiece) of 55 micrograms of umeclidinium. This is equivalent to 65 micrograms of umeclidinium bromide per blister. The active substance is present as a white powder in a blister strip inside the inhaler device.
Inactive Ingredients (Excipients)
- Lactose monohydrate – a sugar derived from milk that acts as a carrier for the powdered medicine. Patients with severe milk protein allergy should discuss alternatives with their doctor (see section on lactose content above).
- Magnesium stearate – a lubricant that helps ensure consistent dose delivery from the blister strip.
Inhaler Device Description
The Ellipta inhaler consists of a light grey plastic body with a pale green mouthpiece cover and a dose counter. It is supplied in a foil-laminated tray with a peelable foil lid. The tray contains a desiccant sachet to reduce moisture. Incruse Ellipta is available in packs containing 1 inhaler with either 7 doses (7-day supply) or 30 doses (30-day supply), as well as multipacks of 90 doses (3 inhalers of 30 doses). Not all pack sizes may be marketed in every country.
Frequently Asked Questions About Incruse Ellipta
Incruse Ellipta is used as a once-daily maintenance bronchodilator treatment for chronic obstructive pulmonary disease (COPD) in adults. It contains umeclidinium, a long-acting muscarinic antagonist (LAMA) that helps keep the airways open for 24 hours by blocking nerve signals that cause airway muscles to constrict. It is not a rescue inhaler and must not be used for sudden breathing problems or for treating asthma.
Using the Ellipta inhaler is straightforward: (1) Slide the cover down until you hear a click – this loads the dose, (2) Breathe out away from the inhaler, (3) Place the mouthpiece between your lips, seal tightly, and take a long, steady, deep breath in, (4) Hold your breath for 3–4 seconds, then breathe out slowly, (5) Close the cover by sliding it up. Use at the same time each day. Do not shake the inhaler or breathe out into it. The dose counter confirms your dose was loaded.
No. Both Incruse Ellipta and Spiriva (tiotropium) are long-acting muscarinic antagonists (LAMAs) that work by the same mechanism. Using two LAMAs together does not provide additional therapeutic benefit but does increase the risk of anticholinergic side effects such as dry mouth, constipation, urinary retention, and increased heart rate. If your COPD is not adequately controlled with one LAMA, your doctor may consider switching you to a LAMA/LABA combination inhaler instead.
If you forget to take a dose of Incruse Ellipta, do not inhale a double dose to compensate. Simply take your next dose at your usual time the following day. If you experience wheezing or breathlessness after missing a dose, use your short-acting rescue inhaler (such as salbutamol/albuterol) and seek medical advice if symptoms persist.
Once you open the foil tray, the Incruse Ellipta inhaler can be used for up to 6 weeks. After 6 weeks from the date of opening, you should discard the inhaler, even if there are still doses remaining on the counter. Write the discard date on the inhaler label as soon as you open the tray. Store the inhaler at or below 30°C and keep it dry to ensure the powder medicine remains effective.
No. Incruse Ellipta is approved only for the treatment of COPD in adults and has not been studied in asthma patients. Asthma and COPD are different conditions that require different treatment approaches. Asthma management typically centres on inhaled corticosteroids as the cornerstone of therapy. If you have asthma, your doctor will prescribe medications specifically indicated for your condition.
References
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: 2024 Report. goldcopd.org.
- European Medicines Agency (EMA). Incruse Ellipta – Summary of Product Characteristics. Updated 2025. ema.europa.eu.
- US Food and Drug Administration (FDA). Incruse Ellipta (umeclidinium inhalation powder) – Prescribing Information. GlaxoSmithKline, 2014. fda.gov.
- Trivedi R, Richard N, Mehta R, Church A. Umeclidinium in patients with COPD: a randomised, placebo-controlled study. European Respiratory Journal. 2014;43(1):72–81. doi:10.1183/09031936.00033213.
- Feldman GJ, Edin A. The combination of umeclidinium bromide and vilanterol in the management of chronic obstructive pulmonary disease: current evidence and future prospects. Therapeutic Advances in Respiratory Disease. 2013;7(6):311–319.
- Pleasants RA, Wang T, Gao J, et al. Inhaled umeclidinium in COPD patients: a review and meta-analysis. Drugs. 2016;76(3):343–361.
- National Institute for Health and Care Excellence (NICE). Chronic obstructive pulmonary disease in over 16s: diagnosis and management. NICE guideline [NG115]. Updated 2024. nice.org.uk.
- World Health Organization (WHO). Chronic obstructive pulmonary disease (COPD). Fact sheet. who.int.
- British National Formulary (BNF). Umeclidinium bromide. NICE/BNF, 2025. bnf.nice.org.uk.
Editorial Team
iMedic Medical Editorial Team – Specialists in Pulmonology, Respiratory Medicine, and Clinical Pharmacology. All content is written by healthcare professionals with extensive clinical and academic experience.
iMedic Medical Review Board – Independent panel of medical experts who verify accuracy, currency, and adherence to international guidelines (GOLD, ERS/ATS, NICE, WHO).
This article follows the GRADE evidence framework and is based on peer-reviewed research, clinical guidelines, and official drug information sources. All medical claims are evidence-based (Level 1A where available). This content has no commercial funding and is independent of pharmaceutical company sponsorship. For our full editorial policy, see our Editorial Standards.