Drug interactions
Indacaterol-glycopyrronium + Physostigmine
Severity: Minor
Indacaterol-glycopyrronium and Physostigmine: minor interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Physostigmine inhibits acetylcholinesterase and so counteracts the antimuscarinic action of glycopyrronium. The two drugs have opposing effects, which may reduce the efficacy of either. Physostigmine is typically used to reverse anticholinergic toxicity.
What this interaction means in plain words
Indacaterol-glycopyrronium and Physostigmine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Pharmacodynamic antagonism between a cholinesterase inhibitor and a muscarinic antagonist.
What to do
No routine action is needed with inhaled glycopyrronium. Monitor for reduced antimuscarinic effect, or for cholinergic effects such as bradycardia or bronchospasm after physostigmine.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Indacaterol-glycopyrronium
Frequently asked questions
Can I take Indacaterol-glycopyrronium with Physostigmine?
MediHelp rates the interaction as minor. Indacaterol-glycopyrronium and Physostigmine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Physostigmine inhibits acetylcholinesterase and so counteracts the antimuscarinic action of glycopyrronium. The two drugs have opposing effects, which may reduce the efficacy of either. Physostigmine is typically used to reverse anticholinergic toxicity.
How serious is the interaction between Indacaterol-glycopyrronium and Physostigmine?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine action is needed with inhaled glycopyrronium. Monitor for reduced antimuscarinic effect, or for cholinergic effects such as bradycardia or bronchospasm after physostigmine.
What other medicines interact with Indacaterol-glycopyrronium?
MediHelp also lists interactions of Indacaterol-glycopyrronium with, for example, Amisulpride, Arformoterol, Arsenic trioxide. The full list is on the Indacaterol-glycopyrronium page.
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