Surrey Heartlands

Joint Formulary & PAD

Beclometasone with formoterol and glycopyrronium (Trimbow 87/5/9) - Chronic Obstructive Pulmonary Disease (COPD)

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Status 1

Green (see narrative)
Formulations :
  • Inhaler (Metered Dose)
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
Restrictions / Comments :

Documentation

Guidelines (Local)
COPD Primary Care Medicines Management Guidelines - updated Jun 23
Guidelines (National)
NICE NG115 COPD diagnosis and management
Webpage
NICE Evidence Summary ES17 Trimbow COPD

PAD Profile

ChemicalSubstance :
Beclometasone with formoterol and glycopyrronium (Trimbow 87/5/9)
Indication :
Chronic Obstructive Pulmonary Disease (COPD)
Group Name :
Triple therapy
Keywords :
Chronic Obstructive Pulmonary Disease, LABA beta agonist, long acting, ICS, antimuscarinic, triple therapy
Brand Names Include :
Trimbow
Important Information :

Trimbow 87/5/9  (higher strengths not licensed for COPD)

Prescribe by BRAND

Latest Additions Date From :
Latest Additions Date To :
Guidelines :
Chronic Obstructive Pulmonary Disease (COPD)
Supporting Documents :
3

Other Indications

Below are listed other indications that Beclometasone with formoterol and glycopyrronium (Trimbow 87/5/9) is used to treat.

  • No records returned.

Other Drugs

Below are listed other drugs that are used to treat Chronic Obstructive Pulmonary Disease (COPD).

Committee Recommendations (1)

07 Aug 19 - Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

The locally preferred triple-therapy devices for COPD are as follows:

Low carbon:

  • Trimbow NEXThaler (dry powder)
  • Trelegy Ellipta (dry powder)

Alternative devices:

  • Trimbow (pMDI). To be used with a spacer.

Triple therapy combination inhalers are recommended as a treatment option in COPD, where clinically appropriate, in line with NICE guidance (NG115 –updated July 2019) as follows:
Before starting LAMA+LABA+ICS, conduct a clinical review to ensure that:

  • the person's non-pharmacological COPD management is optimised and they have used or been offered treatment for tobacco dependence if they smoke
  • acute episodes of worsening symptoms are caused by COPD exacerbations and not by another physical or mental health condition
  • the person's day-to-day symptoms that are adversely impacting their quality of life are caused by COPD and not by another physical or mental health condition.

For people with COPD who are taking LABA+ICS, offer LAMA+LABA+ICS if:

  • their day-to-day symptoms continue to adversely impact their quality of life or
  • they have a severe exacerbation (requiring hospitalisation) or
  • they have 2 moderate exacerbations within a year.

For people with COPD who are taking LAMA+LABA, consider LAMA+LABA+ICS if:

  • they have a severe exacerbation (requiring hospitalisation)

OR

  • they have 2 moderate exacerbations within a year.

For people with COPD who are taking LAMA+LABA and whose day-to-day symptoms adversely impact their quality of life:

  • consider a trial of LAMA+LABA+ICS, lasting for 3 months only
  • after 3 months, conduct a clinical review to establish whether or not LAMA+LABA+ICS has improved their symptoms:
    • if symptoms have not improved, stop LAMA+LABA+ICS and switch back to LAMA+LABA and consider referral to a specialist respiratory team
    • if symptoms have improved, continue with LAMA+LABA+ICS.