budesonide inhaled/formoterol/glycopyrrolate inhaled (Rx)

Chronic Obstructive Pulmonary Disease

Indicated for maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD)

2 oral inhalations BID

Dosage Modifications

Renal impairment

• Formal pharmacokinetic studies not conducted; however, glycopyrronium systemic exposure increased with moderate renal impairment (ie, eGFR 45 mL/min)
• Severe (CrCl ≤30 mL/min/1.73m²) or end-stage renal disease requiring dialysis: Use if expected benefit outweighs potential risk

Hepatic impairment

• Formal pharmacokinetic studies not conducted; however, budesonide and formoterol fumarate are predominantly cleared by hepatic metabolism
• Severe hepatic disease: Closely monitor

Dosing Considerations

Limitations of use: Not indicated for relief of acute bronchospasm or treatment of asthma

Safety and efficacy not established

Contraindicated (1)

• umeclidinium bromide/vilanterol inhaled

  glycopyrrolate inhaled, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Duplicate therapy.

Serious - Use Alternative (64)

• amitriptyline

  amitriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  amitriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• amoxapine

  amoxapine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  amoxapine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• arformoterol

  arformoterol and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• artemether/lumefantrine

  formoterol and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

• chlorpromazine

  chlorpromazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• clarithromycin

  clarithromycin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• clomipramine

  clomipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  clomipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• desipramine

  desipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  desipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• disopyramide

  disopyramide and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• dofetilide

  dofetilide and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• doxepin

  doxepin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  doxepin, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dronedarone

  dronedarone and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• droperidol

  droperidol and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• entrectinib

  formoterol and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

• epinephrine

  epinephrine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• epinephrine racemic

  epinephrine racemic and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin base

  erythromycin base and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin ethylsuccinate

  erythromycin ethylsuccinate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin lactobionate

  erythromycin lactobionate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin stearate

  erythromycin stearate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• fexinidazole

  fexinidazole and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

• fluconazole

  fluconazole and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• fluphenazine

  fluphenazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• glasdegib

  formoterol and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

• glucagon

  glucagon increases toxicity of glycopyrrolate inhaled by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

• glucagon intranasal

  glucagon intranasal increases toxicity of glycopyrrolate inhaled by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

• haloperidol

  formoterol and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

• hydroxychloroquine sulfate

  hydroxychloroquine sulfate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• ibutilide

  formoterol and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

• imipramine

  imipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  imipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• indapamide

  formoterol and indapamide both increase QTc interval. Avoid or Use Alternate Drug.

• inotuzumab

  inotuzumab and formoterol both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

• isocarboxazid

  isocarboxazid increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

• ivosidenib

  ivosidenib and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

• ketoconazole

  formoterol and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

• lefamulin

  lefamulin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• linezolid

  linezolid increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

• lofepramine

  lofepramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  lofepramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• lonafarnib

  lonafarnib will increase the level or effect of budesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

• lumefantrine

  formoterol and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

• macimorelin

  budesonide inhaled, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that directly affect the pituitary secretion of growth hormone (GH) may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH growth hormone release before administering prior to administration of macimorelin. Drugs that directly affect the pituitary secretion of growth hormone (GH) may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.
  
  macimorelin and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

• maprotiline

  maprotiline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  maprotiline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• mobocertinib

  mobocertinib and formoterol both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

• moxifloxacin

  formoterol and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

• nilotinib

  formoterol and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

• nortriptyline

  nortriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  nortriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• octreotide

  formoterol and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

• octreotide (Antidote)

  formoterol and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

• ondansetron

  formoterol and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

• panobinostat

  formoterol and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

• pentamidine

  formoterol and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

• perphenazine

  perphenazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• phenelzine

  phenelzine increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

• pimozide

  formoterol and pimozide both increase QTc interval. Avoid or Use Alternate Drug.

• pitolisant

  formoterol and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

• pramlintide

  pramlintide, glycopyrrolate inhaled. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

• procainamide

  formoterol and procainamide both increase QTc interval. Avoid or Use Alternate Drug.

• prochlorperazine

  prochlorperazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• promazine

  promazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• promethazine

  promethazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• protriptyline

  protriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  protriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• quinidine

  quinidine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• revefenacin

  revefenacin and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

• sotalol

  formoterol and sotalol both increase QTc interval. Avoid or Use Alternate Drug. Drugs known to prolong the QTc interval may potentiate the cardiovascular effects of formoterol.
  
  sotalol and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Drugs known to prolong the QTc interval may potentiate the cardiovascular effects of formoterol.

Monitor Closely (313)

• abobotulinumtoxinA

  abobotulinumtoxinA increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

• acebutolol

  acebutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  acebutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• aceclofenac

  aceclofenac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• acemetacin

  acemetacin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• aclidinium

  glycopyrrolate inhaled and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• albuterol

  albuterol and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  albuterol and formoterol both decrease sedation. Use Caution/Monitor.
  
  albuterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• alfentanil

  alfentanil increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• alfuzosin

  formoterol and alfuzosin both increase QTc interval. Use Caution/Monitor.
  
  alfuzosin and formoterol both increase QTc interval. Use Caution/Monitor.

• alprazolam

  alprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• amantadine

  glycopyrrolate inhaled increases levels of amantadine by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

• amiloride

  amiloride increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• amiodarone

  amiodarone and formoterol both increase QTc interval. Use Caution/Monitor.

• amitriptyline

  amitriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.
  
  amitriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• amobarbital

  amobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• amoxapine

  glycopyrrolate inhaled and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  amoxapine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.

• amoxapine

  amoxapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• anticholinergic/sedative combos

  anticholinergic/sedative combos and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• apomorphine

  apomorphine and formoterol both increase QTc interval. Use Caution/Monitor.

• arformoterol

  arformoterol and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  arformoterol and formoterol both decrease sedation. Use Caution/Monitor.
  
  arformoterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• aripiprazole

  glycopyrrolate inhaled decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  aripiprazole and formoterol both increase QTc interval. Use Caution/Monitor.
  
  aripiprazole increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  aripiprazole increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• armodafinil

  formoterol and armodafinil both decrease sedation. Use Caution/Monitor.

• atenolol

  glycopyrrolate inhaled increases levels of atenolol by unknown mechanism. Use Caution/Monitor.

• arsenic trioxide

  arsenic trioxide and formoterol both increase QTc interval. Use Caution/Monitor.

• artemether

  artemether and formoterol both increase QTc interval. Use Caution/Monitor.

• aspirin

  aspirin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• aspirin rectal

  aspirin rectal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• aspirin/citric acid/sodium bicarbonate

  aspirin/citric acid/sodium bicarbonate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• atenolol

  atenolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  atenolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• atomoxetine

  formoterol, atomoxetine. Other (see comment). Use Caution/Monitor. Comment: Exercise caution if beta-agonists and atomoxetine are coadministered. Interaction may be less likely with inhaled beta-agonists versus those given systemically. .
  
  atomoxetine and formoterol both increase QTc interval. Use Caution/Monitor.

• atracurium

  atracurium and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• atropine

  atropine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• atropine IV/IM

  atropine IV/IM and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• azelastine

  azelastine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• azithromycin

  azithromycin and formoterol both increase QTc interval. Use Caution/Monitor.

• bedaquiline

  formoterol and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

• belladonna alkaloids

  belladonna alkaloids and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• belladonna and opium

  glycopyrrolate inhaled and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  belladonna and opium increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bendroflumethiazide

  formoterol and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.

• benperidol

  glycopyrrolate inhaled decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  benperidol increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• benperidol

  benperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• benzphetamine

  formoterol and benzphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and benzphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• benztropine

  benztropine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• betaxolol

  betaxolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  betaxolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• bethanechol

  bethanechol increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bisoprolol

  bisoprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  bisoprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• brompheniramine

  brompheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bumetanide

  formoterol and bumetanide both decrease serum potassium. Use Caution/Monitor.

• buprenorphine buccal

  buprenorphine buccal increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• butabarbital

  butabarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• butalbital

  butalbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• butorphanol

  butorphanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• caffeine

  formoterol and caffeine both decrease sedation. Use Caution/Monitor.

• carbachol

  carbachol increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• carbenoxolone

  formoterol and carbenoxolone both decrease serum potassium. Use Caution/Monitor.

• carbinoxamine

  carbinoxamine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• carvedilol

  carvedilol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  carvedilol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• celecoxib

  celecoxib increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• celiprolol

  celiprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  celiprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• ceritinib

  ceritinib and formoterol both increase QTc interval. Use Caution/Monitor.

• cevimeline

  cevimeline increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chloral hydrate

  chloral hydrate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chlordiazepoxide

  chlordiazepoxide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chlorothiazide

  formoterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.

• chlorpheniramine

  chlorpheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chlorpromazine

  glycopyrrolate inhaled decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  chlorpromazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  chlorpromazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  chlorpromazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

• chlorthalidone

  formoterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.

• cisatracurium

  cisatracurium and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• choline magnesium trisalicylate

  choline magnesium trisalicylate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• cinnarizine

  cinnarizine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• clemastine

  clemastine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• clomipramine

  clomipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  clomipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• clonazepam

  clonazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• clozapine

  glycopyrrolate inhaled decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  clozapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• clorazepate

  clorazepate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• clozapine

  clozapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• cobicistat

  cobicistat increases levels of budesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• codeine

  codeine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• cyclizine

  cyclizine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  cyclizine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• cyclobenzaprine

  cyclobenzaprine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• cyclopenthiazide

  formoterol and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.

• cyproheptadine

  cyproheptadine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• darifenacin

  darifenacin and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• dasatinib

  dasatinib and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• deflazacort

  formoterol and deflazacort both decrease serum potassium. Use Caution/Monitor.

• degarelix

  degarelix and formoterol both increase QTc interval. Use Caution/Monitor.

• desipramine

  desipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  desipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dexchlorpheniramine

  dexchlorpheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dicyclomine

  dicyclomine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• dexfenfluramine

  formoterol and dexfenfluramine both decrease sedation. Use Caution/Monitor.
  
  formoterol and dexfenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dexmedetomidine

  dexmedetomidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dexmethylphenidate

  formoterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.
  
  formoterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dextroamphetamine

  formoterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dextromoramide

  dextromoramide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diamorphine

  diamorphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dichlorphenamide

  dichlorphenamide and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  dichlorphenamide, formoterol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

• diclofenac

  diclofenac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diethylpropion

  formoterol and diethylpropion both decrease sedation. Use Caution/Monitor.
  
  formoterol and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• difenoxin hcl

  difenoxin hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diflunisal

  diflunisal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• digoxin

  glycopyrrolate inhaled increases levels of digoxin by unknown mechanism. Use Caution/Monitor.
  
  digoxin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dimenhydrinate

  dimenhydrinate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diphenhydramine

  diphenhydramine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• diphenhydramine

  diphenhydramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diphenoxylate hcl

  diphenoxylate hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dipipanone

  dipipanone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dobutamine

  dobutamine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  dobutamine and formoterol both decrease sedation. Use Caution/Monitor.
  
  dobutamine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dolasetron

  dolasetron and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• donepezil

  donepezil increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dopamine

  formoterol and dopamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dopexamine

  dopexamine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  dopexamine and formoterol both decrease sedation. Use Caution/Monitor.
  
  dopexamine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
  
  dopexamine, formoterol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.

• dosulepin

  glycopyrrolate inhaled and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

• doxepin

  glycopyrrolate inhaled and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  doxepin increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  doxepin increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• droperidol

  droperidol increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  droperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

• drospirenone

  drospirenone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• echothiophate iodide

  echothiophate iodide increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ephedrine

  ephedrine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  ephedrine and formoterol both decrease sedation. Use Caution/Monitor.
  
  ephedrine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• epinephrine

  epinephrine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  epinephrine and formoterol both decrease sedation. Use Caution/Monitor.
  
  epinephrine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• epinephrine racemic

  formoterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.
  
  formoterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• escitalopram

  escitalopram increases toxicity of formoterol by QTc interval. Use Caution/Monitor.

• esmolol

  esmolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  esmolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• estazolam

  estazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ethacrynic acid

  formoterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

• ethanol

  ethanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• etodolac

  etodolac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fenfluramine

  formoterol and fenfluramine both decrease sedation. Use Caution/Monitor.
  
  formoterol and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• fenoprofen

  fenoprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fesoterodine

  fesoterodine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• flavoxate

  flavoxate and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• flecainide

  flecainide and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• fluoxetine

  fluoxetine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely. Fluoxetine prolongs the QT interval; the prescribing information for fluoxetine recommends avoiding concurrent use of other drugs that may prolong the QT interval; risk may be increased with higher doses and/or when associated with hypokalemia; drugs that prolong the QTc interval may potentiate the effects of beta2 agonists on the cardiovascular system

• fluphenazine

  fluphenazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  fluphenazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  fluphenazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• flurazepam

  flurazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• galantamine

  galantamine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• flurbiprofen

  flurbiprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fluvoxamine

  fluvoxamine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• foscarnet

  formoterol and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

• fostemsavir

  formoterol and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

• furosemide

  formoterol and furosemide both decrease serum potassium. Use Caution/Monitor.

• gentamicin

  formoterol and gentamicin both decrease serum potassium. Use Caution/Monitor.

• glycopyrronium tosylate topical

  glycopyrronium tosylate topical, glycopyrrolate inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

• goserelin

  goserelin increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• haloperidol

  haloperidol increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  haloperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• henbane

  glycopyrrolate inhaled and henbane both decrease cholinergic effects/transmission. Use Caution/Monitor.

• histrelin

  histrelin increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• homatropine

  glycopyrrolate inhaled and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• huperzine A

  huperzine A increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hydrochlorothiazide

  formoterol and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.

• hydromorphone

  hydromorphone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hydroxyzine

  hydroxyzine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hyoscyamine

  glycopyrrolate inhaled and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• hyoscyamine spray

  glycopyrrolate inhaled and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

• ibuprofen

  ibuprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ibuprofen IV

  ibuprofen IV increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• iloperidone

  glycopyrrolate inhaled decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  iloperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  iloperidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  formoterol and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.

• imipramine

  glycopyrrolate inhaled and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  imipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  imipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• indapamide

  formoterol and indapamide both decrease serum potassium. Use Caution/Monitor.

• ipratropium

  glycopyrrolate inhaled and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• indomethacin

  indomethacin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• isoproterenol

  formoterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and isoproterenol both decrease sedation. Use Caution/Monitor.
  
  formoterol and isoproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• ketoprofen

  ketoprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ketorolac

  ketorolac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ketorolac intranasal

  ketorolac intranasal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ketotifen, ophthalmic

  ketotifen, ophthalmic increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• labetalol

  labetalol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  labetalol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• lapatinib

  formoterol and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.

• lenvatinib

  formoterol and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

• leuprolide

  leuprolide increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• levalbuterol

  formoterol and levalbuterol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and levalbuterol both decrease sedation. Use Caution/Monitor.
  
  formoterol and levalbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• levodopa

  glycopyrrolate inhaled, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

• levofloxacin

  formoterol and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• levorphanol

  levorphanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lisdexamfetamine

  formoterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• lofepramine

  glycopyrrolate inhaled and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  lofepramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lofexidine

  lofexidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• loxapine

  glycopyrrolate inhaled decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  loxapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• loprazolam

  loprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lorazepam

  lorazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lormetazepam

  lormetazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lornoxicam

  lornoxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• loxapine

  loxapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• loxapine inhaled

  glycopyrrolate inhaled decreases levels of loxapine inhaled by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.
  
  loxapine inhaled increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  loxapine inhaled increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• maprotiline

  glycopyrrolate inhaled and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  maprotiline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  maprotiline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• marijuana

  marijuana increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meclizine

  glycopyrrolate inhaled and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• meclofenamate

  meclofenamate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• mefenamic acid

  mefenamic acid increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• melatonin

  melatonin increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meloxicam

  meloxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meperidine

  meperidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meprobamate

  meprobamate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• metaproterenol

  formoterol and metaproterenol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and metaproterenol both decrease sedation. Use Caution/Monitor.
  
  formoterol and metaproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• methadone

  formoterol and methadone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  methadone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• methamphetamine

  formoterol and methamphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• methscopolamine

  glycopyrrolate inhaled and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• methyclothiazide

  formoterol and methyclothiazide both decrease serum potassium. Use Caution/Monitor.

• methylenedioxymethamphetamine

  formoterol and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• methylphenidate

  formoterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• metolazone

  formoterol and metolazone both decrease serum potassium. Use Caution/Monitor.

• metoprolol

  metoprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  metoprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• midazolam

  midazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• midodrine

  formoterol and midodrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• mifepristone

  mifepristone, formoterol. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

• mirtazapine

  mirtazapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• modafinil

  formoterol and modafinil both decrease sedation. Use Caution/Monitor.

• morphine

  morphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• motherwort

  motherwort increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• moxonidine

  moxonidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nabilone

  nabilone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nabumetone

  nabumetone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nadolol

  nadolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  nadolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• nalbuphine

  nalbuphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• naproxen

  naproxen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nebivolol

  nebivolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  nebivolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• neostigmine

  neostigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• norepinephrine

  formoterol and norepinephrine both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and norepinephrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and norepinephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• nortriptyline

  glycopyrrolate inhaled and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  nortriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  nortriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ofloxacin

  formoterol and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• olanzapine

  glycopyrrolate inhaled decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  olanzapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• olanzapine

  olanzapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• olodaterol inhaled

  formoterol and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects

• onabotulinumtoxinA

  onabotulinumtoxinA and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• opium tincture

  opium tincture increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• orphenadrine

  glycopyrrolate inhaled and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• osilodrostat

  osilodrostat and formoterol both increase QTc interval. Use Caution/Monitor.

• osimertinib

  osimertinib and formoterol both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

• oxaliplatin

  oxaliplatin will increase the level or effect of formoterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

• oxaprozin

  oxaprozin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• oxazepam

  oxazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• oxybutynin

  glycopyrrolate inhaled and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin topical

  glycopyrrolate inhaled and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin transdermal

  glycopyrrolate inhaled and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxycodone

  oxycodone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• oxymorphone

  oxymorphone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ozanimod

  ozanimod and formoterol both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

• paliperidone

  paliperidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  paliperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  formoterol and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

• pancuronium

  glycopyrrolate inhaled and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• papaveretum

  papaveretum increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• parecoxib

  parecoxib increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• paroxetine

  formoterol and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

• pasireotide

  formoterol and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

• pazopanib

  formoterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• penbutolol

  penbutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  penbutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• pentazocine

  pentazocine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pentobarbital

  pentobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• perphenazine

  perphenazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  perphenazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  perphenazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phendimetrazine

  formoterol and phendimetrazine both decrease sedation. Use Caution/Monitor.
  
  formoterol and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• physostigmine

  physostigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenobarbital

  phenobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenoxybenzamine

  phenoxybenzamine, formoterol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

• phentermine

  formoterol and phentermine both decrease sedation. Use Caution/Monitor.
  
  formoterol and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• phenylephrine

  formoterol and phenylephrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• phenylephrine PO

  formoterol and phenylephrine PO both decrease sedation. Use Caution/Monitor.
  
  formoterol and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• pholcodine

  pholcodine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pilocarpine

  pilocarpine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pilocarpine ophthalmic

  pilocarpine ophthalmic increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pimozide

  glycopyrrolate inhaled decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
  
  pimozide increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  pimozide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pindolol

  pindolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  pindolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• pralidoxime

  glycopyrrolate inhaled and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.

• pirbuterol

  formoterol and pirbuterol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and pirbuterol both decrease sedation. Use Caution/Monitor.
  
  formoterol and pirbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• piroxicam

  piroxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• posaconazole

  formoterol and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• potassium acid phosphate

  potassium acid phosphate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• potassium chloride

  potassium chloride increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• potassium citrate

  potassium citrate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• primidone

  primidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• procarbazine

  procarbazine increases effects of formoterol by pharmacodynamic synergism. Use Caution/Monitor.

• prochlorperazine

  glycopyrrolate inhaled decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  prochlorperazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  prochlorperazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• promethazine

  promethazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  promethazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

• propantheline

  glycopyrrolate inhaled and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.

• propranolol

  propranolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  propranolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• propylhexedrine

  formoterol and propylhexedrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• protriptyline

  protriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  protriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.

• pseudoephedrine

  formoterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• pyridostigmine

  pyridostigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• quazepam

  quazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• quetiapine

  glycopyrrolate inhaled decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  quetiapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  quetiapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• quinine

  formoterol and quinine both increase QTc interval. Use Caution/Monitor.

• rapacuronium

  glycopyrrolate inhaled and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• ranolazine

  formoterol and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

• ribociclib

  ribociclib increases toxicity of formoterol by QTc interval. Use Caution/Monitor.

• rimantadine

  glycopyrrolate inhaled, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

• risperidone

  risperidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  formoterol and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  glycopyrrolate inhaled decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  risperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• rivastigmine

  rivastigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• sacubitril/valsartan

  sacubitril/valsartan increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• rocuronium

  glycopyrrolate inhaled and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• salicylates (non-asa)

  salicylates (non-asa) increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• salmeterol

  formoterol and salmeterol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and salmeterol both decrease sedation. Use Caution/Monitor.
  
  formoterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• salsalate

  salsalate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• scopolamine

  glycopyrrolate inhaled and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• scullcap

  scullcap increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• secobarbital

  secobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• selpercatinib

  selpercatinib increases toxicity of formoterol by QTc interval. Use Caution/Monitor.

• shepherd's purse

  shepherd's purse increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

  formoterol and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.

• solifenacin

  glycopyrrolate inhaled and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.

• solriamfetol

  formoterol and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• sorafenib

  sorafenib and formoterol both increase QTc interval. Use Caution/Monitor.

• sotalol

  sotalol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  sotalol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

• spironolactone

  spironolactone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• stiripentol

  stiripentol will increase the level or effect of budesonide inhaled by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.

• succinylcholine

  succinylcholine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  succinylcholine increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• thioridazine

  glycopyrrolate inhaled decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  thioridazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• thiothixene

  glycopyrrolate inhaled decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
  
  thiothixene increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• tiotropium

  glycopyrrolate inhaled and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tolterodine

  glycopyrrolate inhaled and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• trifluoperazine

  glycopyrrolate inhaled decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  trifluoperazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• trihexyphenidyl

  glycopyrrolate inhaled and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

• trimipramine

  glycopyrrolate inhaled and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  trimipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.

• trospium chloride

  glycopyrrolate inhaled and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

• umeclidinium bromide

  umeclidinium bromide and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents

• vecuronium

  glycopyrrolate inhaled and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• ziprasidone

  glycopyrrolate inhaled decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  ziprasidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• zotepine

  glycopyrrolate inhaled decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.

Minor (28)

• bendroflumethiazide

  formoterol, bendroflumethiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• bumetanide

  formoterol, bumetanide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• chloroquine

  chloroquine increases toxicity of formoterol by QTc interval. Minor/Significance Unknown.

• chlorothiazide

  formoterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• chlorthalidone

  formoterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• cyclopenthiazide

  formoterol, cyclopenthiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• desipramine

  glycopyrrolate inhaled and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• dimenhydrinate

  dimenhydrinate increases toxicity of glycopyrrolate inhaled by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

• donepezil

  donepezil decreases effects of glycopyrrolate inhaled by pharmacodynamic antagonism. Minor/Significance Unknown.

• ethacrynic acid

  formoterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• eucalyptus

  eucalyptus increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• furosemide

  formoterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• galantamine

  galantamine decreases effects of glycopyrrolate inhaled by pharmacodynamic antagonism. Minor/Significance Unknown.

• green tea

  green tea increases effects of formoterol by pharmacodynamic synergism. Minor/Significance Unknown. Due to caffeine content. Combination may increase CNS stimulatory effects due to caffeine in green tea.

• hydrochlorothiazide

  formoterol, hydrochlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• indapamide

  formoterol, indapamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• lofepramine

  lofepramine increases levels of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• methyclothiazide

  formoterol, methyclothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• metolazone

  formoterol, metolazone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• noni juice

  noni juice increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• prochlorperazine

  prochlorperazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• promazine

  promazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• promethazine

  promethazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• rimantadine

  rimantadine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Minor/Significance Unknown.

• sage

  sage increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• thioridazine

  thioridazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• torsemide

  formoterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• trazodone

  glycopyrrolate inhaled and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.
  
  trazodone increases levels of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• abobotulinumtoxinA

  Monitor Closely (1)abobotulinumtoxinA increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

• acebutolol

  Monitor Closely (2)acebutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  acebutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• aceclofenac

  Monitor Closely (1)aceclofenac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• acemetacin

  Monitor Closely (1)acemetacin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• aclidinium

  Monitor Closely (1)glycopyrrolate inhaled and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• albuterol

  Monitor Closely (3)albuterol and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  albuterol and formoterol both decrease sedation. Use Caution/Monitor.
  
  albuterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• alfentanil

  Monitor Closely (1)alfentanil increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• alfuzosin

  Monitor Closely (2)formoterol and alfuzosin both increase QTc interval. Use Caution/Monitor.
  
  alfuzosin and formoterol both increase QTc interval. Use Caution/Monitor.

• alprazolam

  Monitor Closely (1)alprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• amantadine

  Monitor Closely (2)glycopyrrolate inhaled increases levels of amantadine by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

• amiloride

  Monitor Closely (1)amiloride increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• amiodarone

  Monitor Closely (1)amiodarone and formoterol both increase QTc interval. Use Caution/Monitor.

• amitriptyline

  Monitor Closely (3)amitriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  amitriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)amitriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
  
  amitriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• amobarbital

  Monitor Closely (1)amobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• amoxapine

  Monitor Closely (3)glycopyrrolate inhaled and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  amoxapine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  amoxapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)amoxapine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
  
  amoxapine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• anticholinergic/sedative combos

  Monitor Closely (1)anticholinergic/sedative combos and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• apomorphine

  Monitor Closely (1)apomorphine and formoterol both increase QTc interval. Use Caution/Monitor.

• arformoterol

  Monitor Closely (3)arformoterol and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  arformoterol and formoterol both decrease sedation. Use Caution/Monitor.
  
  arformoterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.Serious - Use Alternative (1)arformoterol and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• aripiprazole

  Monitor Closely (5)glycopyrrolate inhaled decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
  
  aripiprazole and formoterol both increase QTc interval. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  aripiprazole increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  aripiprazole increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• armodafinil

  Monitor Closely (1)formoterol and armodafinil both decrease sedation. Use Caution/Monitor.

• arsenic trioxide

  Monitor Closely (1)arsenic trioxide and formoterol both increase QTc interval. Use Caution/Monitor.

• artemether

  Monitor Closely (1)artemether and formoterol both increase QTc interval. Use Caution/Monitor.

• artemether/lumefantrine

  Serious - Use Alternative (1)formoterol and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

• aspirin

  Monitor Closely (1)aspirin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• aspirin rectal

  Monitor Closely (1)aspirin rectal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• aspirin/citric acid/sodium bicarbonate

  Monitor Closely (1)aspirin/citric acid/sodium bicarbonate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• atenolol

  Monitor Closely (3)atenolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled increases levels of atenolol by unknown mechanism. Use Caution/Monitor.
  
  atenolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• atomoxetine

  Monitor Closely (2)atomoxetine and formoterol both increase QTc interval. Use Caution/Monitor.
  
  formoterol, atomoxetine. Other (see comment). Use Caution/Monitor. Comment: Exercise caution if beta-agonists and atomoxetine are coadministered. Interaction may be less likely with inhaled beta-agonists versus those given systemically. .

• atracurium

  Monitor Closely (1)atracurium and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• atropine

  Monitor Closely (1)atropine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• atropine IV/IM

  Monitor Closely (1)atropine IV/IM and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• azelastine

  Monitor Closely (1)azelastine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• azithromycin

  Monitor Closely (1)azithromycin and formoterol both increase QTc interval. Use Caution/Monitor.

• bedaquiline

  Monitor Closely (1)formoterol and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

• belladonna alkaloids

  Monitor Closely (1)belladonna alkaloids and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• belladonna and opium

  Monitor Closely (2)glycopyrrolate inhaled and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  belladonna and opium increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bendroflumethiazide

  Monitor Closely (1)formoterol and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, bendroflumethiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• benperidol

  Monitor Closely (4)glycopyrrolate inhaled decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  benperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  benperidol increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• benzphetamine

  Monitor Closely (2)formoterol and benzphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and benzphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• benztropine

  Monitor Closely (1)benztropine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• betaxolol

  Monitor Closely (2)betaxolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  betaxolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bethanechol

  Monitor Closely (1)bethanechol increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bisoprolol

  Monitor Closely (2)bisoprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  bisoprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• brompheniramine

  Monitor Closely (1)brompheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bumetanide

  Monitor Closely (1)formoterol and bumetanide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, bumetanide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• buprenorphine buccal

  Monitor Closely (1)buprenorphine buccal increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• butabarbital

  Monitor Closely (1)butabarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• butalbital

  Monitor Closely (1)butalbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• butorphanol

  Monitor Closely (1)butorphanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• caffeine

  Monitor Closely (1)formoterol and caffeine both decrease sedation. Use Caution/Monitor.

• carbachol

  Monitor Closely (1)carbachol increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• carbenoxolone

  Monitor Closely (1)formoterol and carbenoxolone both decrease serum potassium. Use Caution/Monitor.

• carbinoxamine

  Monitor Closely (1)carbinoxamine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• carvedilol

  Monitor Closely (2)carvedilol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  carvedilol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• celecoxib

  Monitor Closely (1)celecoxib increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• celiprolol

  Monitor Closely (2)celiprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  celiprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ceritinib

  Monitor Closely (1)ceritinib and formoterol both increase QTc interval. Use Caution/Monitor.

• cevimeline

  Monitor Closely (1)cevimeline increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chloral hydrate

  Monitor Closely (1)chloral hydrate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chlordiazepoxide

  Monitor Closely (1)chlordiazepoxide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chloroquine

  Minor (1)chloroquine increases toxicity of formoterol by QTc interval. Minor/Significance Unknown.

• chlorothiazide

  Monitor Closely (1)formoterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• chlorpheniramine

  Monitor Closely (1)chlorpheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• chlorpromazine

  Monitor Closely (5)glycopyrrolate inhaled decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  chlorpromazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  chlorpromazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  chlorpromazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.Serious - Use Alternative (1)chlorpromazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• chlorthalidone

  Monitor Closely (1)formoterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• choline magnesium trisalicylate

  Monitor Closely (1)choline magnesium trisalicylate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• cinnarizine

  Monitor Closely (1)cinnarizine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• cisatracurium

  Monitor Closely (1)cisatracurium and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• clarithromycin

  Serious - Use Alternative (1)clarithromycin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• clemastine

  Monitor Closely (1)clemastine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• clomipramine

  Monitor Closely (3)clomipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  clomipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
  
  clomipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• clonazepam

  Monitor Closely (1)clonazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• clorazepate

  Monitor Closely (1)clorazepate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• clozapine

  Monitor Closely (4)glycopyrrolate inhaled decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  clozapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  clozapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• cobicistat

  Monitor Closely (1)cobicistat increases levels of budesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• codeine

  Monitor Closely (1)codeine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• cyclizine

  Monitor Closely (2)cyclizine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  cyclizine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• cyclobenzaprine

  Monitor Closely (1)cyclobenzaprine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• cyclopenthiazide

  Monitor Closely (1)formoterol and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, cyclopenthiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• cyproheptadine

  Monitor Closely (1)cyproheptadine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• darifenacin

  Monitor Closely (1)darifenacin and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• dasatinib

  Monitor Closely (1)dasatinib and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• deflazacort

  Monitor Closely (1)formoterol and deflazacort both decrease serum potassium. Use Caution/Monitor.

• degarelix

  Monitor Closely (1)degarelix and formoterol both increase QTc interval. Use Caution/Monitor.

• desipramine

  Monitor Closely (2)desipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  desipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)desipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  desipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.Minor (1)glycopyrrolate inhaled and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• dexchlorpheniramine

  Monitor Closely (1)dexchlorpheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dexfenfluramine

  Monitor Closely (2)formoterol and dexfenfluramine both decrease sedation. Use Caution/Monitor.
  
  formoterol and dexfenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dexmedetomidine

  Monitor Closely (1)dexmedetomidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dexmethylphenidate

  Monitor Closely (2)formoterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.
  
  formoterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dextroamphetamine

  Monitor Closely (2)formoterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dextromoramide

  Monitor Closely (1)dextromoramide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diamorphine

  Monitor Closely (1)diamorphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dichlorphenamide

  Monitor Closely (2)dichlorphenamide and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  dichlorphenamide, formoterol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

• diclofenac

  Monitor Closely (1)diclofenac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dicyclomine

  Monitor Closely (1)dicyclomine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• diethylpropion

  Monitor Closely (2)formoterol and diethylpropion both decrease sedation. Use Caution/Monitor.
  
  formoterol and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• difenoxin hcl

  Monitor Closely (1)difenoxin hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• diflunisal

  Monitor Closely (1)diflunisal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• digoxin

  Monitor Closely (2)glycopyrrolate inhaled increases levels of digoxin by unknown mechanism. Use Caution/Monitor.
  
  digoxin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dimenhydrinate

  Monitor Closely (1)dimenhydrinate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dimenhydrinate increases toxicity of glycopyrrolate inhaled by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

• diphenhydramine

  Monitor Closely (2)diphenhydramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  diphenhydramine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• diphenoxylate hcl

  Monitor Closely (1)diphenoxylate hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dipipanone

  Monitor Closely (1)dipipanone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• disopyramide

  Serious - Use Alternative (1)disopyramide and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• dobutamine

  Monitor Closely (3)dobutamine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  dobutamine and formoterol both decrease sedation. Use Caution/Monitor.
  
  dobutamine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dofetilide

  Serious - Use Alternative (1)dofetilide and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• dolasetron

  Monitor Closely (1)dolasetron and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• donepezil

  Monitor Closely (1)donepezil increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)donepezil decreases effects of glycopyrrolate inhaled by pharmacodynamic antagonism. Minor/Significance Unknown.

• dopamine

  Monitor Closely (2)formoterol and dopamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dopexamine

  Monitor Closely (4)dopexamine, formoterol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.
  
  dopexamine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  dopexamine and formoterol both decrease sedation. Use Caution/Monitor.
  
  dopexamine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• dosulepin

  Monitor Closely (1)glycopyrrolate inhaled and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

• doxepin

  Monitor Closely (3)glycopyrrolate inhaled and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  doxepin increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  doxepin increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)doxepin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  doxepin, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dronedarone

  Serious - Use Alternative (1)dronedarone and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• droperidol

  Monitor Closely (4)droperidol increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  droperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.Serious - Use Alternative (1)droperidol and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• drospirenone

  Monitor Closely (1)drospirenone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• echothiophate iodide

  Monitor Closely (1)echothiophate iodide increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• entrectinib

  Serious - Use Alternative (1)formoterol and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

• ephedrine

  Monitor Closely (3)ephedrine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  ephedrine and formoterol both decrease sedation. Use Caution/Monitor.
  
  ephedrine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• epinephrine

  Monitor Closely (3)epinephrine and formoterol both decrease serum potassium. Use Caution/Monitor.
  
  epinephrine and formoterol both decrease sedation. Use Caution/Monitor.
  
  epinephrine and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.Serious - Use Alternative (1)epinephrine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• epinephrine racemic

  Monitor Closely (3)formoterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.
  
  formoterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.Serious - Use Alternative (1)epinephrine racemic and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin base

  Serious - Use Alternative (1)erythromycin base and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin ethylsuccinate

  Serious - Use Alternative (1)erythromycin ethylsuccinate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin lactobionate

  Serious - Use Alternative (1)erythromycin lactobionate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin stearate

  Serious - Use Alternative (1)erythromycin stearate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• escitalopram

  Monitor Closely (1)escitalopram increases toxicity of formoterol by QTc interval. Use Caution/Monitor.

• esmolol

  Monitor Closely (2)esmolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  esmolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• estazolam

  Monitor Closely (1)estazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ethacrynic acid

  Monitor Closely (1)formoterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• ethanol

  Monitor Closely (1)ethanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• etodolac

  Monitor Closely (1)etodolac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• eucalyptus

  Minor (1)eucalyptus increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• fenfluramine

  Monitor Closely (2)formoterol and fenfluramine both decrease sedation. Use Caution/Monitor.
  
  formoterol and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• fenoprofen

  Monitor Closely (1)fenoprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fesoterodine

  Monitor Closely (1)fesoterodine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• fexinidazole

  Serious - Use Alternative (1)fexinidazole and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

• flavoxate

  Monitor Closely (1)flavoxate and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• flecainide

  Monitor Closely (1)flecainide and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• fluconazole

  Serious - Use Alternative (1)fluconazole and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• fluoxetine

  Monitor Closely (1)fluoxetine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely. Fluoxetine prolongs the QT interval; the prescribing information for fluoxetine recommends avoiding concurrent use of other drugs that may prolong the QT interval; risk may be increased with higher doses and/or when associated with hypokalemia; drugs that prolong the QTc interval may potentiate the effects of beta2 agonists on the cardiovascular system

• fluphenazine

  Monitor Closely (5)fluphenazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  fluphenazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  fluphenazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• flurazepam

  Monitor Closely (1)flurazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• flurbiprofen

  Monitor Closely (1)flurbiprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fluvoxamine

  Monitor Closely (1)fluvoxamine and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• foscarnet

  Monitor Closely (1)formoterol and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

• fostemsavir

  Monitor Closely (1)formoterol and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

• furosemide

  Monitor Closely (1)formoterol and furosemide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• galantamine

  Monitor Closely (1)galantamine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)galantamine decreases effects of glycopyrrolate inhaled by pharmacodynamic antagonism. Minor/Significance Unknown.

• gentamicin

  Monitor Closely (1)formoterol and gentamicin both decrease serum potassium. Use Caution/Monitor.

• glasdegib

  Serious - Use Alternative (1)formoterol and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

• glucagon

  Serious - Use Alternative (1)glucagon increases toxicity of glycopyrrolate inhaled by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

• glucagon intranasal

  Serious - Use Alternative (1)glucagon intranasal increases toxicity of glycopyrrolate inhaled by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

• glycopyrronium tosylate topical

  Monitor Closely (1)glycopyrronium tosylate topical, glycopyrrolate inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

• goserelin

  Monitor Closely (1)goserelin increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• green tea

  Minor (1)green tea increases effects of formoterol by pharmacodynamic synergism. Minor/Significance Unknown. Due to caffeine content. Combination may increase CNS stimulatory effects due to caffeine in green tea.

• haloperidol

  Monitor Closely (4)haloperidol increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  haloperidol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.Serious - Use Alternative (1)formoterol and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

• henbane

  Monitor Closely (1)glycopyrrolate inhaled and henbane both decrease cholinergic effects/transmission. Use Caution/Monitor.

• histrelin

  Monitor Closely (1)histrelin increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• homatropine

  Monitor Closely (1)glycopyrrolate inhaled and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• huperzine A

  Monitor Closely (1)huperzine A increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hydrochlorothiazide

  Monitor Closely (1)formoterol and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, hydrochlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• hydromorphone

  Monitor Closely (1)hydromorphone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hydroxychloroquine sulfate

  Serious - Use Alternative (1)hydroxychloroquine sulfate and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• hydroxyzine

  Monitor Closely (1)hydroxyzine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hyoscyamine

  Monitor Closely (1)glycopyrrolate inhaled and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• hyoscyamine spray

  Monitor Closely (1)glycopyrrolate inhaled and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

• ibuprofen

  Monitor Closely (1)ibuprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ibuprofen IV

  Monitor Closely (1)ibuprofen IV increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ibutilide

  Serious - Use Alternative (1)formoterol and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

• iloperidone

  Monitor Closely (5)iloperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  iloperidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  formoterol and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.

• imipramine

  Monitor Closely (3)glycopyrrolate inhaled and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  imipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  imipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)imipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  imipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• indapamide

  Monitor Closely (1)formoterol and indapamide both decrease serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)formoterol and indapamide both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)formoterol, indapamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• indomethacin

  Monitor Closely (1)indomethacin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• inotuzumab

  Serious - Use Alternative (1)inotuzumab and formoterol both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

• ipratropium

  Monitor Closely (1)glycopyrrolate inhaled and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• isocarboxazid

  Serious - Use Alternative (1)isocarboxazid increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

• isoproterenol

  Monitor Closely (3)formoterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and isoproterenol both decrease sedation. Use Caution/Monitor.
  
  formoterol and isoproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• ivosidenib

  Serious - Use Alternative (1)ivosidenib and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

• ketoconazole

  Serious - Use Alternative (1)formoterol and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

• ketoprofen

  Monitor Closely (1)ketoprofen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ketorolac

  Monitor Closely (1)ketorolac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ketorolac intranasal

  Monitor Closely (1)ketorolac intranasal increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ketotifen, ophthalmic

  Monitor Closely (1)ketotifen, ophthalmic increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• labetalol

  Monitor Closely (2)labetalol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  labetalol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lapatinib

  Monitor Closely (1)formoterol and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.

• lefamulin

  Serious - Use Alternative (1)lefamulin and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• lenvatinib

  Monitor Closely (1)formoterol and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

• leuprolide

  Monitor Closely (1)leuprolide increases toxicity of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• levalbuterol

  Monitor Closely (3)formoterol and levalbuterol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and levalbuterol both decrease sedation. Use Caution/Monitor.
  
  formoterol and levalbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• levodopa

  Monitor Closely (1)glycopyrrolate inhaled, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

• levofloxacin

  Monitor Closely (1)formoterol and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• levorphanol

  Monitor Closely (1)levorphanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• linezolid

  Serious - Use Alternative (1)linezolid increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

• lisdexamfetamine

  Monitor Closely (2)formoterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• lofepramine

  Monitor Closely (2)glycopyrrolate inhaled and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  lofepramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)lofepramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  lofepramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.Minor (1)lofepramine increases levels of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• lofexidine

  Monitor Closely (1)lofexidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lonafarnib

  Serious - Use Alternative (1)lonafarnib will increase the level or effect of budesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

• loprazolam

  Monitor Closely (1)loprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lorazepam

  Monitor Closely (1)lorazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lormetazepam

  Monitor Closely (1)lormetazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lornoxicam

  Monitor Closely (1)lornoxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• loxapine

  Monitor Closely (4)loxapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  loxapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

• loxapine inhaled

  Monitor Closely (4)glycopyrrolate inhaled decreases levels of loxapine inhaled by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.
  
  loxapine inhaled increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  loxapine inhaled increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lumefantrine

  Serious - Use Alternative (1)formoterol and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

• macimorelin

  Serious - Use Alternative (2)macimorelin and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
  
  budesonide inhaled, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that directly affect the pituitary secretion of growth hormone (GH) may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH growth hormone release before administering prior to administration of macimorelin. Drugs that directly affect the pituitary secretion of growth hormone (GH) may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.

• maprotiline

  Monitor Closely (3)glycopyrrolate inhaled and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  maprotiline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  maprotiline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)maprotiline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
  
  maprotiline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• marijuana

  Monitor Closely (1)marijuana increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meclizine

  Monitor Closely (1)glycopyrrolate inhaled and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• meclofenamate

  Monitor Closely (1)meclofenamate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• mefenamic acid

  Monitor Closely (1)mefenamic acid increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• melatonin

  Monitor Closely (1)melatonin increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meloxicam

  Monitor Closely (1)meloxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meperidine

  Monitor Closely (1)meperidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• meprobamate

  Monitor Closely (1)meprobamate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• metaproterenol

  Monitor Closely (3)formoterol and metaproterenol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and metaproterenol both decrease sedation. Use Caution/Monitor.
  
  formoterol and metaproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• methadone

  Monitor Closely (2)formoterol and methadone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  methadone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• methamphetamine

  Monitor Closely (2)formoterol and methamphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• methscopolamine

  Monitor Closely (1)glycopyrrolate inhaled and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• methyclothiazide

  Monitor Closely (1)formoterol and methyclothiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, methyclothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• methylenedioxymethamphetamine

  Monitor Closely (2)formoterol and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.
  
  formoterol and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• methylphenidate

  Monitor Closely (1)formoterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• metolazone

  Monitor Closely (1)formoterol and metolazone both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, metolazone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• metoprolol

  Monitor Closely (2)metoprolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  metoprolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• midazolam

  Monitor Closely (1)midazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• midodrine

  Monitor Closely (2)formoterol and midodrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• mifepristone

  Monitor Closely (1)mifepristone, formoterol. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

• mirtazapine

  Monitor Closely (1)mirtazapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• mobocertinib

  Serious - Use Alternative (1)mobocertinib and formoterol both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

• modafinil

  Monitor Closely (1)formoterol and modafinil both decrease sedation. Use Caution/Monitor.

• morphine

  Monitor Closely (1)morphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• motherwort

  Monitor Closely (1)motherwort increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• moxifloxacin

  Serious - Use Alternative (1)formoterol and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

• moxonidine

  Monitor Closely (1)moxonidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nabilone

  Monitor Closely (1)nabilone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nabumetone

  Monitor Closely (1)nabumetone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nadolol

  Monitor Closely (2)nadolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  nadolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nalbuphine

  Monitor Closely (1)nalbuphine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• naproxen

  Monitor Closely (1)naproxen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nebivolol

  Monitor Closely (2)nebivolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  nebivolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• neostigmine

  Monitor Closely (1)neostigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nilotinib

  Serious - Use Alternative (1)formoterol and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

• noni juice

  Minor (1)noni juice increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• norepinephrine

  Monitor Closely (3)formoterol and norepinephrine both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and norepinephrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and norepinephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• nortriptyline

  Monitor Closely (3)glycopyrrolate inhaled and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  nortriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  nortriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)nortriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
  
  nortriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• octreotide

  Serious - Use Alternative (1)formoterol and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

• octreotide (Antidote)

  Serious - Use Alternative (1)formoterol and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

• ofloxacin

  Monitor Closely (1)formoterol and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• olanzapine

  Monitor Closely (4)olanzapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  olanzapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

• olodaterol inhaled

  Monitor Closely (1)formoterol and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects

• onabotulinumtoxinA

  Monitor Closely (1)onabotulinumtoxinA and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

• ondansetron

  Serious - Use Alternative (1)formoterol and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

• opium tincture

  Monitor Closely (1)opium tincture increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• orphenadrine

  Monitor Closely (1)glycopyrrolate inhaled and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• osilodrostat

  Monitor Closely (1)osilodrostat and formoterol both increase QTc interval. Use Caution/Monitor.

• osimertinib

  Monitor Closely (1)osimertinib and formoterol both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

• oxaliplatin

  Monitor Closely (1)oxaliplatin will increase the level or effect of formoterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

• oxaprozin

  Monitor Closely (1)oxaprozin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• oxazepam

  Monitor Closely (1)oxazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• oxybutynin

  Monitor Closely (1)glycopyrrolate inhaled and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin topical

  Monitor Closely (1)glycopyrrolate inhaled and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin transdermal

  Monitor Closely (1)glycopyrrolate inhaled and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxycodone

  Monitor Closely (1)oxycodone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• oxymorphone

  Monitor Closely (1)oxymorphone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ozanimod

  Monitor Closely (1)ozanimod and formoterol both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

• paliperidone

  Monitor Closely (5)paliperidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  paliperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  formoterol and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

• pancuronium

  Monitor Closely (1)glycopyrrolate inhaled and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• panobinostat

  Serious - Use Alternative (1)formoterol and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

• papaveretum

  Monitor Closely (1)papaveretum increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• parecoxib

  Monitor Closely (1)parecoxib increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• paroxetine

  Monitor Closely (1)formoterol and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

• pasireotide

  Monitor Closely (1)formoterol and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

• pazopanib

  Monitor Closely (1)formoterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• penbutolol

  Monitor Closely (2)penbutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  penbutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pentamidine

  Serious - Use Alternative (1)formoterol and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

• pentazocine

  Monitor Closely (1)pentazocine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pentobarbital

  Monitor Closely (1)pentobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• perphenazine

  Monitor Closely (5)perphenazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  perphenazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  perphenazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)perphenazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• phendimetrazine

  Monitor Closely (2)formoterol and phendimetrazine both decrease sedation. Use Caution/Monitor.
  
  formoterol and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• phenelzine

  Serious - Use Alternative (1)phenelzine increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

• phenobarbital

  Monitor Closely (1)phenobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenoxybenzamine

  Monitor Closely (1)phenoxybenzamine, formoterol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

• phentermine

  Monitor Closely (2)formoterol and phentermine both decrease sedation. Use Caution/Monitor.
  
  formoterol and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• phenylephrine

  Monitor Closely (2)formoterol and phenylephrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• phenylephrine PO

  Monitor Closely (2)formoterol and phenylephrine PO both decrease sedation. Use Caution/Monitor.
  
  formoterol and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• pholcodine

  Monitor Closely (1)pholcodine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• physostigmine

  Monitor Closely (1)physostigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pilocarpine

  Monitor Closely (1)pilocarpine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pilocarpine ophthalmic

  Monitor Closely (1)pilocarpine ophthalmic increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pimozide

  Monitor Closely (4)glycopyrrolate inhaled decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
  
  pimozide increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  pimozide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)formoterol and pimozide both increase QTc interval. Avoid or Use Alternate Drug.

• pindolol

  Monitor Closely (2)pindolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  pindolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pirbuterol

  Monitor Closely (3)formoterol and pirbuterol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and pirbuterol both decrease sedation. Use Caution/Monitor.
  
  formoterol and pirbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• piroxicam

  Monitor Closely (1)piroxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• pitolisant

  Serious - Use Alternative (1)formoterol and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

• posaconazole

  Monitor Closely (1)formoterol and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• potassium acid phosphate

  Monitor Closely (1)potassium acid phosphate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• potassium chloride

  Monitor Closely (1)potassium chloride increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• potassium citrate

  Monitor Closely (1)potassium citrate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• pralidoxime

  Monitor Closely (1)glycopyrrolate inhaled and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.

• pramlintide

  Serious - Use Alternative (1)pramlintide, glycopyrrolate inhaled. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

• primidone

  Monitor Closely (1)primidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• procainamide

  Serious - Use Alternative (1)formoterol and procainamide both increase QTc interval. Avoid or Use Alternate Drug.

• procarbazine

  Monitor Closely (1)procarbazine increases effects of formoterol by pharmacodynamic synergism. Use Caution/Monitor.

• prochlorperazine

  Monitor Closely (4)glycopyrrolate inhaled decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  prochlorperazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  prochlorperazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)prochlorperazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)prochlorperazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• promazine

  Serious - Use Alternative (1)promazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)promazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• promethazine

  Monitor Closely (4)promethazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  promethazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.Serious - Use Alternative (1)promethazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)promethazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• propantheline

  Monitor Closely (1)glycopyrrolate inhaled and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.

• propranolol

  Monitor Closely (2)propranolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  propranolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• propylhexedrine

  Monitor Closely (2)formoterol and propylhexedrine both decrease sedation. Use Caution/Monitor.
  
  formoterol and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• protriptyline

  Monitor Closely (3)protriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  protriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.Serious - Use Alternative (2)protriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  protriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• pseudoephedrine

  Monitor Closely (1)formoterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• pyridostigmine

  Monitor Closely (1)pyridostigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• quazepam

  Monitor Closely (1)quazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• quetiapine

  Monitor Closely (4)glycopyrrolate inhaled decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  quetiapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  quetiapine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• quinidine

  Serious - Use Alternative (1)quinidine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

• quinine

  Monitor Closely (1)formoterol and quinine both increase QTc interval. Use Caution/Monitor.

• ranolazine

  Monitor Closely (1)formoterol and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

• rapacuronium

  Monitor Closely (1)glycopyrrolate inhaled and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• revefenacin

  Serious - Use Alternative (1)revefenacin and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

• ribociclib

  Monitor Closely (1)ribociclib increases toxicity of formoterol by QTc interval. Use Caution/Monitor.

• rimantadine

  Monitor Closely (1)glycopyrrolate inhaled, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.Minor (1)rimantadine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Minor/Significance Unknown.

• risperidone

  Monitor Closely (5)risperidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  formoterol and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  glycopyrrolate inhaled decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  risperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• rivastigmine

  Monitor Closely (1)rivastigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• rocuronium

  Monitor Closely (1)glycopyrrolate inhaled and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• sacubitril/valsartan

  Monitor Closely (1)sacubitril/valsartan increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• sage

  Minor (1)sage increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• salicylates (non-asa)

  Monitor Closely (1)salicylates (non-asa) increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• salmeterol

  Monitor Closely (3)formoterol and salmeterol both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and salmeterol both decrease sedation. Use Caution/Monitor.
  
  formoterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• salsalate

  Monitor Closely (1)salsalate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• scopolamine

  Monitor Closely (1)glycopyrrolate inhaled and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• scullcap

  Monitor Closely (1)scullcap increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• secobarbital

  Monitor Closely (1)secobarbital increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• selpercatinib

  Monitor Closely (1)selpercatinib increases toxicity of formoterol by QTc interval. Use Caution/Monitor.

• shepherd's purse

  Monitor Closely (1)shepherd's purse increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

  Monitor Closely (1)formoterol and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.

• solifenacin

  Monitor Closely (1)glycopyrrolate inhaled and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.

• solriamfetol

  Monitor Closely (1)formoterol and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• sorafenib

  Monitor Closely (1)sorafenib and formoterol both increase QTc interval. Use Caution/Monitor.

• sotalol

  Monitor Closely (2)sotalol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  sotalol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)formoterol and sotalol both increase QTc interval. Avoid or Use Alternate Drug. Drugs known to prolong the QTc interval may potentiate the cardiovascular effects of formoterol.
  
  sotalol and formoterol both increase QTc interval. Avoid or Use Alternate Drug. Drugs known to prolong the QTc interval may potentiate the cardiovascular effects of formoterol.

• spironolactone

  Monitor Closely (1)spironolactone increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• stiripentol

  Monitor Closely (1)stiripentol will increase the level or effect of budesonide inhaled by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.

• succinylcholine

  Monitor Closely (2)succinylcholine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  succinylcholine increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• sufentanil

  Monitor Closely (1)sufentanil increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• sulfamethoxazole

  Monitor Closely (1)sulfamethoxazole and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.

• sulfasalazine

  Monitor Closely (1)sulfasalazine increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• sulindac

  Monitor Closely (1)sulindac increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• tapentadol

  Monitor Closely (1)tapentadol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• telavancin

  Monitor Closely (1)formoterol and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

• temazepam

  Monitor Closely (1)temazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• terbutaline

  Monitor Closely (3)formoterol and terbutaline both decrease serum potassium. Use Caution/Monitor.
  
  formoterol and terbutaline both decrease sedation. Use Caution/Monitor.
  
  formoterol and terbutaline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• thioridazine

  Monitor Closely (4)thioridazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  thioridazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Serious - Use Alternative (1)thioridazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)thioridazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• thiothixene

  Monitor Closely (4)thiothixene increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  thiothixene increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

• timolol

  Monitor Closely (2)timolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.
  
  timolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• tiotropium

  Monitor Closely (1)glycopyrrolate inhaled and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tolfenamic acid

  Monitor Closely (1)tolfenamic acid increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• tolmetin

  Monitor Closely (1)tolmetin increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• tolterodine

  Monitor Closely (1)glycopyrrolate inhaled and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tolvaptan

  Monitor Closely (1)tolvaptan increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• topiramate

  Monitor Closely (1)topiramate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• torsemide

  Monitor Closely (1)formoterol and torsemide both decrease serum potassium. Use Caution/Monitor.Minor (1)formoterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

• tramadol

  Monitor Closely (1)tramadol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• tranylcypromine

  Serious - Use Alternative (1)tranylcypromine increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

• trazodone

  Monitor Closely (1)trazodone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)trazodone and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.Minor (2)glycopyrrolate inhaled and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.
  
  trazodone increases levels of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• triamterene

  Monitor Closely (1)triamterene increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

• triazolam

  Monitor Closely (1)triazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• triclofos

  Monitor Closely (1)triclofos increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• trifluoperazine

  Monitor Closely (4)trifluoperazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
  
  trifluoperazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)trifluoperazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• trihexyphenidyl

  Monitor Closely (1)glycopyrrolate inhaled and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

• trimethoprim

  Monitor Closely (1)formoterol and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

• trimipramine

  Monitor Closely (3)trimipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  glycopyrrolate inhaled and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  trimipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.Serious - Use Alternative (2)trimipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  trimipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• triprolidine

  Monitor Closely (1)triprolidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• triptorelin

  Monitor Closely (1)triptorelin increases levels of formoterol by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• tropisetron

  Monitor Closely (1)formoterol and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

• trospium chloride

  Monitor Closely (1)glycopyrrolate inhaled and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

• umeclidinium bromide

  Monitor Closely (1)umeclidinium bromide and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents

• umeclidinium bromide/vilanterol inhaled

  Contraindicated (1)glycopyrrolate inhaled, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Duplicate therapy.Serious - Use Alternative (1)formoterol increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

• vecuronium

  Monitor Closely (1)glycopyrrolate inhaled and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

• venlafaxine

  Monitor Closely (1)formoterol and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

• vilanterol/fluticasone furoate inhaled

  Serious - Use Alternative (1)formoterol increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

• voriconazole

  Monitor Closely (1)formoterol and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• xylometazoline

  Monitor Closely (2)formoterol and xylometazoline both decrease sedation. Use Caution/Monitor.
  
  formoterol and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• yohimbine

  Monitor Closely (2)formoterol and yohimbine both decrease sedation. Use Caution/Monitor.
  
  formoterol and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

• ziconotide

  Monitor Closely (1)ziconotide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ziprasidone

  Monitor Closely (4)glycopyrrolate inhaled decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
  
  ziprasidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
  
  glycopyrrolate inhaled decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  ziprasidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)formoterol and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

• zotepine

  Monitor Closely (2)glycopyrrolate inhaled decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
  
  glycopyrrolate inhaled decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.