Store in a dry place away from direct heat or sunlight. These drugs represent 2 different classes of medications (an anticholinergic and a LABA) that have different effects on clinical and physiological indices. They had a mean age of 63 years and an average smoking history of 45 pack-years, with 50% identified as current smokers. For more information, ask your healthcare provider or pharmacist.Call your doctor for medical advice about side effects. Use with caution in patients with narrow-angle glaucoma and instruct patients to contact a physician immediately if symptoms occur.Worsening of urinary retention may occur. In preclinical in vitro as well as in vivo studies, prevention of methacholine- and acetylcholine-induced bronchoconstrictive effects was dose-dependent and lasted longer than 24 hours. Treatment of overdosage consists of discontinuation of ANORO ELLIPTA together with institution of appropriate symptomatic and/or supportive therapy. No dosage adjustment is required for geriatric patients, patients with renal impairment, or patients with moderate hepatic impairment ANORO and ELLIPTA are trademarks of the GlaxoSmithKline group of companies.National Institutes of Health, U.S. National Library of Medicine, Do not initiate in acutely deteriorating COPD or to treat acute symptoms. Each delivered dose (the dose leaving the mouthpiece of the inhaler) contains 92 micrograms fluticasone furoate, 55 micrograms umeclidinium (equivalent to 65 micrograms umeclidinium [as bromide]) and 22 micrograms vilanterol (as trifenatate). The safety data described below are based on the four 6-month and one 12-month trials. Umeclidinium was detected in the plasma of offspring of lactating rats treated with umeclidinium suggesting its presence in maternal milk. Chronic obstructive pulmonary disease (COPD) is a common respiratory disease that is predicted to be one of the leading causes of death worldwide. Recent and significant clinical trials about the monocomponents and their combination were identified, in addition to reviews, guidelines for COPD, data from manufacturer and FDA product labels. These findings are considered a class effect of LABA monotherapy. Further studies comparing umeclidinium/vilanterol 62.5 mcg/25 mcg (ANORO) to other LABA/LAMA fixed‐dose combination are definitely desired to help health‐care professionals differentiate among LABA/LAMA combined therapy and will certainly add to the already existing pool of evidence.The authors declare that they have no conflicts of interest with the contents of this article.Wijdan Ramadan designed, initiated the review, collected some studies, wrote a part of the article, analysed the drug studies and reviewed the completed article. (See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling.ANORO ELLIPTA is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD).ANORO ELLIPTA is NOT indicated for the relief of acute bronchospasm or for the treatment of asthma. Umeclidinium tested negative in the following genotoxicity assays: the in vitro Ames assay, in vitro mouse lymphoma assay, and in vivo rat bone marrow micronucleus assay.No evidence of impairment of fertility was observed in male and female rats at subcutaneous doses up to 180 mcg/kg/day and at inhaled doses up to 294 mcg/kg/day, respectively (approximately 100 and 50 times, respectively, the MRHDID in adults on an AUC basis).In a 2-year carcinogenicity study in mice, vilanterol caused a statistically significant increase in ovarian tubulostromal adenomas in females at an inhalation dose of 29,500 mcg/kg/day (approximately 7,800 times the MRHDID in adults on an AUC basis). 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