Prevalence and Impact of COPD in Long-Term Care | LONHALA® MAGNAIR® (glycopyrrolate)

Prevalence and Impact of COPD in Long-Term Care

COPD is a widespread health concern

An estimated 1 in 5 LTC residents has COPD1

The fourth-leading cause of death in the United States2

It affects 14% of the population aged ≥653

The third most common condition associated with potentially preventable hospitalizations for dual-eligible Medicare/Medicaid beneficiaries4

LONHALA® MAGNAIR® (glycopyrrolate) Inhalation Solution has not been shown or indicated to reduce mortality and/or hospitalizations in prospective, randomized, placebo-controlled trials.

Despite its sizable health burden, COPD is undertreated in the LTC setting

Among SNF residents with COPD in a retrospective analysis:

At least 20% experienced at least 2 acute exacerbations of COPD during the 12 months of study1

COPD in the LTC setting is associated with increased ED visits and hospitalizations.

In a retrospective cohort study of LTC residents diagnosed with COPD5:

43% had ≥1 hospitalization and 90% had ≥1 ED visit

Both GOLD and AMDA recommend long-acting bronchodilators for the maintenance treatment of COPD.6,7

Despite this recommendation, in a retrospective analysis of SNF residents with COPD1:

received no long-acting agent

received no long-acting agent

received no respiratory treatment at all

received no respiratory treatment at all

LONHALA MAGNAIR has not been shown or indicated to reduce exacerbations in prospective, randomized, placebo-controlled trials.

AMDA and GOLD do not endorse any specific treatments.

AMDA=AMDA – The Society for Post-Acute and Long-Term Care Medicine; ED=emergency department; GOLD=Global Initiative for Chronic Obstructive Lung Disease; LTC=long-term care; SABA=short-acting beta2-agonist; SNF=skilled nursing facility.

1. Zarowitz BJ, O'Shea T. Chronic obstructive pulmonary disease: prevalence, characteristics, and pharmacologic treatment in nursing home residents with cognitive impairment. J Manag Care Pharm. 2012;18(8):598-606.
2. Kochanek KD, Murphy SL, Xu J, Arias E. Mortality in the United States, 2016. NCHS Data Brief. 2017;(293):1-8.
3. Halbert RJ, Natoli LM, Gano A, Badamgarav E, Buist AS, Mannino DM. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006;28(3):523-532.
4. Jiang HJ, Wier LB, Potter DEB, Burgess J. Potentially preventable hospitalizations among Medicare-Medicaid dual eligibles, 2008. Published September 2010. Accessed December 3, 2018.
5. Simoni-Wastila L, Blanchette CM, Qian J, et al. Burden of chronic obstructive pulmonary disease in Medicare beneficiaries residing in long-term care facilities. Am J Geriatr Pharmacother. 2009;7(5):262-270.
6. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2019 report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2019:1-139.
7. AMDA - The Society for Post-Acute and Long-Term Care Medicine. COPD Management in the Post-Acute and Long-Term Care Setting Clinical Practice Guideline. Columbia, MD: AMDA 2016.
8. Thomson MS, Gruneir A, Lee M, et al. Nursing time devoted to medication administration in long-term care: clinical, safety, and resource implications. J Am Geriatr Soc. 2009;57(2):266-272.

Important Safety Information & Indication

Important Safety Information

LONHALA MAGNAIR is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.

LONHALA MAGNAIR should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

As with other inhaled medicines, LONHALA MAGNAIR can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs following dosing with LONHALA MAGNAIR, it should be treated immediately with an inhaled, short-acting bronchodilator; LONHALA MAGNAIR should be discontinued immediately and alternative therapy instituted.

Immediate hypersensitivity reactions have been reported with LONHALA MAGNAIR. If signs occur, discontinue LONHALA MAGNAIR immediately and institute alternative therapy.

LONHALA MAGNAIR should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any of these signs or symptoms develop.

The most common adverse events reported in ≥2% of patients taking LONHALA MAGNAIR, and occurring more frequently than in patients taking placebo, were dyspnea (4.9% vs 3.0%) and urinary tract infection (2.1% vs 1.4%).

LONHALA solution is for oral inhalation only and should not be injected or swallowed. LONHALA vials should only be administered with MAGNAIR.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

For additional information, please see full Prescribing Information and Patient Information for LONHALA MAGNAIR at


LONHALA® MAGNAIR® (glycopyrrolate) is an anticholinergic indicated for the long-term maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.