Trimbow: a new triple-therapy single-inhaler option for COPD

Trimbow is a third triple-therapy single-inhaler option for chronic obstructive pulmonary disease (COPD) to be marketed in Canada. Supplied by Methapharm, it contains beclomethasone dipropionate 100 µg, glycopyrronium (as bromide) 10 µg and formoterol fumarate dihydrate 6 µg per metered actuation and is available as an inhalation solution in a metered-dose inhaler (with dose counter) containing 120 actuations.1 Trimbow is indicated for the long-term maintenance treatment of airflow obstruction in adults with COPD, including chronic bronchitis and/or emphysema. It is also indicated to reduce exacerbations of COPD in adults with a history of exacerbations.The product is intended for use in patients who are not adequately controlled by a combination of an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA), or a combination of a LABA and a long-acting muscarinic antagonist (LAMA).1The beclomethasone dipropionate component in Trimbow has glucocorticoid anti-inflammatory action within the lungs. Glycopyrronium is a long-acting muscarinic receptor antagonist (anticholinergic) that blocks the bronchoconstrictor action of acetylcholine on airway smooth muscle cells, thereby dilating the airways. Formoterol is a selective beta2-adrenergic agonist that produces relaxation of bronchial smooth muscle in patients with reversible airways obstruction.1 The recommended dosage of Trimbow is two inhalations twice daily (morning and evening) at the same time every day. Patients should also have a rapid-onset, short-duration inhaled bronchodilator (e.g., salbutamol) available for use at all times to relieve acute symptoms (e.g., shortness of breath).1The Trimbow inhaler must be primed before first use and re-primed if not used for more than 14 days. Pharmacy staff should train patients to use the inhaler by following the instructions provided in the product monograph.1 It may be used with the AeroChamber Plus spacer device, if needed. Patients should be instructed to rinse their mouth with water (and spit out) after each dose to prevent fungal infections in the mouth and throat. Patients should also be shown how to clean their inhaler (to be done once weekly).The overall safety profile of Trimbow is consistent with the known pharmacologic class effects of inhaled corticosteroids, LAMAs and LABAs. Pharmacists should consider the potential for interactions based on each of the individual components (see product monograph for additional details). Trimbow is the third single-inhaler triple-therapy (ICS/LAMA/LABA) option for COPD in Canada, joining Trelegy Ellipta (fluticasone furoate, umeclidinium and vilanterol) and Breztri Aerosphere (budesonide, glycopyrronium and formoterol fumarate dihydrate). Trimbow is supplied as an inhalation solution and is dosed as two inhalations twice daily.1 Trelegy Ellipta is available as a dry powder for oral inhalation and is dosed as one inhalation daily.2 Breztri Aerosphere is supplied as an inhalation suspension and is dosed as two inhalations twice daily.3ReferencesMethapharm Inc. Trimbow (beclomethasone dipropionate, glycopyrronium [as bromide] and formoterol fumarate dihydrate pressurized inhalation solution) product monograph. Brantford, ON; (accessed September 24, 2026). May 16, 2025 (accessed September 29, 2026).GlaxoSmithKline Inc. Trelegy Ellipta (fluticasone furoate, umeclidinium and vilanterol dry powder for oral inhalation) product monograph. Mississauga, ON; September 12, 2023 (accessed September 29, 2026).AstraZeneca Canada Inc. Breztri Aerosphere (budesonide/glycopyrronium/formoterol fumarate dihydrate pressurized inhalation suspension) product monograph. Mississauga, ON; April 14, 2023 (accessed September 29, 2026).

Trimbow: a new triple-therapy single-inhaler option for COPD

Register for free access or login.

Related Topics