3. Duplicative Therapy

Concurrent administration of inhaled anticholinergics has not been evaluated in controlled studies and may not offer additional clinical benefit but may increase anticholinergic adverse effects. Combined administration of multiple inhaled anticholinergics is not recommended and will be reviewed.

Although inhaled anticholinergic systemic absorption is minimal, adjunctive administration with other anticholinergic medications has the potential to amplify anticholinergic pharmacologic and adverse effects. Combined therapy with inhaled anticholinergics and other anticholinergic dosage forms should be considered cautiously.