Incruse Ellipta Side Effects & How to Manage Them

Incruse Ellipta is a long-acting anticholinergic inhaler prescribed to adults dealing with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. This maintenance medication helps open the airways, making it easier to breathe daily. It contains umeclidinium bromide, a type of bronchodilator that targets the muscles around the airways to keep them relaxed.

Incruse Ellipta comes with a potential for side effects. While many people tolerate it well, others may experience mild or more serious reactions. This guide walks you through the most common and rare side effects of Incruse Ellipta, how to recognize them early, and how to manage or minimize them.

What Is Incruse Ellipta Used For?

Incruse Ellipta is not a rescue inhaler. It won’t relieve sudden breathing problems. Instead, it’s taken once a day to keep your airways open over the long term. Its main function is to prevent symptoms of chronic obstructive pulmonary disease (COPD), such as:

• • Wheezing
  • Shortness of breath
  • Chest tightness

How does it work?

Umeclidinium, Incruse Ellipta’s active ingredient, is a long-acting anticholinergic that works for 24 hours or longer. It works by blocking certain signals in the nervous system that tighten the muscles in your airways or cause mucus production.

Specifically, it blocks receptors called M1, M2, and M3, which are part of the parasympathetic nervous system, the part of your body that can cause airway narrowing and mucus buildup.

• • M1 receptors help carry nerve signals.

• • M2 receptors help control how much of a chemical called acetylcholine gets released. Blocking M2 means less acetylcholine, so fewer signals telling your lungs to tighten up.

• • M3 receptors are on the airway muscles and glands. Blocking these helps relax the muscles, reduce mucus, and ease swelling in the airways.

Although umeclidinium doesn’t target just one receptor, the biggest effect in COPD comes from blocking the M3 receptors. This stops a chain of chemical reactions that would normally make the airway muscles tighten. Instead, the muscles relax, mucus goes down, and breathing becomes easier.

What Are The Side Effects Of Incruse Ellipta?

Clinical studies and post-marketing data suggest that most people tolerate Incruse Ellipta well, but some do experience side effects. According to the FDA prescribing information, the most frequently reported side effects affect the upper respiratory tract or involve anticholinergic effects like dry mouth.

Let’s examine these effects more closely.

Common Side Effects

These reactions were reported in at least 2% of participants in clinical trials. They are usually mild and go away as the body adjusts to the medication.

1. Infections and Infestations

Incruse Ellipta can reduce the amount of mucus produced in the airways. Normally, mucus helps trap germs and irritants, stopping them from reaching the lungs. When mucus levels drop and immune activity in the airways decreases slightly, the body becomes more prone to viral and bacterial infections, especially in the nose and throat.

The most common infection reported in clinical trials was nasopharyngitis (the common cold), affecting about 8% of users. Other respiratory infections may cause symptoms such as:

• • Nasal congestion
  • Sore throat
  • Scratchy or painful throat
  • Difficulty swallowing
  • Swollen glands

2. Dry Mouth

This is one of the most common anticholinergic effects. Blocking acetylcholine affects the salivary glands, reducing saliva production. Although dry mouth isn’t dangerous, it can be uncomfortable and may lead to:

• • Bad breath
  • Trouble swallowing
  • Higher risk of cavities or oral infections

3. Cough

Incruse Ellipta is a dry powder inhaler, and the powder can sometimes irritate the throat or upper airway, particularly if it doesn’t reach the lungs completely. This irritation may trigger a reflex cough shortly after inhalation.

The frequency of cough varies across studies. In one trial, 3% of patients using Incruse Ellipta reported coughing, compared to 2% in the placebo group. While generally mild, this side effect may be bothersome for some users.

4. Joint and Muscle Pain

Although Incruse Ellipta is designed to work primarily in the lungs, a small amount of the medication can enter the bloodstream. Once it circulates through the body, it may affect other areas, including the joints and muscles.

In some cases, this can lead to pain or stiffness. The drug relaxes smooth muscles in the airways, and this effect might also influence skeletal muscles, such as those in the arms, legs, or back, causing mild soreness or discomfort. Others also reported pain in the extremities, back pain, and neck pain.

Less Common Side Effects

These side effects are reported less frequently but still occur in some users.

1. Gastrointestinal (GI) Disorders 

Blocking acetylcholine, which helps stimulate muscle movement in the digestive tract, can reduce the normal motion of the intestines. This slowdown may lead to constipation, bloating, or a sense of fullness.

Some users report nausea or abdominal pain, though the exact mechanism isn’t fully understood. It’s possible that by acting on the nervous system pathways involved in gut regulation, Incruse might disturb normal GI rhythms or signaling.

2. Toothache

Saliva helps maintain your oral health by:

• • Neutralizing acids in the mouth
  • Washing away food particles
  • Protecting tooth enamel

Incruse Ellipta can reduce saliva production, leading to a dry mouth. When this happens, it increases the risk of:

• • Tooth decay
  • Gum disease
  • Tooth sensitivity

These conditions can eventually result in a toothache.

Improper use of the inhaler may also allow some of the powder to settle in your mouth or throat and cause local irritation or inflammation. While this doesn’t directly damage the teeth, it can worsen existing dental problems, especially around the gumline or in areas already prone to sensitivity.

3. Bruising

Anticholinergic medications can indirectly affect your blood vessel tone and skin structure, which might make you more prone to bruising from even minor bumps.

If you’re living with COPD, you may also experience fatigue, weakness, or occasional dizziness from your medications. These symptoms can increase the chance of small accidents without you realizing it.

These unnoticed bumps can lead to contusions, especially as your skin becomes more delicate with age. You might notice:

• • Skin turning blue, purple, or dark red
  • Mild pain or tenderness at the site
  • Some swelling
  • No broken skin or open wounds

4. Increased Heartbeat

Incruse Ellipta blocks muscarinic receptors, which belong to the parasympathetic nervous system, the part of your body responsible for slowing your heart rate. When these receptors are blocked, the calming influence on your heart (called vagal input) is reduced.

As a result, your sympathetic nervous system, which triggers your fight-or-flight response, can take over more easily, causing your heart rate to increase. You might experience:

• • A pounding or racing heartbeat (palpitations)
  • Dizziness or lightheadedness
  • Shortness of breath
  • Chest discomfort
  • Fatigue

5. Sinus Pain or Pressure

Dry sinus passages can easily become irritated and inflamed. When this happens, you may feel pressure or pain in areas like your cheeks, forehead, or behind your eyes—classic signs of a sinus headache. The lack of moisture also causes mucus to thicken, which can block sinus drainage and increase that uncomfortable pressure.

If you already have sinus issues, Incruse Ellipta may make them worse. This includes conditions like:

• • Allergic rhinitis
  • Chronic sinusitis
  • Postnasal drip

Warnings and Serious Risks

Although rare, Incruse Ellipta can cause more serious reactions. These require immediate medical attention.

1. Deterioration of Disease and Acute Episodes

Don’t start using Incruse Ellipta if you’re having a serious or quickly worsening COPD flare-up. This medication hasn’t been tested in people during sudden or severe COPD episodes, so using it at that time isn’t safe or recommended.

Incruse Ellipta is not a rescue inhaler. If you’re having sudden shortness of breath or a bronchospasm, this inhaler won’t work fast enough to help you. It’s meant for daily maintenance, not for quick relief. If you need fast relief, you should use a short-acting inhaler like albuterol (often called a “rescue inhaler”).

Watch for signs that your COPD might be getting worse. If:

• • Incruse Ellipta isn’t helping as much as it used to
  • Your rescue inhaler doesn’t work as well
  • You find yourself needing your rescue inhaler more often than usual

They may mean your COPD is getting worse, and you need to contact your doctor right away to recheck your treatment plan.

Don’t increase your Incruse Ellipta dose on your own. Taking extra puffs won’t help and could be unsafe. Stick to your prescribed dose, even if your symptoms get worse. Always speak with your healthcare provider before making changes.

2. Paradoxical Bronchospasm

Paradoxical bronchospasm is when your airways suddenly tighten or narrow right after using an inhaler. The exact opposite of what’s supposed to happen. Instead of opening up to help you breathe, your lungs react by constricting, which can make your symptoms worse.

If you ever feel worse right after using your inhaler, stop using it and seek medical help immediately. You may need a different type of inhaler or a change in your treatment plan.

3. Hypersensitivity Reactions

Some people may have allergic reactions after using Incruse Ellipta. These reactions can range from mild to life-threatening and may include:

• • Anaphylaxis (a severe, whole-body allergic reaction)
  • Swelling of the face, lips, tongue, or throat (called angioedema)
  • Itching (pruritus)
  • Skin rash
  • Hives (also called urticaria)

If you ever experience any of these symptoms after using Incruse Ellipta, stop using it immediately and call your doctor or go to the emergency room.

Also, if you have a severe milk protein allergy, you should not use Incruse Ellipta. That’s because the powder in the inhaler contains lactose, which may trigger a dangerous allergic reaction in people with this type of allergy.

4. Worsening of Narrow-Angle Glaucoma

Narrow-angle glaucoma (also called angle-closure glaucoma) is a serious eye condition where the drainage angle between the iris and cornea becomes too narrow or blocked, preventing fluid inside your eye (aqueous humor) from draining properly.

This buildup of fluid increases eye pressure (intraocular pressure), which can damage the optic nerve and lead to sudden vision loss if not treated quickly.

Symptoms can come on suddenly and may include:

• • Severe eye pain
  • Blurred vision
  • Headache
  • Nausea or vomiting
  • Seeing halos around lights

If you have narrow-angle glaucoma, you should use Incruse Ellipta carefully and only under your doctor’s guidance. If you notice any symptoms while using Incruse Ellipta, contact your doctor or an eye specialist immediately. Quick treatment is important to prevent vision damage.

5. Worsening of Urinary Retention

Urinary retention is when your bladder doesn’t empty completely, or at all, even though you feel the urge to urinate. If you already have urinary issues, such as from an enlarged prostate (BPH) or bladder obstruction, Incruse Ellipta may make those problems worse.

Be alert for urinary symptoms like:

• • Trouble starting to pee
  • A weak stream
  • Feeling like your bladder doesn’t fully empty
  • Pain or pressure in your lower belly

If you notice any of these signs, talk to your doctor right away. They may adjust your medication or monitor you more closely, especially if you already have urinary problems.

Drug Interactions That Can Worsen Side Effects

Always share your full medication list with your doctor or pharmacist before starting Incruse Ellipta. It can interact with other medications, increasing the risk of side effects. Medications to watch out for include:

How to Use Incruse Ellipta Properly to Reduce Side Effects

Many side effects stem from improper usage. Following the correct inhaler technique can lower the risk of throat irritation, coughing, or insufficient dosing.

Here’s how:

1. 1. Prepare the Inhaler: Open the cover only when you’re ready to take your dose. Sliding the cover down clicks the dose into place—you’ll hear a click. Do not open and close the cover multiple times, or you might waste medication.
   2. Exhale Away from the Inhaler: Before inhaling, breathe out fully, but not into the inhaler. Breathing into the device can blow moisture into it and affect the dose.
   3. Inhale the Dose Correctly: Place the mouthpiece between your lips and create a tight seal. Take a long, steady, deep breath in through your mouth, not your nose. Do not block the air vents with your fingers.
   4. Hold Your Breath: After inhaling, remove the inhaler from your mouth and hold your breath for about 3-5 seconds, or as long as you comfortably can. Then exhale slowly.
   5. Rinse Your Mouth After Use: Rinse your mouth with water and spit it out, don’t swallow. This helps prevent dry mouth, throat irritation, and infections like oral thrush.

Avoid these common mistakes:

• • Don’t shake the inhaler, it’s a dry powder, not a spray.
  • Don’t breathe out into the device.
  • Don’t take an extra dose if you accidentally open the cover twice.
  • Don’t skip rinsing your mouth, it helps reduce several side effects.

Here’s a YouTube tutorial demonstrating how to use the Incruse Ellipta inhaler correctly:

Wrap-up

Incruse Ellipta is a once-daily maintenance inhaler for COPD. It helps keep your airways open by relaxing the muscles around them and reducing mucus. It does not work during sudden breathing problems. It’s not a rescue inhaler.

The most common side effects include dry mouth, sore throat, cough, and muscle or joint pain. Less common but serious risks include urinary retention, fast heartbeat, and worsening glaucoma. Most side effects can be managed by rinsing your mouth, staying hydrated, and using the inhaler correctly.

Always use Incruse Ellipta exactly as directed. Don’t take extra doses, and don’t skip rinsing after use. Watch for symptoms that may signal worsening COPD or serious side effects, and talk to your doctor if anything feels off.

Frequently Asked Questions