Incruse Ellipta Side Effects: What to Expect and When to Call Your Doctor

Most people who use Incruse Ellipta (umeclidinium) tolerate it well, but like all medications, it can cause side effects. Understanding what to expect — and more importantly, which symptoms require urgent medical attention — is a critical part of safe use. This guide covers all known side effects of Incruse Ellipta, from mild and common to rare but serious.

How Incruse Ellipta Works and Why Side Effects Occur

Incruse Ellipta works by blocking muscarinic receptors (M1, M2, and M3) in the bronchial smooth muscle. This prevents the nerve signal chemical acetylcholine from causing muscle contraction, which keeps the airways open for easier breathing. However, the same muscarinic receptors are found throughout the body — in the bladder, salivary glands, eyes, heart, and gastrointestinal tract. When umeclidinium's effects extend beyond the lungs, that's where many of the side effects come from.

Common Side Effects of Incruse Ellipta

In clinical trials, the most common adverse reactions reported with Incruse Ellipta 62.5 mcg (those occurring in ≥2% of patients and more frequently than placebo) were:

• Nasopharyngitis (8%): Common cold symptoms including runny nose, sore throat, and nasal congestion. This is the most frequently reported side effect.
• Upper respiratory tract infection (5%): Infections of the nose, throat, and upper airways. This may be partly due to the mild reduction in airway mucus production caused by anticholinergic effects.
• Cough (3%): Mild irritation from the dry powder inhaler is relatively common, especially when first starting the medication.
• Arthralgia (2%): Joint pain, reported in approximately 2% of patients.
• Pharyngitis (1%), oropharyngeal pain (1%): Mild throat discomfort related to powder inhalation.
• Tachycardia (fast heartbeat, 1%): Increased heart rate can occur, though it is uncommon at the recommended dose.
• Dry mouth: A classic anticholinergic effect. Blocking salivary gland muscarinic receptors reduces saliva production. Staying hydrated and using sugarless gum or lozenges can help.
• Headache and dizziness: Generally mild and tend to resolve with continued use.

Serious Side Effects — When to Call Your Doctor Immediately

The following side effects are serious and require prompt medical attention. Stop using Incruse Ellipta and contact your healthcare provider right away if you experience any of these:

• Paradoxical bronchospasm: This is sudden worsening of breathing or wheezing immediately after using the inhaler — the opposite of what the medication is supposed to do. Discontinue Incruse Ellipta immediately if this occurs and contact your provider. This is a rare but potentially serious reaction.
• Urinary retention: Difficulty urinating, weak urine stream, painful urination, or feeling like the bladder won't empty. This is particularly concerning for patients with prostatic hyperplasia (enlarged prostate) or bladder neck obstruction. Stop the medication and call your provider right away if any of these symptoms occur.
• Narrow-angle glaucoma worsening: Eye pain or discomfort, blurred vision, visual halos or colored images, and red eyes (from conjunctival congestion) may indicate worsening glaucoma. Seek medical attention immediately. Long-term use of Incruse Ellipta can increase intraocular pressure.
• Anaphylaxis (severe allergic reaction): Hives, rash, severe itching, difficulty breathing, or swelling of the face, lips, tongue, or throat indicate a serious allergic reaction. Call 911 immediately. Incruse Ellipta contains lactose monohydrate (milk proteins), and patients with severe milk protein allergy should not use this medication at all.
• Atrial fibrillation: Irregular or racing heartbeat, palpitations, shortness of breath, or lightheadedness may signal atrial fibrillation. This was observed at low rates (<1%) in clinical trials but more frequently in the long-term safety trial. Contact your provider if you experience these symptoms.

Side Effects More Common When Combined With Other Anticholinergics

The prescribing information for Incruse Ellipta specifically warns against using it with other anticholinergic medications. Combining Incruse Ellipta with tiotropium, ipratropium, aclidinium, or anticholinergics used for overactive bladder (like oxybutynin or tolterodine) significantly increases the risk of:

• Worsening urinary retention
• Worsening narrow-angle glaucoma
• Severe dry mouth, constipation, and confusion (anticholinergic toxidrome, especially in elderly patients)

Tips to Minimize Side Effects

• Use the inhaler correctly — ensure full inhalation to get medication to the lungs, not the throat.
• Rinse your mouth with water after each dose to reduce oropharyngeal irritation and dry mouth.
• Stay well hydrated to offset the drying effects of anticholinergic therapy.
• Tell your doctor about all medications you take, especially other anticholinergics or medications for overactive bladder or Parkinson's disease.

When to Go to the Emergency Room

Call 911 or go to the ER immediately if you experience: anaphylaxis symptoms (severe swelling, throat closing, difficulty breathing); sudden severe eye pain; complete inability to urinate; or sudden worsening breathing immediately after inhaling. For information about drug interactions that can worsen side effects, see our guide on Incruse Ellipta drug interactions.