I've been taking this newly FDA approved med for 1 month. Also taking Trelegy. Good results. I'm not seeing any of the possible side effects. I no longer feel the Trelegy "wearing off" at the end of the day. I have stopped regular use of my Albuterol rescue inhaler at the beginning and end of the day. Hardly using it otherwise. I'm In the process of reducing my daily Prednisone intake. Goal is zero. I'm at stage 3 (severe) COPD. breathing is easier. very little coughing. sleeping well on 3L. No exacerbation symptoms to speak of.