indacaterol

Indacaterol is a bronchodilator drug whose use was recently approved (November 2009) by the European Medicines Agency (EMA).

Indacaterol is a selective β2-adrenergic receptor agonist belonging to the family of so - called ultra-LABAs ( ltra Long Acting Beta-adrenoceptor Agonists, ie the agonists of β2-adrenergic receptors with ultra long duration of action).

Indacaterol - Chemical Structure

Thanks to its remarkable duration of action, indacaterol can be administered only once a day, unlike drugs such as formoterol and salmeterol (long-acting selective β2-adrenergic receptor agonists) that must be taken twice per day.

Examples of medicinal specialties containing indacaterol

Onbrez Breezhaler ®
Hirobriz Breezhaler ®
Oslif Breezhaler ®
Ulunar Breezhaler ® (in association with glycopyrronium)
Ultibro Breezhaler ® (in association with glycopyrronium)
Xoterna Breezhaler ® (in association with glycopyrronium)

Indications

For what it uses

The use of indacaterol is indicated for the treatment of bronchospasm in patients with chronic obstructive pulmonary disease (COPD).

In fact, COPD is a disease that causes airway constriction, making breathing difficult. The indacaterol induces the relaxation of the bronchial smooth musculature therefore favoring the breathing in the patients suffering from this pathology.

Warnings

Before taking indacaterol you must inform your doctor if you are in any of the following situations:

If you suffer from asthma;
If you are suffering from heart disease;
If you suffer from epilepsy;
If you are suffering from thyrotoxicosis;
If you have diabetes.

Indacaterol can cause paradoxical bronchospasm, if this should occur, treatment with the drug should be immediately suspended and the doctor should be contacted immediately.

If, despite treatment with indacaterol, the symptoms of chronic obstructive pulmonary disease do not improve or worsen, you should immediately inform your doctor.

Indacaterol should not be used in children and adolescents under 18 years of age.

Interactions

Before starting treatment with indacaterol, you must tell your doctor if you are already taking any of the following medications:

Salmeterol or formoterol, other selective beta2-adrenergic receptor agonist bronchodilators;
Β-blocking drugs, such as propranolol and atenolol (used in the treatment of hypertension) or timolol (used in the treatment of glaucoma);
Drugs able to lower blood levels of potassium, among which we recall:

Steroid drugs, such as, for example, prednisolone;
Diuretics used in the treatment of hypertension, such as, for example, hydrochlorothiazide;
Drugs used in the treatment of asthma, such as theophylline .

In any case, it is still advisable to inform your doctor if you are taking - or have recently been - any type of medication, including non-prescription medicines and herbal and homeopathic products.

Side effects

Indacaterol can cause various types of side effects, although not all patients experience them.

The type of adverse effects and the intensity with which they arise depend on the different sensitivity that each individual has towards the drug.

The main side effects that may occur during treatment with indacaterol are listed below.

Allergic reactions

Like any other medicine, indacaterol can also trigger allergic reactions in sensitive individuals. Generally, these reactions take the form of:

Skin eruptions;
Itch;
Urticaria;
Difficulty breathing;
Difficulty swallowing;
Dizziness.

Should any of the above symptoms occur during treatment with indacaterol, you should contact your doctor immediately.

Respiratory tract disorders

During indacaterol therapy, the following can occur:

Sense of chest constriction;
Difficulty breathing associated with wheezing or coughing;
Inflammation of the paranasal sinuses;
Cough;
A runny nose;
Sore throat.

Cardiac disorders

Treatment with indacaterol can cause palpitations and arrhythmias.

Musculoskeletal disorders

Indacaterol therapy may favor the onset of:

Muscle spasms;
Muscular pain;
arthralgia;
Bone pain.

Nervous system disorders

During treatment with indacaterol may occur:

Headache;
dizziness;
Numbness;
Tingling.

Other side effects

Other side effects that could occur during indacaterol therapy are:

Cold symptoms (such as sore throat, stuffy nose or runny nose, sneezing, coughing and headache);
Edema;
Chest pain;
Skin rashes and / or itching;
Increased blood sugar levels;
Fatigue;
Increased thirst and / or appetite;
Urination difficulties.

Overdose

If excessive amounts of indacaterol are used, side effects may occur, such as:

Palpitations;
Headache;
Nausea or vomiting;
Drowsiness.

In any case, if you suspect an indacaterol overdose, you must contact your doctor immediately or contact your nearest emergency department.

Action mechanism

As mentioned, indacaterol is a selective β2-adrenergic receptor agonist. These receptors are quite common in the smooth muscles of the bronchi and - once activated - are able to induce bronchodilation.

When indacaterol is inhaled, it activates the aforementioned β2 receptors. In doing so, indacaterol reduces the bioavailability of calcium ions (responsible for bronchoconstriction), causing, consequently, a decrease in its concentration within the bronchial smooth muscle cells.

In this way indacaterol induces a bronchodilation, therefore favoring respiration in patients suffering from chronic obstructive pulmonary disease.

Method of use and dosage

Indacaterol is available as capsules containing inhalation powder that must be administered through the appropriate inhaler.

The capsules containing the inhalation powder must NOT be swallowed at all.

The dose of indacaterol to be used should be established by the doctor on an individual basis, depending on the condition and response to therapy by each individual patient.

Generally, the dose of drug usually administered varies from 150 to 300 micrograms per day. It is advisable to inhale the drug at the same time each day.

To avoid the occurrence of dangerous adverse effects, it is essential to follow the indications provided by the doctor, both as regards the amount of drug to be inhaled, and as regards the duration of treatment.