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Indacaterol is available in the market in concentration.
Indacaterol
Before using Indacaterol, it is important to consult with a healthcare provider, especially in the following circumstances:
- Pre-existing Heart Conditions: Indacaterol is a long-acting beta-agonist (LABA) and can cause increased heart rate (tachycardia) or palpitations. It should be used cautiously in individuals with a history of heart disease, hypertension, or arrhythmias.
- Respiratory Conditions: While Indacaterol is commonly used to treat chronic obstructive pulmonary disease (COPD) and asthma, it should be used with caution in patients with bronchospasm or a history of severe respiratory infections. Monitoring is important to ensure that the medication is not exacerbating these conditions.
- Pregnancy and Lactation: Indacaterol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as there are limited studies on its safety during pregnancy. It is unknown whether Indacaterol is excreted in breast milk, so caution is advised if the medication is used while breastfeeding.
- Hypersensitivity: Patients who have a history of severe allergic reactions to Indacaterol or any of its components should avoid using it. Anaphylactic reactions or serious allergic reactions, though rare, can occur.
- Liver or Kidney Disease: Indacaterol should be used cautiously in patients with severe liver or kidney impairment, as the drug’s metabolism and clearance could be affected, potentially increasing the risk of side effects.
Indacaterol is primarily used for the management of chronic obstructive pulmonary disease (COPD) and asthma. It is a long-acting bronchodilator and is indicated for the following:
- Chronic Obstructive Pulmonary Disease (COPD): Indacaterol is used to relieve bronchospasm and improve airflow in adults with COPD, including those with chronic bronchitis and emphysema. It is typically prescribed as a maintenance therapy to improve lung function and reduce exacerbations.
- Asthma: Indacaterol is used as an adjunctive treatment for asthma in combination with other inhaled medications. It helps to relax the airway muscles, improving airflow and reducing symptoms such as wheezing, shortness of breath, and coughing.
- Prevention of Bronchospasm: Indacaterol is used to prevent exercise-induced bronchospasm in patients with asthma.
Indacaterol is contraindicated in the following situations:
- Hypersensitivity: It is contraindicated in patients who have a known hypersensitivity or allergic reaction to Indacaterol or any of its components, including the inhaler device or other ingredients.
- Acute Bronchospasm: Indacaterol is not intended for the acute treatment of bronchospasm. It should not be used for sudden worsening of symptoms or acute asthma attacks. Short-acting beta-agonists (e.g., albuterol) should be used in such cases.
- Severe Milk Protein Allergy: Some formulations of Indacaterol contain lactose, which may be a concern for individuals with severe milk protein allergies. These individuals should avoid the medication if they are sensitive to lactose or milk proteins.
Common and severe side effects of Indacaterol include:
- Common Side Effects:
- Headache: This is a relatively common side effect, which may occur during the initiation of therapy and usually resolves as the body adjusts.
- Cough: Some patients may experience a dry cough or throat irritation after inhalation.
- Nausea: A mild feeling of nausea can occasionally be experienced.
- Dizziness: Some individuals may feel lightheaded or dizzy, particularly when standing up suddenly.
- Pharyngitis (sore throat): A mild sore throat is a commonly reported side effect.
- Serious Side Effects:
- Cardiovascular Issues: Tachycardia (increased heart rate), palpitations, and arrhythmias can occur. These side effects are typically seen more in individuals with pre-existing heart conditions.
- Hypokalemia: Indacaterol may cause low potassium levels (hypokalemia), especially when used with other medications like diuretics.
- Chest Pain: Some patients may experience chest pain, which can be concerning if it becomes severe or persistent.
- Bronchospasm: Although rare, bronchospasm (narrowing of the airways) may occur, particularly if the inhaler is not used properly.
- Paradoxical Bronchospasm: In rare cases, the medication may cause worsening symptoms, such as difficulty breathing, coughing, or wheezing, which should be treated immediately by discontinuing the medication and seeking medical attention.
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Indacaterol works by stimulating the beta-2 adrenergic receptors on the smooth muscles of the airways in the lungs:
- Beta-2 Receptor Activation: Indacaterol is a long-acting beta-agonist (LABA). It binds to and activates the beta-2 adrenergic receptors located in the smooth muscle of the airways.
- Bronchodilation: Activation of these receptors causes the muscles around the airways to relax, which leads to bronchodilation (widening of the air passages), thus improving airflow and making it easier to breathe.
- Duration of Action: Indacaterol has a long half-life (about 40 hours), which allows for once-daily dosing. This makes it convenient for long-term management of asthma and COPD by providing sustained bronchodilation throughout the day.
Indacaterol may interact with various medications and substances, potentially affecting its efficacy and safety:
- Other Beta-Agonists: When used with other beta-agonists (e.g., albuterol, salmeterol), there may be an increased risk of cardiovascular side effects, such as tachycardia and palpitations. Combining beta-agonists should be done cautiously and under medical supervision.
- Corticosteroids: Co-administration with inhaled corticosteroids (ICS) is common in asthma and COPD treatment. While generally safe, it may increase the risk of oral thrush and systemic corticosteroid effects, such as immune suppression and bone density loss.
- Diuretics: Use of diuretics (e.g., furosemide, hydrochlorothiazide) may increase the risk of hypokalemia (low potassium levels) when used with Indacaterol, which can exacerbate the risk of heart arrhythmias.
- Monoamine Oxidase Inhibitors (MAOIs): Indacaterol should be used with caution in patients taking monoamine oxidase inhibitors (e.g., phenelzine), as the combination can enhance the sympathetic effects (e.g., tachycardia, hypertension).
- Beta-Blockers: The combination of beta-blockers (e.g., propranolol, atenolol) and Indacaterol may reduce the bronchodilatory effects of Indacaterol, leading to worsened bronchospasm in patients with asthma or COPD. Non-selective beta-blockers should be avoided when using Indacaterol.
- Anticholinergic Drugs: Combining Indacaterol with other anticholinergic drugs may increase the risk of dry mouth, blurred vision, and urinary retention.
For adults, the typical dosage for Indacaterol is:
- Chronic Obstructive Pulmonary Disease (COPD): The usual dose is 75 mcg once daily, administered via an inhaler.
- Asthma: Indacaterol is used as adjunct therapy in combination with other medications, such as inhaled corticosteroids (ICS). The recommended dose for asthma management is also typically 75 mcg once daily.
It is important to follow the specific dosing instructions provided by the healthcare provider and use the inhaler properly to ensure correct administration.
Indacaterol is not typically recommended for use in children under 18 years of age, as there is limited data on the safety and efficacy of the medication in this age group. For pediatric asthma or COPD treatment, other age-appropriate medications and treatment options should be considered.
As always, it is important for patients to consult their healthcare provider before beginning therapy with Indacaterol, particularly if they have any pre-existing health conditions or are taking other medications that might interact with the drug.
No specific dose adjustments are generally required for mild to moderate renal impairment (creatinine clearance of 30–80 mL/min), but patients with severe renal impairment should use Indacaterol with caution and may need closer monitoring.
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