Other Names/Brands

Onbrez Breezhaler, Ultibro Breezhaler

Mechanism of Action

Indacaterol is a long-acting beta-2 agonist (LABA) used to widen the airways in people with chronic obstructive pulmonary disease (COPD).

Indacaterol works by stimulating beta-2 adrenergic receptors in the smooth muscles of the airways, causing them to relax and widen the airways. This effect helps make breathing easier and reduces symptoms of shortness of breath or wheezing. Indacaterol has a duration of action of up to 24 hours.

Indications

Indacaterol is indicated for the long-term maintenance treatment of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, to relieve symptoms of shortness of breath and improve lung function.

This medication is not used to treat acute asthma attacks or sudden shortness of breath but rather for daily symptom control and to improve the quality of life of COPD patients.

Contraindications

Indacaterol is contraindicated in patients with known hypersensitivity or allergy to indacaterol or any of its components. This medication should not be used in patients with asthma, as it may increase the risk of serious side effects without providing sufficient benefit.

Indacaterol should also be avoided in patients with certain heart conditions, such as severe arrhythmias or unstable ischemic heart disease, unless under a doctor's supervision.

Side Effects

Possible side effects of indacaterol include coughing immediately after inhalation, headache, dizziness, tremors, and palpitations. Some patients may also experience throat irritation, muscle cramps, or increased blood sugar levels. Less common but serious side effects include allergic reactions such as rash, swelling, or difficulty breathing.

Preparations

Indacaterol is available as a single-dose inhalation powder used with a special inhaler device, such as an inhaler capsule (e.g., Onbrez Breezhaler®). Each capsule typically contains 150 micrograms or 300 micrograms of indacaterol maleate, which is inhaled once daily as directed by a doctor.

This preparation is designed to deliver the medication directly to the airways, resulting in a rapid onset of action and a lower risk of systemic side effects than oral medications.

Dosage

The therapeutic dose of indacaterol is generally administered once daily, at 150 µg or 300 µg per inhalation, according to clinical indications and physician discretion. The preparation is administered via a capsule inhaler, with a delivery mechanism directly into the respiratory tract to ensure optimal local bioavailability. More than one dose per day is not recommended, and the capsules should be inhaled through the inhaler, not swallowed, to prevent decreased efficacy.

Safety of Drugs

Indacaterol is classified as pregnancy category C by the FDA, meaning animal studies have shown adverse effects on the fetus, but human data are limited. This medication should only be used if the expected benefit outweighs the potential risks. Use in breastfeeding mothers should be avoided or undertaken under medical supervision, as the effects on the infant are not fully understood.

Drug Interactions

Indacaterol may interact with other medications that affect the heart or cardiovascular system, such as beta-blockers, diuretics, or digoxin, increasing the risk of side effects such as palpitations, hypertension, or arrhythmias.

Concurrent use with other beta-2 stimulant medications should also be avoided, as this can potentiate the pharmacological effects and increase the risk of tremor or tachycardia.

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