Indacaterol is a type of drug known as a long-acting beta2 agonist that works by activating beta2 adrenoceptors in the body and leading to relaxation of the bronchial tubes in the airways. This makes it easier for you to breathe and helps to reduce the symptoms of chronic obstructive respiratory disease (COPD.)
It has a long duration of action and can continue to have an effect on your body for up to 24 hours after taking a dose, which makes it useful for preventative treatment.
Brand Names and Doses
Indacaterol is the generic name of the drug, which is the name of the active ingredient inside the medication that has an effect on your body. However, you may know it better the brand name, Onbrez, which is the name given by the pharmaceutical company that produces it.
There are two doses available of Onbrez capsules: 150 mcg and 130 mcg.
The Onbrez capsules need to be taken with a special inhalation device, called Breezhaler, so that you can inhale the contents of the capsule rather than swallow them.
What type of drug is it?
Indacaterol is a type of drug known as a beta2 agonist. This is a group of drugs that act in a similar way to activate the beta2 adrenoceptors and cause the airways to relax.
Specifically, it is a long-acting beta2 agonist because it works for a longer period of time in your body. Other long-acting beta2 agonists include eformeterol and salmeterol.
Short-acting beta2 agonists that also work in a similar way but for a shorter period of time include salbutamol and terbutaline.
How does Indacaterol work?
Indacaterol works by stimulating certain receptors in the body, called beta2 adrenoceptors. When these adrenoceptors become activated, the smooth muscle surrounding the bronchial tubes relaxes, allowing the airways to expand and the air to pass through more easily. This is useful in the management of respiratory conditions such as COPD. However, it is a newer drug so there may be unreported adverse effects that we are not yet aware of.
Indacaterol has a longer duration of action than other types of beta2 agonists, which is what makes it a good choice for ongoing preventative treatment. It is also quick to have an effect, which means that it can also help to relieve acute symptoms.
What is it used for?
Indacaterol is usually used in the management of respiratory conditions such as COPD. It is quite quick to have an effect on your body and can begin working within 5 minutes of administration. The effect of the drug reaches a peak a 2-4 hours after being administered and can last for up to 24 hours.
As it has an extended duration of action, it can be useful for the ongoing management of COPD symptoms to help prevent them from worsening.
As indacaterol is a preventative medication, it is important to take it regularly as your doctor recommended, even if you feel better and don’t have any symptoms. This is because it may be helping to prevent COPD symptoms in the background and you may begin to experience symptoms once again if you stop taking it.
How is Indacaterol administered?
It is best for Indacaterol to be delivered straight to the airways where it is needed so that it is able to work more quickly and you are less likely to experience side effects in other areas of your body.
Indacaterol is available in capsule form, but they should not be swallowed and should, instead, be administered with the use of a Breezhaler, which comes with the Onbrez capsules.
Side Effects
Some people who take indacaterol may experience some side effects, particularly if they take high doses of the medication. Side effects may include:
- Tremor in the hands
- Heart palpitations
- Fast heart rate (tachycardia)
- Headache
- Hyperglycemia
- Muscle cramps
- Agitation
Drug Interactions
Indacaterol can interact with some other drugs that you may be taking, and it is important for you to be aware of these interactions so that you can double check that the combination is okay.
When it is used alongside sympathomimetic amines (e.g. ephedrine, phenylephrine, pseudoephedrine,) there is an increased risk of side effects such as tremor, tachycardia and headache. This combination can sometimes be used, but the doses may need to be changed to account for the interaction.
Beta-blockers are another group of drugs that are commonly used in the management of hypertension and arrhythmias. Beta-blockers and Indacaterol have an opposite effect on the beta2 adrenoceptors in the body, so they are not usually used together, or a selective beta blocker should be recommended.
When theophylline and indacaterol are taken together, there is a higher risk of low levels of potassium in the blood (hypokalemia). If you are taking both together, your doctor will need to monitor your potassium levels more closely than usual so that you can take action if needed.
Precautions
There are some people who may be more likely to experience side effects when taking Indacaterol.
For example, if you have hypertension, ischemic heart disease, heart failure or arrhythmias you may be more likely to experience side effects related to the heart, such as palpitation and fast heart rate. People with hyperthyroidism are also more likely to experience these effects.
Additionally, you may be at an increased risk of high levels of glucose in your blood (hyperglycemia), if you have diabetes.
Indacaterol is not usually used alone to prevent COPD symptoms because it may worsen symptoms when used in high doses. Instead, it is best to combine it with an inhaled corticosteroid medication so that they can both help to prevent symptoms and lower doses may be used.
Pregnancy and Breastfeeding
There is not much evidence to guarantee the safety of indacaterol for women who are pregnant or breastfeeding. However, it is important that asthma symptoms are well controlled and many women are recommended to continue taking indacaterol as usual if they were taking it regularly before becoming pregnant.
There is little data about the use of indacaterol for women who are breastfeeding, although it should be safe to use.
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