Bambuterol

It is an oral prodrug of terbutaline with a prolonged duration of bronchodilator action that allows once-daily administration. It is an inactive site-specific prodrug that delivers active terbutaline only to the target tissue i.e., lung. Clinical studies have shown that bambuterol is as effective as other oral and inhaled b2-agonists including salbutamol, terbutaline and salmeterol, and theophylline(both conventional and controlled release formulations).

Indications

Maintenance treatment of bronchial asthma, Nocturnal asthma, COPD

Dosage

Adults: 10mg tablet once daily in the evening, may be increased to 20mg after 1-2 weeks.

Contra-Indications

Hypersensitivity to any of the ingredients or terbutaline, Hepatic impairment liver, cirrhosis or severely impaired liver function.

Special Precautions

Dose should be reduced in patient with severely impaired renal function, care should be taken while prescribing bambuterol in patients with genetic deficiencies of plasma cholinesterase, caution should be implemented in patients with severe ischaemic heart failure. Pregnancy and lactation: Not recommended.

Side Effects

Tremor, headache, muscle cramps, palpitation, fatigue and insomnia. Generally, these effects were mild in nature and their incidence decreased with time.

Drug Interactions

Bambuterol reversibly inhibits plasma cholinesterase which prolongs the neuromuscular blockade induced by succinylcholine, by upto four times. Hypertensive crisis and other adverse effects occur frequently with the concurrent use of bambuterol with monoamine oxidase inhibitors, bambuterol may partly or totally inhibit the effect of b-blockers.