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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Selective beta-2-adrenoreceptor agonists
tulobuterol
R03AC11
Forms & Strengths
- Transdermal patch: 0.5 mg
- Transdermal patch: 1 mg
- Transdermal patch: 2 mg
Adult Dosing
- Asthma and COPD: 2 mg transdermal patch applied once daily to the chest, back, or upper arm
- Titration: May start with 0.5 mg or 1 mg daily in sensitive patients or children, increasing to 2 mg as needed
Pediatric Dosing
- Infants and children < 6 months: Safety and efficacy not established
- Children 6 months to 3 years: 0.5 mg transdermal patch once daily
- Children 3 to 9 years: 1 mg transdermal patch once daily
- Children >= 9 years: 2 mg transdermal patch once daily
Indications
- Bronchial asthma
- Chronic bronchitis
- Emphysema
Mechanism of Action
- Selective beta-2 adrenergic receptor agonist
- Stimulates intracellular adenylate cyclase, increasing cyclic AMP levels
- Relaxes bronchial smooth muscle and inhibits release of immediate hypersensitivity mediators from mast cells
Contraindications
- Hypersensitivity to tulobuterol or any component of the patch
- Hypertrophic obstructive cardiomyopathy (HOCM)
- Pheochromocytoma
Adverse Reactions
- Palpitations and tachycardia
- Tremor (typically of the fingers)
- Application site reactions (erythema, itching, rash)
- Nervousness, headache, or dizziness
- Hypokalemia (with high doses)
Drug Interactions
- Other beta-adrenergic agonists: May potentiate cardiovascular adverse effects and toxicity
- Non-potassium-sparing diuretics (e.g., loop or thiazide): May exacerbate ECG changes or hypokalemia
- Beta-blockers (non-selective): May antagonize the bronchodilatory effect of tulobuterol
- Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants: May potentiate vascular effects and lead to hypotension or hypertension
Curated Content: Needs Vetting Before Put to Clinical Use