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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS FOR SYSTEMIC USE › Selective beta-2-adrenoreceptor agonists
tulobuterol
R03CC11
Forms & Strengths
- Transdermal patch 1 mg/24 h (pediatric)
- Transdermal patch 2 mg/24 h (adult)
Adult Dosing
- 1 × 2‑mg patch applied once daily, replace every 24 h
- Maximum 2 mg per day; do not apply additional patches
- Use as maintenance therapy, adjunct to inhaled corticosteroids
- Avoid concomitant use of other long‑acting β2‑agonists
Pediatric Dosing
- Children ≥5 yr: 1‑mg patch applied once daily, replace every 24 h
- Dose may be increased to 2 mg/day if clinically indicated and tolerated
- Do not use in children <5 yr
Indications
- Maintenance treatment of asthma
- Prevention of bronchospasm in COPD
- Adjunct for exercise‑induced bronchoconstriction
Mechanism of Action
- Selective β2‑adrenergic receptor agonist
- Stimulates adenylate cyclase → ↑cAMP → bronchodilation
- Prolonged bronchodilator effect via transdermal absorption
Contraindications
- Hypersensitivity to tulobuterol or patch excipients
- Severe cardiac arrhythmias or tachyarrhythmias
- Uncontrolled hypertension
- Thyrotoxicosis
- Acute narrow‑angle glaucoma
Adverse Reactions
- Tremor (especially hands)
- Palpitations or tachycardia
- Headache
- Insomnia
- Nausea or dyspepsia
- Hypokalemia
- Hyperglycemia
- Muscle cramps
Drug Interactions
- Non‑selective β‑blockers (e.g., propranolol) antagonize bronchodilation
- Concurrent sympathomimetics may augment cardiovascular effects
- Loop or thiazide diuretics may worsen hypokalemia
- Digitalis – increased arrhythmia risk
- MAO inhibitors – potentiation of sympathomimetic actions
- CYP2C9 inhibitors may raise plasma tulobuterol levels
Curated Content: Needs Vetting Before Put to Clinical Use