olodaterol hydrochloride: clinical use

Prescribing considerations

• Confirm COPD and that maintenance bronchodilation, rather than acute symptom relief, is intended.
• Assess and demonstrate reusable Respimat preparation and inhaler technique.
• Use cautiously in significant cardiovascular disease, arrhythmia, QT prolongation, hypertension, aneurysm, thyrotoxicosis, convulsive disorders or unusual sensitivity to sympathomimetics.
• Evidence is limited in severe renal impairment; the product has not been studied in severe hepatic impairment.

Contraindications and cautions

• Hypersensitivity to olodaterol or any excipient.
• Do not use for asthma, acute bronchospasm or with another long-acting beta2 agonist.

Monitoring

• COPD symptoms, exacerbations and rescue-treatment use.
• Inhaler technique, adherence and cartridge/device handling.
• Pulse, blood pressure and cardiac symptoms in susceptible patients.
• Serum potassium and blood glucose where risk is increased.
• Immediate hypersensitivity or paradoxical bronchospasm after inhalation.

Clinical pharmacology

A selective inhaled beta2-adrenoceptor agonist that raises intracellular cyclic AMP, relaxing airway smooth muscle. Systemic availability after inhalation is principally determined by pulmonary absorption; metabolism mainly involves glucuronidation and O-demethylation followed by conjugation.

Formulation and product differences

• Clear, colourless inhalation solution in cartridges for a reusable Respimat soft-mist inhaler.
• The inhaler accepts replacement cartridges and is intended for one patient.
• Contains benzalkonium chloride, which can cause wheezing or bronchospasm in susceptible people.
• Contains no inhaled corticosteroid or antimuscarinic component.