Oxis turbuhaler - Precautions | Dosage
Oxis turbuhaler contains an active substance called eformoterol (also known as formoterol). It belongs to the group of beta-2 agonists that exhibit bronchodilatory effect. It works by binding to beta-2 receptors in the airway passages, which causes the relaxation of the smooth muscles in the respiratory tract, thus leading to the dilation of airways and facilitated breathing.
Due to such effects, Oxis turbuhaler is used for the treatment of asthma in patients above the age of 6 (taken only in combination with an inhaled corticosteroid) as well as for the treatment of chronic obstructive pulmonary disease in adults.
It is sometimes used to prevent the symptoms of asthma.
It should not be used to relieve asthma symptoms when they have already appeared.
Oxis turbuhaler can increase blood glucose levels and trials have shown that it reduces the effects of insulin. Therefore, caution is advised if this medicine is used in diabetics.
Since it belongs to beta-2 agonists, this drug also exhibits a sympathomimetic effect because it binds to beta-2 receptors in the heart. Due to this effect, it can lead to hypertension, prolonged QTc interval and tachycardia (rapid heart rate), and must be very carefully applied in patients with cardiovascular diseases.
This medicine can cause thyrotoxicosis, and patients who experience symptoms, such as: palpitations, muscle weakness, increased sweating, anxiety, increased appetite, nervousness, and insomnia should immediately contact a doctor. In such situations, ultrasound of the thyroid gland should be performed to confirm thyrotoxicosis.
Oxis turbuhaler can cause a decrease in blood potassium levels (causing condition called hypokalaemia), and low potassium levels can cause serious heart arrhythmias. Patients who are taking water pills (e.g. hydrochlorothiazide) that increase potassium excretion should not use these medicines concomitantly with Oxis turbuhaler without prior consultation with the doctor.
There are no data on the use of this medicine in patients with hepatic impairment, which is the reason why it should not be used in such patients.
Oxis turbuhaler, pregnancy and breastfeeding
Studies that investigated the use of high doses of eformoterol have demonstrated that this drug can cause a decrease in birth weight.
It can be used during pregnancy only if your gynecologist estimates that the benefit to you is greater than the potential risk for the fetus.
Studies in rats have shown that this drug is excreted in milk at low concentrations. For now, there is no evidence that Oxis turbuhaler is excreted into breast milk. It can be used during breastfeeding only if your pediatrician estimates that the benefit to you is greater than the risk for your baby.
Oxis turbuhaler exists in the form of a powder for inhalation at doses of 6 micrograms/actuations, 9 micrograms/actuations and 12 micrograms/actuations.
It starts to work immediately, after only a few minutes and its effects last about 12 hours.
The usual maintenance dose in asthma therapy in patients above 6 years of age is one or two actuations (inhalations) of 6-12 micrograms per day (not more than 24 micrograms per day). Always use the lowest effective dose. Never increase the dose without your doctor's advice.
The usual dose for the prevention of exercise-induced asthma is 6-12 micrograms in the morning or half an hour before exercise.
The usual dose for the treatment of chronic obstructive pulmonary disease (used only in patient older than 18 years) is 12 micrograms once or twice daily.
Oxis turbuhaler should not be used concomitantly with the following medicines:
- Beta-blockers (medicines used to treat cardiovascular diseases), such as:
- Diuretics that decrease blood potassium levels. Simultaneous use with these medicines increases the risk of hypokalaemia.
- Mineral corticosteroids. Simultaneous use with these medicines increases the risk of hypokalaemia.
- Newer antihistamines, such as: terfenadine and astemizole. These drugs can prolong QTc interval, just like Oxis turbuhaler, which can induce serious arrhythmias.
Antiarrhythmic agents, such as:
- Antibiotics, such as: erythromycin, ciprofloxacin, ofloxacin and others. These drugs can also prolong the QTc interval and simultaneous use must be avoided.
Tricyclic antidepressants, such as:
- Efedrine, dopamine, naphazoline and other sympathomimetics. Simultaneous use with these medicines increases the risk of side effects.
Simultaneous use with alcoholic beverages increases the risk of side effects.
Oxis turbuhaler can cause the following side effects:
- Paradoxical bronchospasm
- Palpitations and tachycardia