Indacaterol (Inhalation)

Overview

Patients who suffer from COPD often have shortness of breath, wheezing, coughing and tightness in their chests. Indacaterol inhaled powder medication is prescribed to ease these symptoms by opening the air passageways and relaxing the lungs, making it easier to breathe.

This medication is for once daily use only and is not a rescue type inhaled medication. It is meant to treat symptoms before they start, by being present in the lungs on a consistent basis. It is, therefore, very important that patients take their inhaled dose at the same time every day. Indacaterol is not a cure for any lung condition and may become less effective over time.

Considered the longest acting bronchodilator drug on the market, Indacaterol has only been approved for use in the US since 2011, though it has been used in the European market since 2009. This drug is considered safe and ultra-long lasting, with an effectiveness period of 24 hours. The primary effect that patients may feel after a dose of Indacaterol is coughing, which typically subsides in a few minutes.

The air passages in our lungs are controlled by muscle groups that, in patients with COPD, can be spastic and tight, causing symptoms such as wheezing, choking, coughing and difficulty breathing. Indacaterol targets the muscles found in the air passages, relaxing them and enlarging the air passage diameter, which makes breathing easier.

Conditions Treated

  • Chronic obstructive pulmonary disease (COPD)

Type Of Medicine

  • Long-acting beta2 agonist brochodilator

Side Effects

As previously mentioned, many patients experience a short period of coughing after a dose of Indacaterol. Other effects on health may occur with use of this medication that could be severe or dangerous. Report any symptoms, such as those listed below, to your physician right away:

  • Pain in jaw, back or arm
  • Discomfort or pain in chest
  • Tight, heavy feeling in chest
  • Coughing
  • Dizziness
  • Fainting spells
  • Irregular or rapid heart rhythm
  • Chills
  • Fever
  • Nausea
  • Difficulty breathing
  • Sneezing, stuffed or runny nose
  • Throat soreness
  • Sweating
  • Wheezing
  • Pain in stomach or abdomen
  • Swollen, bloated arms, face, hands, feet or lower legs
  • Vision changes or blurring
  • Dry mouth
  • Stuffed ears
  • Dry skin that appears flushed
  • Fruity breath
  • Headache
  • Hunger and thirst have increased
  • Urination is more in volume or frequency
  • Passing out
  • Vocal changes
  • Gaining weight
  • Stomach ache or ill feeling
  • Feet or hands tingle
  • Losing weight unexpectedly
  • Weak muscles
  • Fatigue
  • Vomiting
  • Racing heart, pounding or irregular rhythm

Rarely, the following adverse health symptoms are experienced by some patients. These typically go away over time with continued treatment, but should be reported to your physician in case they can be simply alleviated:

  • Pain in bones or muscles
  • Muscle spasms
  • Tender cheekbones or eyes
  • Skin rashes
  • Itching

Other symptoms may occur in some patients; should you experience any changes to your overall health during your treatment with Indacaterol, inform your doctor at once.

Dosage

Indacaterol should be taken at the same time every day, once per day as indicated on your prescription. Follow what your doctor has written on your prescription to the letter and do not take more of the medication or take it more frequently than indicated.

This medication is indicated for a 24 hour long-term ease of your COPD symptoms by dilating your air passages. This is not to be used as a rescue treatment; another drug and inhaler method will be prescribed to you for emergency situations. Do not use the inhaler device that comes with your Indacaterol with any other drug and do not use any other device with your Indacaterol.

Your Indacaterol will arrive with a patient information leaflet that is full of information that you should read and comprehend. Ask any questions necessary of your doctor or pharmacist to ensure that you are aware how this medication will work for you and any risks you are under by taking it.

Indacaterol arrives in individual capsules encased in a blister pack. Do not remove the capsules from the blister pack until you are ready for a dose. Do not swallow the capsule; you will insert this into the inhaler device and inhale the medication from the capsule.

To take your Indacaterol with the inhaler device, follow these steps:

  • Wash hands and dry completely before you touch the medication
  • Remove a capsule from the blister pack
  • Open the base of the inhaler device and tilt the mouthpiece
  • Place the capsule in the chamber at the inhaler's base
  • Hold the mouthpiece upright and press both buttons simultaneously to pierce the capsule with a click
  • Exhale fully before placing the mouthpiece to your mouth
  • Put the mouthpiece in your mouth, close your lips and inhale deeply
  • Remove the inhaler and hold your breath as long as possible
  • Exhale
  • Open the inhaler to eject the empty capsule, which should be discarded immediately
  • Close and replace the cover of the inhaler device

Keep your inhaler device dry and do not wash it in any liquids. Replace your inhaler with each refill of your medication, but use the same one throughout your cycle. Do not use the inhaler device with any other medications.

Follow the instructions written on your prescription exactly, which will most likely consist of 75 micrograms of Indacaterol contained in a single capsule once per day, inhaled through the device that comes with your prescription only. Do not use any other devices to inhale Indacaterol.

If you miss a dose of this medication, you should not double dose if it is close to the time of your next dosage - skip the missing dose. Stick to a once daily dosing routine as closely as you can to avoid missing any doses of this medication.

Interactions

Any hypersensitivity you have experienced to medications in the past should be made known to your physician before taking Indacaterol. Include any incidents involving animals, foods, perfumes, preservatives or dyes that could be considered sensitive reactions.

Pediatric patients are not candidates for treatment with Indacaterol, as the drug has not been proven to be safe on this segment of the population, nor is it effective in treating any conditions common to this age group.

Geriatric patients are able to take Indacaterol with the same confidence in the effectiveness and safety of adult patients.

Women who are pregnant and those who are breastfeeding have not been studied for any risks that they may pass on to their children with use of Indacaterol. In these groups, avoid this medication if at all possible or proceed with caution under doctor's advisement.

Certain inhaled anesthetic agents known as sympathomimetics may interact with Indacaterol and put your health in danger, having adverse effects on your heart rhythm. Make sure all health care professionals who treat you are aware that you take Indacaterol prior to any treatments, including surgical interventions where inhaled anesthetics will be used.

Patients who are on beta-blocker type medications for heart problems or certain anti-depressants for mood symptoms are also at risk for adverse health effects through the interaction of these drugs with Indacaterol. Make sure your doctor knows of all medications that you take before being prescribed this drug, especially heart medicines and anti-depressants.

Disclose your full list of prescribed medications to your medical doctor, as well as any non-prescription remedies you rely on and any vitamins, herbs or holistic supplements you take, as well.

It is best to avoid the use of tobacco products when you are taking Indacaterol inhaled medications. Discuss cessation methods with your physician prior to taking this medication for your condition, or you could risk serious health effects by combining the effects of tobacco products with this medication. Your doctor can advise you if there are any foods you should avoid and what the interaction risk is with alcoholic beverage consumption, as well.

Some health conditions can change the way your body processes Indacaterol and can even become worse with the use of this drug. Disclose your full medical history to your physician prior to being treated with this medication, especially if you have:

  • Milk protein allergy
  • Asthma
  • Severe COPD attacks
  • Diabetes
  • Blood vessel or heart disease
  • Long QT syndrome
  • Hypertension
  • Overactive thyroid
  • Low blood potassium level
  • High blood ketone level
  • Seizures

Warnings

The effectiveness of this drug may diminish over long term use; for this reason, your physician will schedule regular visits with you to make sure Indacaterol is still working on your symptoms and that no extra dosing is required on your part. You will also be checked for any ill effects on your health as the result of using this drug. Alert your doctor as to how many times you've had to use your rescue method of inhaler and if incidences of emergency breathing difficulty have increased.

Indicate any other COPD medications you are using at the time you are prescribed Indacaterol, as you may need to continue using them or keep them available for emergencies. Follow your doctor's prescribed instructions on how to use your medications.

Do not use Indacaterol if you are having a COPD attack, especially if the attack symptoms have started, even if it is your dosage time. Use your prescribed rescue inhaled medication for any attack symptoms and alert your physician if the rescue medication isn't working for you.

If your COPD symptoms do not improve after a few days use of this medication, alert your physician to this fact. Avoid taking Indacaterol if you are taking other inhaled medications, such as Symbicort, Foradil, Brovana, Perforomist, Serevent and Advair.

Indacaterol may cause you to have breathing or wheezing issues that are worse than normal, which indicates a condition known as paradoxical bronchospasm. This condition can be life-threatening, so discontinue use of Indacaterol and seek emergency help from your physician. Symptoms include difficulty breathing, coughing, wheezing or shortness of breath after your inhaled dose of Indacaterol.

Indacaterol may put you at risk for a condition where the potassium level in your blood dips drastically low, known as hypokalemia. Symptoms of this condition include a decrease in urine, dryness in your mouth, increased thirst, appetite loss, mood changes, cramps or pain in your muscles, vomiting, nausea, tingling lips, hands or feet, seizures, irregular heart rhythm, shortness of breath and fatigue. Report any sign of hypokalemia to your physician right away.

Your blood sugar levels could be affected by use of Indacaterol, so if you are diabetic or have a glucose sensitivity, make sure your doctor is informed so that they can show you how to test and control your blood sugar levels during your treatment.

Avoid taking other medications while you are on a regular dose of Indacaterol unless they are specifically prescribed by your physician. This includes any homeopathic, herbal, vitamin or non-prescription drugs and substances. Do not smoke or use tobacco products while you are taking an inhaled medication such as Indacaterol.

Avoid situations that put your breathing at risk, such as dusty, dirty, moldy air conditions, places with excessive smoke, humidity, pet dander or pollen.

Storage

To properly and safely store Indacaterol, keep it in the original packaging with the container closed at room temperature. Do not expose Indacaterol to excessive heat, light or moisture and never allow it to freeze. It is best not to store Indacaterol in the bathroom, as there is excessive moisture in bathrooms from steam.

This and all medications should be kept out of sight and reach of children. When it comes time to dispose of expired or unused Indacaterol, consult your doctor or pharmacist for the safest way to do so.

Summary

Indacaterol is an inhaled, ultra-long acting beta2 adrenoceptor antagonist drug that works to dilate air passages in patients who suffer from COPD. This medication is intended as a maintenance level treatment to be taken once daily to keep symptoms such as wheezing, coughing and shortness of breath at bay in patients with this condition. It is not a cure for COPD, nor is it an emergency inhaled medication for acute attack situations.

Patients are urged to take Indacaterol once daily at the same time of day in order to keep a steady supply in their air passages. Double dosing is not recommended in the case of a missed dosage, which is why it is important to stick to a consistent dosing schedule.

Indacaterol arrives in a capsule form, but is not to be swallowed. The capsule is inserted into a special inhalation device that is included with the prescription. This inhalation device pierces the capsule and releases the medication for the patient to inhale through the mouthpiece. This device should only be used with Indacaterol medication and no other and should be kept dry. Discard used capsules after inhaling and store the device empty and ready for the next dose. Do not store the medication or the inhaler in the bathroom or other steam-filled environments.

Patients should be alert for any changes to their health when taking Indacaterol inhaled medication and report these symptoms to their doctors at once. Some patients reported coughing after taking their dose of Indacaterol, which disappeared after a few moments. Prolonged coughing or any worsening of your COPD symptoms while taking Indacaterol should be reported to your physician.

Avoid taking any other medications if you are on a treatment regimen with Indacaterol unless your doctor has specifically approved and prescribed their use. Some patients will be prescribed another inhaled medication that is to be used only in emergency situations. Should the frequency of your breathing emergencies increase, your doctor will want to know.

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Last Reviewed:
March 26, 2018
Last Updated:
April 16, 2018
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