Mechanism of effect
Bitolterol is an adrenergic beta-2 agonist. Asthma results from a narrowing of the bronchial tubes. This narrowing is caused by muscle spasm and inflammation within the bronchial tubes. Agonism of the beta-2 adrenergic receptors by bitolterol leads to a relaxation of the smooth muscles surrounding these airway tubes which then increases the diameter and ease of air flow through the tubes.
Pharmacodynamic
Bitolterol, an adrenergic bronchodilator, is a prodrug that widens constricted airways in the lungs by relaxing the smooth muscles that surround the bronchial passages.
Pharmacokinetics
Not Available
Dosage
Adult
Asthma - Acute
Inhalation aerosol: 2 inhalations at an interval of at least 1 to 3 minutes followed by a third inhalation if needed. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Continuous flow nebulization: 2.5 mg 3 times a day with a maximum daily dose of 14 mg. Treatments should be at least 4 hours apart.
Asthma - Maintenance
Inhalation aerosol: 2 inhalations every 8 hours. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Continuous flow nebulization: 2.5 mg 3 times a day with a maximum daily dose of 14 mg. Treatments should be at least 4 hours apart.
Chronic Obstructive Pulmonary Disease - Acute
Inhalation aerosol: 2 inhalations at an interval of at least 1 to 3 minutes followed by a third inhalation if needed. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Continuous flow nebulization: 2.5 mg 3 times a day with a maximum daily dose of 14 mg. Treatments should be at least 4 hours apart.
Chronic Obstructive Pulmonary Disease - Maintenance
Inhalation aerosol: 2 inhalations every 8 hours. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Continuous flow nebulization: 2.5 mg 3 times a day with a maximum daily dose of 14 mg. Treatments should be at least 4 hours apart.
Pediatric
Asthma - Acute
>=12 years:
Inhalation aerosol: 2 inhalations at an interval of at least 1 to 3 minutes followed by a third inhalation if needed. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Continuous flow nebulization: 2.5 mg 3 times a day with a maximum daily dose of 14 mg. Treatments should be at least 4 hours apart.
Asthma - Maintenance
>=12:
Inhalation aerosol: 2 inhalations every 8 hours. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Continuous flow nebulization: 2.5 mg 3 times a day with a maximum daily dose of 14 mg. Treatments should be at least 4 hours apart.
Chronic Obstructive Pulmonary Disease - Acute
>=12 years:
Inhalation aerosol: 2 inhalations at an interval of at least 1 to 3 minutes followed by a third inhalation if needed. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Chronic Obstructive Pulmonary Disease - Maintenance
>=12:
Inhalation aerosol: 2 inhalations every 8 hours. Do not exceed 3 inhalations every 6 hours or 2 inhalations every 4 hours.
Inhalation solution:
Intermittent nebulization: 0.5 to 1.5 mg every 8 hours. Treatments may be increased to four times a day, however, the interval between treatments should not be less than 4 hours. In severely obstructed patients, a dose of 2 mg may be used with a maximum daily dose of 8 mg.
Continuous flow nebulization: 2.5 mg 3 times a day with a maximum daily dose of 14 mg. Treatments should be at least 4 hours apart.
Side effects
Headache , nausea , vertigo , palpitations , Tremor , difficulty urinating , Restlessness , lightheadedness , rhinitis , mouth irritationInteractions
Levobunolol , Carteolol , Propranolol , Timolol , Sotalol , Labetalol , Carvedilol , cocaine , Pindolol , Ribociclib , Penbutolol , NadololAlerts
- heart disease or high blood pressure,
- epilepsy or another seizure disorder,
- diabetes,
- an overactive thyroid (hyperthyroidism), or
- any type of liver or kidney disease.
Points of recommendation
It is very important that you use your bitolterol inhaler or nebulizer properly, so that the medicine gets into your lungs. Your doctor may want you to use a spacer with your inhaler. Talk to your doctor about proper inhaler and nebulizer use.
If you also use a steroid inhaler, use your bitolterol inhaler or nebulization solution first to open up your airways, then use the steroid inhaler as directed.
Use the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.
Avoid situations that may trigger an asthma attack such as exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens such as pet fur.
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