Onbrez Breezhaler (Indacaterol)

Indacaterol is a bronchodilator that acts on the airway smooth‑muscle pathway to improve airflow in chronic obstructive pulmonary disease.

• COPD maintenance therapy: improves lung function and reduces symptom burden.
• Exercise intolerance in COPD: enhances exercise capacity and reduces dyspnoea.
• Preventive bronchodilation: provides 24‑hour bronchodilation to reduce the need for rescue medication.

• Indacaterol selectively stimulates β2‑adrenergic receptors on airway smooth muscle, leading to activation of adenylate cyclase, increased cyclic AMP, and relaxation of bronchial smooth muscle. This results in sustained bronchodilation for up to 24 hours after inhalation, improving airway patency in patients with chronic obstructive pulmonary disease.

Adverse reactions reported with indacaterol inhalation are generally mild to moderate in severity.

Common Side Effects

• Cough
• Throat irritation
• Nasal congestion
• Headache
• Upper respiratory tract infection
• Dry mouth

Serious or Rare Side Effects

• Paradoxical bronchospasm
• Cardiovascular events such as tachycardia or palpitations
• Severe allergic reactions (anaphylaxis)
• Hypersensitivity skin rash
• Pneumonia
• Acute respiratory failure

When prescribing Onbrez Breezhaler, clinicians should consider several safety aspects.

• Assess risk of cardiovascular disease : review patient’s history and monitor heart rate and blood pressure.
• Monitor for paradox bronchospasm : advise patients to stop treatment if worsening breath lessness occurs.
• Review concomitant beta‑beta agonist use : avoid excessive β‑agonist exposure.
• Caution in patients with severe renal impairment : dose adjustment is not required but monitor closely.
• Educate on proper inhaler technique : incorrect use can reduce efficacy.
• Store at ambient temperature: keep in original pack and protect from moisture.

Indacaterol may interact with other medicines that affect the cardiovascular or respiratory systems.

Major Interactions (Avoid)

• Non‑selective β‑blockers : increased risk of reduced bronchodilation.
• Monoamine oxidase inhibitors (MAOIs) : potential for heightened cardiovascular effects.

Moderate Interactions (Monitor Closely)

• Other long‑acting β2‑agonists : additive bronchodilator effect may increase side‑effect risk.
• Diuretics : may potentiate tachycardia.
• Theophylline : monitor for increased theophylline levels.
• Anticholinergic bronchodilators : watch for cumulative airway effects.