Home Drug Guide Indacaterol Maleate

Drug Guide

Generic Name

Indacaterol Maleate

Brand Names Arcapta Neohaler

Classification

Therapeutic: Bronchodilator for COPD

Pharmacological: Beta-2 adrenergic agonist

FDA Approved Indications

  • Maintenance treatment of bronchospasm associated with COPD

Mechanism of Action

Indacaterol is a long-acting beta-2 adrenergic agonist that relaxes airway smooth muscle by stimulating beta-2 receptors, leading to bronchodilation.

Dosage and Administration

Adult: 75 mcg once daily via inhalation using Neohaler device

Pediatric: Not indicated for pediatric use

Geriatric: Use with caution; monitor for cardiovascular effects; no specific dosage adjustment required

Renal Impairment: No specific adjustment recommended

Hepatic Impairment: Use with caution; limited data available, adjust as necessary

Pharmacokinetics

Absorption: Rapid absorption after inhalation

Distribution: Widely distributed in tissues, protein binding about 50%

Metabolism: Partially metabolized in the liver, primarily via CYP450 enzymes

Excretion: Excreted mainly via feces; minimal renal excretion

Half Life: Approximately 34 hours, allowing once-daily dosing

Contraindications

  • Hypersensitivity to indacaterol or any component of the formulation

Precautions

  • Use with caution in patients with cardiovascular disease, tremor, or hyperthyroidism; monitor for paradoxical bronchospasm

Adverse Reactions - Common

  • Upper respiratory tract infection (Common)
  • Cough (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Paradoxical bronchospasm (Serious—rare)
  • Cardiovascular effects (e.g., tachycardia, arrhythmias) (Serious—rare)

Drug-Drug Interactions

  • Other long-acting beta-2 agonists, beta-blockers (may diminish efficacy)

Drug-Food Interactions

  • None specific

Drug-Herb Interactions

  • None established

Nursing Implications

Assessment: Assess respiratory status and auscultate lungs before and periodically during therapy; monitor for paradoxical bronchospasm.

Diagnoses:

  • Impaired gas exchange related to bronchospasm
  • Risk for decreased cardiac output related to cardiovascular stimulation

Implementation: Administer via inhalation once daily; instruct patient on proper inhaler technique; monitor for adverse effects.

Evaluation: Evaluate effectiveness by assessing improved respiratory symptoms and lung function.

Patient/Family Teaching

  • Use daily as prescribed; do not double doses.
  • Report new or worsening cough, chest pain, or irregular heartbeat.
  • Carry quick-relief inhaler for rescue use.
  • Avoid excessive use of bronchodilators.

Special Considerations

Black Box Warnings:

  • None currently

Genetic Factors: None well established

Lab Test Interference: None known

Overdose Management

Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, tremors, chest pain

Treatment: Discontinue drug, monitor cardiovascular status, provide supportive care as needed, and treat symptoms accordingly.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F); protect from moisture and heat.

Stability: Stable within specified storage conditions, follow manufacturer guidelines.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.