Orciprenaline

Indications
 Oral
Chronic management of reversible airways obstruction
Adult: As sulfate: 20 mg 3 or 4 times daily.
Child: As sulfate: Up to 1 yr: 5-10 mg tid; 1-3 yr: 5-10 mg 4 times daily; 3-12 yr: 40-60 mg daily in divided doses.
Oral
Bradycardia
Adult: As sulfate: Up to 240 mg daily in divided doses.
Inhalation
Acute bronchospasm
Adult: As sulfate: Metered-dose inhaler releasing 750 mcg per inhalation: 1 or 2 inhalations; repeat if necessary. Max: Up to 12 inhalations in 24 hr. As 5% soln from a hand nebuliser: 10 inhalations. With a nebulising device e.g. intermittent positive-pressure breathing (IPPB) apparatus: 0.2-0.3 ml of a 5% solution diluted up to 2.5 ml physiological saline, administered not more often than every 4 hr.
Child: As sulfate: Metered-dose inhaler: >12 yr: 1 or 2 inhalations (750 mcg); repeat if necessary after not <3 hr. Max in 24 hr: <6 yr: Up to 4 inhalations; 6-12 yr: Up to 8 inhalations; >12 yr: Up to 12 inhalations. Nebuliser: Infants and children: 0.01-0.02 ml of 5% solution; min dose: 0.1 ml; max dose: 0.3 ml diluted in 2-3 ml normal saline every 4-6 hr or more frequently if necessary.
Intravenous
Bradycardia
Adult: As sulfate: 250-500 mcg by slow IV inj.
Contraindications
 Cardiac arrhythmias associated with tachycardia.
Warnings / Precautions
 CV disease (e.g. arrhythmia, hypertension, CHF), DM, glaucoma, hyperthyroidism, hypokalaemia, seizure disorders. Pregnancy and lactation.
Adverse Reactions
 Tachycardia, nervousness, increased serum glucose, increased potassium levels, tremor, palpitation, headache, dizziness, insomnia, nausea, vomiting, bad taste, heartburn, xerostomia, trembling, muscle cramps, weakness, coughing, pharyngitis, increased diaphoresis, paradoxical bronchospasm, hypertension, chest pain, angina, drowsiness, diarrhoea, taste change.
Overdose Reactions
 Symptoms: Tachycardia, tremor, hypertension, angina, seizures, hypokalaemia. Treatment: Immediate discontinuation and symptomatic and supportive therapies. Cautious use of β-blockers may be considered in severe cases.
Drug Interactions
 Effects may be antagonised by β-blockers e.g. propranolol. Duration of bronchodilation may be increased with inhaled ipratropium. Increased adverse effects with MAOIs, TCAs, sympathomimetics.
Potentially Fatal: Increased risk of malignant arrhythmias with halothane.
See Below for More orciprenaline Drug Interactions
Mechanism of Actions
 Orciprenaline is a direct acting sympathomimetic with predominantly β2-adrenoceptor stimulant activity. It has minimal effect on heart rate.
Onset: Inhaler: Within 1 min. Nebuliser: 5-30 min. Oral: 15 min.
Duration: Up to 6 hr (inhalation).
Absorption: Absorbed from the GI tract (oral).
Metabolism: Hepatic; undergoes extensive first-pass metabolism.
Excretion: Via urine (mainly as metabolites).
Administration
 May be taken with or without food.
Storage Conditions
 Inhalation: Metered-dose inhaler: Store at 15-25°C. Nebuliser: Store below 25°C. Protect from light. Oral: Store in tight, light-resistant containers at 15-30°C.
ATC Classification
 R03AB03 - orciprenaline ; Belongs to the class of adrenergic inhalants, non-selective beta-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
R03CB03 - orciprenaline ; Belongs to the class of adrenergics for systemic use, non-selective beta-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
Storage
 Inhalation: Metered-dose inhaler: Store at 15-25°C. Nebuliser: Store below 25°C. Protect from light. Oral: Store in tight, light-resistant containers at 15-30°C.
Available As
  • Orciprenaline 0.5 mg
  • Orciprenaline 10 mg

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