Highlights
- Hundreds of millions of people worldwide suffer from chronic respiratory diseases.
- Bronchodilators make a normal life possible for many people.
- Bronchodilators work by relaxing the smooth muscles of the airways and lungs.
- Find the lowest price for asthma medications with BidRx.
Being unable to get sufficient air through your lungs to provide your body with the oxygen it needs is an agonizing experience. More than half a billion people who suffer from chronic respiratory problems go through that experience regularly.
For many, bronchodilators are a lifeline.
How Do Bronchodilators Work?
Chronic respiratory diseases like asthma and COPD are among the leading causes of mortality worldwide.
Bronchodilators help by relaxing the smooth muscles in the airways and lungs, which widens the airways and allows more air to pass through. These life-saving drugs are available as pills, inhalers, or nebulizing solutions.
Many bronchodilators are combined with corticosteroids, another class of drugs that are often used to treat asthma and COPD. Corticosteroids work by reducing inflammation in the airways. When used together with bronchodilators, corticosteroids can help to improve lung function and reduce the frequency and severity of asthma attacks.
Bronchodilators are available in two forms: short-acting and long-acting:
- Short-acting bronchodilators are used to relieve acute asthma symptoms, such as wheezing, shortness of breath, and chest tightness. They work quickly, but their effects only last for a few hours.
- Long-acting bronchodilators are used to prevent asthma symptoms from occurring in the first place. They work more slowly than short-acting bronchodilators, but their effects can last for up to 12 hours.
Adrenergic Bronchodilators
The smooth muscle lining the airways carries beta2 adrenergic receptors. The human body creates compounds that act on these receptors, causing them to relax the smooth muscles of the airways, intestines, and uterus. Some of these compounds are epinephrine, dopamine, and norepinephrine.
Some stimulants act indirectly, causing the body to release more of these compounds.
Adrenergic bronchodilators mimic the action of these compounds. They interact with the beta2 adrenergic receptors directly to quickly open the airways.
Doctors use adrenergic bronchodilators to treat many condition, including:
- COPD
- Shock
- Premature labor
- Anaphylaxis
- Asthma
- Allergic reactions
- AV heart block
- Bronchospasm
- Pupillary dilation
- Cardiac arrest
- Arrhythmias
Bronchodilators can have severe side effects. Improper use may cause patients to lose sensitivity to these drugs. They are all prescription-only medications.
- Albuterol systemic (Proventil HFA, RespiClick, Ventolin HFA, and others )
- Epinephrine systemic (Primatene Mist Inhaler)
- Levalbuterol systemic (Xopenex, Xopenex HFA)
- Racepinephrine systemic (Nephron, Micronefrin, S2 Inhalant, and others)
- Formoterol systemic (Perforomist, Foradil Aerolizer)
- Terbutaline systemic
- Arformoterol systemic (Brovana)
- Olodaterol systemic (Striverdi Respimat)
- Pirbuterol systemic (Maxair, Maxair Autohaler)
- Isoproterenol systemic (Isuprel HCl, Isuprel Mistometer, Medihaler-Iso)
- Salmeterol systemic (Serevent, Serevent Diskus)
- Metaproterenol systemic (Alupent, Metaprel)
- Indacaterol systemic (Arcapta Neohaler)
Warnings and Contraindications – Adrenergic Bronchodilators
Patients who use adrenergic bronchodilators like albuterol must keep their medication on hand at all times. If you use an adrenergic bronchodilator, ensure you have your prescription refilled before you run out of medication.
Always take your medications as directed by your doctor. Talk to your doctor if you need to use more than prescribed.
Drugs like albuterol may increase hospitalization and risk of death in patients with asthma. Do not use these medications if you are allergic to them or their components. Some brands are not suited for people with milk protein allergies.
When your doctor prescribes you an adrenergic bronchodilator, tell him/her if you have any of the following conditions:
- Diabetes
- Problems with your thyroid
- Epilepsy
- Heart rhythm problems
- Low blood potassium levels
- Heart disease or heart failure
Adrenergic bronchodilators may affect unborn babies, but doctors prescribe them to pregnant mothers anyway, as the risks of uncontrolled asthma far outweigh the risks the medications may pose.
Try not to get these drugs in your eyes. If you do, rinse with plenty of water.
Side Effects – Adrenergic Bronchodilators
Some of the common side effects of adrenergic bronchodilators like albuterol include:
- Dizziness
- Fast heartbeats
- Chest pain
- Restlessness and shakiness
- Vomiting and stomach pain
- Cough
- Sore throat
- Headaches
- Body aches
- Runny nose
- Difficult and painful urination
The list is not complete. You may experience other, less-severe side effects when taking adrenergic bronchodilators.
The severe side effects of this drug class can include:
- Irregular heartbeats
- Constipation
- Extreme thirst
- Cramps
- Muscle weakness
- Other signs of low blood potassium
- Fruity breath odor
- Hunger
- Dryness in the mouth
- Choking
- Painful urination
Seek medical attention immediately if you experience these side effects. If you have an allergy to the adrenergic bronchodilator you’re taking, you may experience the following symptoms:
- Swelling face, lips, tongue, throat
- Difficulty breathing
- Hives
Allergic reactions can be life-threatening, so seek medical attention immediately if you experience any of these.
Drug Interactions – Adrenergic Bronchodilators
Adrenergic bronchodilators can interact with many drugs, including other bronchodilators. Talk to your doctor about all drugs and supplements you take, and don’t leave out anything. In addition to other bronchodilators, adrenergic bronchodilators can interact with:
- Beta-blockers
- MAO inhibitors
- Diuretics
- Digoxin
- Antidepressants
The list is not complete. Adrenergic bronchodilators may also interact with over-the-counter supplements, vitamins, and herbal products.
Anticholinergic Bronchodilators
Unlike adrenergic bronchodilators, which work by stimulating receptors that relax smooth muscles, anticholinergic bronchodilators block chemicals that cause the tightening of smooth muscles.
Anticholinergic bronchodilators block the action of the neurotransmitter acetylcholine. Acetylcholine plays an essential role in promoting inflammation and the constriction of airways in asthma.
Anticholinergics are long-acting bronchodilators. Researchers have found that they can combine anticholinergics with adrenergic bronchodilators for enhanced muscle-relaxing effects.
Because they have a different mechanism of action, doctors may prescribe anticholinergic bronchodilators to patients who don’t respond to adrenergic bronchodilators.
Doctors use this class of drugs to treat COPD rather than asthma. The drugs in this class are all available by prescription only.
- Tiotropium systemic (Spiriva, Spiriva HandiHaler, Spiriva Respimat, and others)
- Umeclidinium systemic (Incruse Ellipta)
- Aclidinium systemic (Tudorza Pressair)
- Ipratropium systemic (Atrovent HFA)
- Glycopyrrolate systemic (Cuvposa, Glycate, and others)
- Revefenacin systemic (Yupelri)
Warnings and Contraindications – Anticholinergic Bronchodilators
You should not use anticholinergic bronchodilators for bronchospasm attacks. Only fast-acting bronchodilators are suitable for that purpose. If you are allergic to the anticholinergic bronchodilator you use or develop an allergic reaction over time, seek medical attention immediately.
People who use anticholinergic bronchodilators may need frequent lung tests. Children should never use these drugs without adult supervision.
Let your doctor know about every condition and illness you have before you start taking an anticholinergic bronchodilator. You may not be able to take these medications if you suffer from:
- Urination problems
- Benign prostate hyperplasia
- Glaucoma
- Lactose allergy
A list of potential effects or interactions is never complete, which is why you should always be fully transparent with your doctors about the conditions you have and medications you take.
Other conditions that may interfere with anticholinergic bronchodilators include:
- Severe constipation
- Bowel obstruction
- Low blood pressure
- Fast heartbeats
- Cold hands and feet
- Ulcerative colitis
- High blood pressure
- Nerve disorders
- Thyroid problems
Some anticholinergic bronchodilators aren’t suitable for use in people younger than 18. Pregnant and breastfeeding women should talk to their doctors before taking these drugs.
If you miss a dose and are close to when your next dose is due, you can skip it. Do not take two doses to make up for the missed one.
Side Effects – Anticholinergic Bronchodilators
If your face, tongue, or throat swell after taking an anticholinergic bronchodilator, you find it difficult to breathe, or experience itching or hives, seek medical help immediately. These are signs of an allergic reaction that can be fatal.
Other severe side effects of these drugs may be:
- Eye pain
- Vision problems
- Choking
- Experiencing breathing problems
- Pain while urinating
- The inability to urinate
- Sores in the mouth
- Diarrhea
- Confusion
- Fever
If you experience any of these side effects, call your doctor immediately.
Some of the common side effects of anticholinergic bronchodilators include:
- Digestive problems
- Upset stomach
- Fast heartbeats
- Chest pain
- Sore throat
- Stuffy nose
- Dry mouth
- Constipation
- Rash
- Headache
- Impotence
- Insomnia
These lists are incomplete.
Drug Interactions – Anticholinergic Bronchodilators
Drugs belonging to this class of medications can interact with many other drugs. Always talk to your doctor about the drugs you take before starting an anticholinergic bronchodilator.
Drugs that can interact with anticholinergic bronchodilators include:
- Medications for anxiety, depression, and mood disorders
- Medications used to treat Parkinson’s disease
- Other asthma medications
- Cold medicines
- Medications used to treat irritable bowel syndrome, motion sickness, and other stomach ailments
- Medications used for the treatment of an overactive bladder
- Opioids
- Sleep medication
- Seizure drugs
Medication interaction lists are never complete. In addition to these drugs, anticholinergic bronchodilators can also interact with vitamins and herbal supplements.
Bronchodilator Combinations
Bronchodilator combinations provide doctors with effective tools to alleviate asthma and COPD symptoms and make life easier for their patients. These complex medications come as inhalers that contain more than one active substance.
Some bronchodilator combinations consist of two bronchodilators. One is a short-acting bronchodilator, while the other is a long-acting one. Such combinations provide quick and lasting relief for patients suffering from chronic respiratory conditions. They may also work in different ways to compound their effects.
Other combinations contain a bronchodilator, which acts as a preventer, and a steroid, which heads off the body’s inflammatory response. This combination can effectively improve lung function in addition to opening up the airways. Doctors use this one-two punch to prevent asthma attacks.
Some combinations may include three active substances.
Bronchodilator combinations are potent drugs. Incorrectly used, they can be dangerous and even fatal for those with allergies to their components. They are all strictly prescription-based.
- Fluticasone/salmeterol systemic (Advair HFA, AirDuo RespiClick, Wixela Inhub, and others)
- Fluticasone/vilanterol systemic (Breo Ellipta)
- Budesonide/formoterol systemic (Symbicort, Symbicort Turbuhaler, and others)
- Fluticasone/umeclidinium/vilanterol systemic (Trelegy Ellipta)
- Umeclidinium/vilanterol systemic (Anoro Ellipta)
- Formoterol/mometasone systemic (Dulera)
- Albuterol/ipratropium systemic (Combivent, DuoNeb, Combivent Respimat)
- Olodaterol/tiotropium systemic (Stiolto Respimat)
- Budesonide/formoterol/glycopyrrolate systemic (Breztri Aerosphere)
- Formoterol/glycopyrrolate systemic (Bevespi Aerosphere)
- Aclidinium/formoterol systemic (Duaklir Pressair)
- Glycopyrrolate/indicaterol systemic (Utibron Noaler)
Warnings and Contraindications – Bronchodilator Combinations
These potent combinations of active substances can interact with many other drugs, dietary supplements, and vitamins. If your doctor prescribes you one of these drug combinations, follow the instructions of your healthcare provider closely. Take the drugs exactly as prescribed.
Some bronchodilator combinations are short-term solutions. Others are for long-term treatment. Some can be used for both. The fluticasone/salmeterol combination, for instance, is suitable for the long-term treatment of COPD. At the same time, doctors prescribe it for the short-term treatment of asthma.
Understand whether your bronchodilator combination is suitable as rescue medication. Many are not. Something like fluticasone/salmeterol does not act fast enough to save you from bronchospasm.
If you think your medications no longer work as well as they did, talk to your doctor.
Allergic reactions are always potential problems with drugs like bronchodilator combinations. Seek medical attention immediately if you suspect you may have developed an allergy to one of the components of your combination.
Your doctor may not prescribe bronchodilator combinations if you have severe lactose intolerance/allergy to milk proteins.
You may not be a good candidate to use bronchodilator combinations if you have ever had one of the following conditions:
- Cataracts
- Glaucoma
- Seizures
- Osteoporosis
- Any allergy to a drug or food
- High blood pressure
- Diabetes
- Thyroid disorder
- Kidney or liver disease
- Fungal, bacterial, or viral infection
- A weakened immune system
- Heart disease
Osteoporosis is a severe risk and potential consequence of long-term bronchodilator combination use. You are at an increased risk of developing osteoporosis if:
- You are a smoker
- You do not get enough calcium or vitamin D
- You do not get enough exercise
- You have a family history of osteoporosis
Bronchodilator combinations may harm unborn babies. Pregnant and lactating women should not use these drugs unless their doctor prescribes them. Although they may represent a risk for unborn babies, uncontrolled bouts of asthma create an even bigger risk, so your provider will want to weigh the risk versus benefit of these medications.
Never use two doses of these drugs at one time. If you miss a dose, skip it and take the next one at your usual time. If you happen to overdose, seek medical attention immediately.
Never give these drugs to children.
Side Effects – Bronchodilator Combinations
Like all other medications, bronchodilator combinations can have many side effects. Some of these effects are severe, others less so. Here’s a brief look at the possible risks.
Over time, people can develop allergies to medications they’ve been taking for a while. Seek medical help immediately if you experience signs of an allergic reaction, like hives, swelling of your lips, face, tongue, or throat, or difficulty breathing. An allergic reaction to a bronchodilator combination can be fatal.
Other severe side effects that require immediate medical attention are:
- Fever and chills
- Cough
- Ear congestion
- Muscle aches
- Sore throat
- Chest tightness
- Stuffy nose
- Losing your voice
- Sensitive eyes and/or cheekbones
- Headache
Some less common but still severe side effects are:
- Murky or bloody urine
- Difficult or painful urination
- Pain in the bladder
- Nausea
- Sweating
- Pain in the lower back
- Stomach pain
- Throwing up
- Sore mouth
- Patches of white lesions in the mouth or on the tongue
- Shivering
- Joint pain
- Shakiness
- Frequent urination
This list is not complete.
Some rare but severe side effects these drugs can cause are:
- Fruity breath odor
- Seizures
- Blurred vision
- Increased hunger or thirst
- Dry mouth
- Confusion
- Intense pain in the chest
- Irregular heartbeats
- Sore neck
- Sudden weight loss
- Muscle cramps
- Dilated pupils
- Fainting
- Intense headache
Extremely rare side effects include:
- Tearing
- Blindness
- Pain in the eyes
- Vision problems
The less-severe side effects may not require immediate medical attention, but you should tell your doctor if you experience:
- Digestive problems
- Belching
- Upset stomach
- Indigestion and acid reflux
- Swollen and stiff joints
- Pain in the extremities
You may have overdosed on your bronchodilator combination if you experience any of these side effects:
- Jaw pain
- Discoloration (darkening) of your skin
- Stomach cramps
- Rashes
- Chest pain
- Restlessness
- Pain in your back, arms, or jaw
- Depression
Bear in mind that these potent medications can cause other side effects. Contact your doctor if you’re experiencing any new or unusual symptoms.
Drug Interactions – Bronchodilator Combinations
Complex medications like bronchodilator combinations can interact with many other drugs. Some of the interactions merely reduce or eliminate the effectiveness of your drugs. Others may result in severe, life-threatening reactions.
Some of the drugs which interact with bronchodilator combinations are:
In addition to these drugs, bronchodilator combinations can interact with vitamins, herbal supplements, and over-the-counter medications you may take.
Methylxanthines
Xanthine is the base compound from which methylxanthines are derived. Although they know much about how these drugs affect various immune-related functions of the body, researchers don’t fully understand how methylxanthines work to control chronic airway disease.
Xanthine is an interesting substance that is relatively abundant in nature — plants and animals produce it. Caffeine, the best-known ingredient of coffee, is a methylxanthine. Theobromine is a less-known but similarly common methylxanthine present in chocolate.
Doctors use methylxanthines to treat the airways-obstructing effects of chronic bronchitis, asthma, and emphysema. We know that methylxanthines inhibit phosphodiesterase enzymes and bind to adenosine receptors.
At lower, safer doses, they protect the bronchi, fight inflammation, and modulate immune responses. To obtain bronchodilation, doctors must prescribe higher doses. And at higher doses, some of these medications may be toxic.
It makes more sense to use methylxanthines to keep chronic airway problems under control.
Methylxanthines are all prescription-only medications.
- Theophylline (Elixophillin, Respbid, Aerolate III, Uni-Dur, TheoCap, and others)
- Aminophylline (Truphylline, Phyllocontin)
- Dyphylline
Warnings and Contraindications – Methylxanthines
Methylxanthines like theophylline can be toxic at larger doses, so always stick to the dosage your doctor prescribed. You can overdose on a one-time larger dose or a larger-than-recommended daily dose over time.
Seek medical attention immediately if you have reasons to believe that your methylxanthine-based bronchodilator is not working.
Talk to your doctor about the conditions you have and the drugs you take. Methylxanthines like theophylline can interact with many other drugs. Some of these interactions can be severe.
You may not be a good candidate for methylxanthine-based bronchodilation if you suffer from:
- Heart problems
- An ulcer (gastric or peptic)
- Kidney disease
- Sepsis
- Thyroid problems
- Liver diseases like hepatitis or cirrhosis
- Seizures
Let your doctor know if you are a regular drinker or smoker. If you have recently had a high fever for more than 24 hours or are pregnant or breastfeeding, you may also not be a good candidate for treatment with methylxanthines.
Be aware that methylxanthines are not rescue medications for bronchospasms and sudden asthma attacks. Using them for these purposes can be dangerous.
If you happen to miss a dose, don’t try to make up for it. Skip it and take your next one as prescribed.
Side Effects — Methylxanthines
Methylxanthines can cause allergic reactions. Seek medical help if you experience symptoms indicative of an allergic reaction.
Some of the severe side effects these drugs can cause are:
- Irregular heartbeats
- Constipation
- Muscular cramps
- Fever
- Seizures
- Fruity breath odor
- Thirst
- Headaches
- Insomnia
Seek medical help immediately if you experience any of these side effects. Methylxanthines are more likely to cause severe side effects in older adults. Some of the more common side effects of these drugs are:
- Diarrhea
- Vomiting
- Nausea
- Irritability
- Sweating
- Restlessness
- Headaches
- Insomnia
Drug Interactions – Methylxanthines
Some of the drugs that can interact with methylxanthines are:
- Metoprolol (severe interaction)
- Fluticasone
- Albuterol
- Esomeprazole
- Pantoprazole
In addition to these drugs, methylxanthines can also interact with vitamins and herbal supplements. Exercise special caution if you take St. John’s wort.
Find the Lowest Price for Asthma Medications
Bronchodilators can help you cope with chronic respiratory problems and significantly improve your quality of life. By picking the right medication, you can ensure that you continue to enjoy all that life has to offer.
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