Tulobuterol Hydrochloride

Indications

Asthma Chronic Obstructive Pulmonary Disease Bronchitis

Breton is indicated for the prevention and control of bronchospasm in bronchial asthma, chronic bronchitis, asthmatic bronchitis, pulmonary emphysema, bronchiectasis, tracheobronchitis with emphysema, and other bronchospastic disorders and conditions marked by bronchoconstriction. Because oral tulobuterol acts over a long duration, it is well suited for routine maintenance therapy in chronic asthma and chronic bronchitis. In controlled single and multiple dose studies, Breton has been shown to be more effective than terbutaline and fenoterol, and at least as effective as salbutamol (albuterol), in relieving bronchospasm associated with reversible obstructive airways disease such as asthma, as well as chronic bronchitis and emphysema. A clinically significant improvement in pulmonary function, shown by an increase in FEV of 15% or more, occurred within 30 minutes of oral dosing, with peak improvement occurring within two to three hours. In some patients, a therapeutic response was still apparent at 12 hours, and continued effectiveness was demonstrated over a one year period.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

The main way beta-adrenergic drugs work is by stimulating adenyl cyclase, the enzyme that turns adenosine triphosphate (ATP) into cyclic-3',5' adenosine monophosphate (cyclic AMP). This cyclic AMP triggers the cell response that opens up the airways, a process called bronchodilation. Tulobuterol acts very selectively on beta-2 adrenoceptors. This relaxes the smooth muscle of the bronchi, and it has been shown to work well in relieving the symptoms of reversible obstructive airways disease (ROAD), such as bronchial asthma, and also in bronchitis and emphysema.

Some bronchodilators also stimulate beta-1 receptors in the heart, as well as beta-2 receptors. In people who are susceptible, this can cause a fast heartbeat (tachycardia), angina, and possibly arrhythmias. Animal studies and laboratory experiments suggest that tulobuterol is more selective for beta-2 activity than other drugs in this class, so it should cause fewer heart-related side effects.

Pregnancy & Breastfeeding

The safety of this product during pregnancy has not been established. It is also not known whether tulobuterol passes into human breast milk or whether it could harm a newborn. Because of this, as with any medication, using this drug during pregnancy, while breastfeeding, or in women who may become pregnant requires weighing its expected therapeutic benefit against its possible risks to the mother and child.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Long-term clinical studies have shown that tulobuterol continues to be effective and does not lead to cumulative or toxic side effects. Because the disease varies from patient to patient and dosage needs must be individualized, flexibility in dosing is essential. Long-acting beta agonists should not be used without an asthma controller medication such as an inhaled corticosteroid, and they should be used for the shortest time needed to bring asthma symptoms under control, being discontinued if possible once control is achieved; the patient should then continue on a long-term asthma controller medication such as a corticosteroid. Tablets: the usual oral adult dose of tulobuterol is one 2 mg tablet twice a day. A convenient starting dose for children aged 12 years and over and for adults is 1 mg twice a day, particularly for elderly patients and those with a history of sensitivity to beta-adrenergic agents. Unless drug-related side effects rule it out, the dose may be increased after seven to ten days to 2 mg twice a day if a greater therapeutic response is needed. Although most patients can be maintained on 1 to 2 mg twice daily, differences in patient response and symptom severity may call for further dose adjustment, as with any bronchodilator treatment. If necessary, the adult dose of tulobuterol may therefore be increased to 6 mg a day in divided doses according to clinical response. Syrup: based on dose-ranging studies in children, the usual dose of tulobuterol syrup (1 mg/5 mL) for children is 40 to 80 mcg/kg/day in two divided doses. Clinical studies in children have found effective doses ranging from 20 to 100 mcg/kg/day. This gives the following age-based recommendations: for children aged one to six years, 0.25 tsp (1.25 mL) to 0.5 tsp (2.5 mL) bid; for children aged six to twelve years, 0.5 tsp (2.5 mL) to 1 tsp (5 mL) bid; for children over twelve years, 1 tsp (5 mL) to 2 tsp (10 mL) bid. These age-based doses may need to be adjusted according to how the patient responds.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.

Key Interactions

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