Metaproterenol

Metaproterenol Brand Names- Alupent | Metaprel

What is Metaproterenol

Metaproterenol is an oral and inhaled synthetic beta-2 and beta-1 agonist that is structurally and pharmacologically similar to isoproterenol. It is more selective for beta-2 receptors than isoproterenol; however, unlike isoproterenol, metaproterenol is used exclusively as a bronchodilator.

Metaproterenol use for asthma and chronic obstructive pulmonary disease (COPD) has declined due to the availability of more selective short-acting beta-2 agonists (SABAs) such as albuterol and levalbuterol.

Orally inhaled selective short-acting beta-2 agonists (SABAs) such as albuterol are considered the preferred pharmacologic treatment to relieve acute bronchospasm according to the Expert Panel of the National Asthma Education and Prevention Program (NAEPP).

Selective SABAs (e.g., albuterol) are preferred over less beta-2 selective agents such as metaproterenol to minimize potential for adverse cardiac effects

In general, if a SABA is required more than 2 days a week or significant symptoms recur, the Panel recommends initiating treatment for persistent asthma (e.g., inhaled corticosteroids).

Quick-relief medication such as SABAs should be made available to all patients with persistent asthma for acute symptom control.

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for COPD, inhaled SABAs may be used for therapy in patients with mild COPD (Group A) and in combination with other treatments in those with more severe disease (Groups B, C, and D); inhaled SABAs are preferred for the management of COPD exacerbations, with or without an inhaled antimuscarinic agent.

Oral beta agonists such as metaproterenol are not preferred for COPD patients.

Metaproterenol was initially approved by the FDA in 1973.

Indications

  1. acute bronchospasm
  2. asthma
  3. chronic bronchitis
  4. chronic obstructive pulmonary disease (COPD)
  5. emphysema

For the treatment of asthma or acute bronchospasm due to asthma

Side Effects

  1. arrhythmia exacerbation
  2. blurred vision
  3. chest pain (unspecified)
  4. chills
  5. cough
  6. diaphoresis
  7. diarrhea
  8. dizziness
  9. drowsiness
  10. dysgeusia
  11. edema
  12. fatigue
  13. fever
  14. headache
  15. hypertension
  16. hypokalemia
  17. influenza
  18. insomnia
  19. muscle cramps
  20. musculoskeletal pain
  21. myoclonia
  22. nausea
  23. palpitations
  24. premature ventricular contractions (PVCs)
  25. pruritus
  26. QT prolongation
  27. sinus tachycardia
  28. syncope
  29. tremor
  30. urticaria
  31. vomiting
  32. weakness
  33. xerostomia

Monitoring Parameters

  • pulmonary function tests (PFTs)

Contraindications

  • alcoholism
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • children
  • coronary artery disease
  • deterioration of asthma
  • diabetes mellitus
  • females
  • geriatric
  • heart failure
  • hepatic disease
  • hypertension
  • hyperthyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • infants
  • labor
  • long QT syndrome
  • malnutrition
  • MAOI therapy
  • myocardial infarction
  • neonates
  • paradoxical bronchospasm
  • pheochromocytoma
  • pregnancy
  • QT prolongation
  • seizure disorder
  • seizures
  • tachycardia
  • thyroid disease
  • thyrotoxicosis

Interactions

  • Abarelix
  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine; Dextroamphetamine Salts
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atomoxetine
  • Azithromycin
  • Bedaquiline
  • Bendroflumethiazide; Nadolol
  • Benzphetamine
  • Beta-adrenergic blockers
  • Betaxolol
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Brimonidine; Timolol
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Bumetanide
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Caffeine
  • Caffeine; Ergotamine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Carteolol
  • Carvedilol
  • Ceritinib
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloroquine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clofazimine
  • Clomipramine
  • Clozapine
  • Cocaine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Crizotinib
  • Dasatinib
  • Degarelix
  • Desipramine
  • Desloratadine; Pseudoephedrine
  • Deutetrabenazine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diethylpropion
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Disopyramide
  • Dobutamine
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Dopamine
  • Dorzolamide; Timolol
  • Doxepin
  • Dronedarone
  • Droperidol
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Eliglustat
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Enflurane
  • Entrectinib
  • Ephedrine
  • Epinephrine
  • Eribulin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esmolol
  • Ethacrynic Acid
  • Ezogabine
  • Fexofenadine; Pseudoephedrine
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluvoxamine
  • Foscarnet
  • Furosemide
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Goserelin
  • Granisetron
  • Green Tea
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibuprofen; Pseudoephedrine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Inotuzumab Ozogamicin
  • Isocarboxazid
  • Isoflurane
  • Isoproterenol
  • Itraconazole
  • Ivosidenib
  • Ketoconazole
  • Labetalol
  • Lapatinib
  • Lefamulin
  • Lenvatinib
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levobetaxolol
  • Levobunolol
  • Levofloxacin
  • Levomethadyl
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Linezolid
  • Liothyronine
  • Lithium
  • Lofexidine
  • Lomefloxacin
  • Loop diuretics
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Loratadine; Pseudoephedrine
  • Macimorelin
  • Maprotiline
  • Mefloquine
  • Meperidine; Promethazine
  • Mesoridazine
  • Methacholine
  • Methadone
  • Methamphetamine
  • Metoprolol
  • Metronidazole
  • Midodrine
  • Midostaurin
  • Mifepristone
  • Mirtazapine
  • Monoamine oxidase inhibitors
  • Moxifloxacin
  • Nadolol
  • Naproxen; Pseudoephedrine
  • Nebivolol
  • Nebivolol; Valsartan
  • Nilotinib
  • Norepinephrine
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Ondansetron
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Ozanimod
  • Paliperidone
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Penbutolol
  • Pentamidine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phendimetrazine
  • Phenelzine
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Pimavanserin
  • Pimozide
  • Pindolol
  • Pitolisant
  • Posaconazole
  • Prilocaine; Epinephrine
  • Primaquine
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Propranolol
  • Protriptyline
  • Pseudoephedrine
  • Quetiapine
  • Quinidine
  • Quinine
  • Racepinephrine
  • Ranolazine
  • Rasagiline
  • Ribociclib
  • Ribociclib; Letrozole
  • Rilpivirine
  • Risperidone
  • Romidepsin
  • Saquinavir
  • Selpercatinib
  • Sertraline
  • Sevoflurane
  • Siponimod
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Theophylline, Aminophylline
  • Thiazide diuretics
  • Thioridazine
  • Thyroid hormones
  • Timolol
  • Tolterodine
  • Toremifene
  • Torsemide
  • Tranylcypromine
  • Trazodone
  • Triclabendazole
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Voriconazole
  • Vorinostat
  • Ziprasidone
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