Methacholine

Methacholine Brand Name– Provocholine

What is Methacholine

Methacholine is an orally inhaled cholinergic agonist indicated for the diagnosis of bronchial airway hyperreactivity (methacholine challenge test) in patients 5 years of age and older who do not have clinically apparent asthma.

Severe acute bronchospasm can result from methacholine administration, including at the lowest dose.

Methacholine use requires an experienced clinician and a specialized care setting.

For safety and accuracy, methacholine use is limited to a pulmonary function laboratory or clinic, by adequately trained personnel and only under the responsibility of a healthcare professional trained in and thoroughly familiar with the aspects of the technique of the methacholine challenge test and the management of respiratory distress.

The methacholine challenge test may occasionally be false-positive after influenza or other upper respiratory infection; after vaccination; in very young or geriatric patients; in patients with chronic lung disease (CLD), such as cystic fibrosis, sarcoidosis, tuberculosis, or chronic obstructive pulmonary disease (COPD); in patients with allergic rhinitis with or without asthma symptoms; in tobacco smoking patients; or in patients after exposure to air pollutants.

Indications & Dosage

  • bronchial airway hyperreactivity diagnosis

For bronchial airway hyperreactivity diagnosis in patients who do not have clinically apparent asthma

Side Effects

  1. bronchospasm
  2. cough
  3. headache
  4. pruritus
  5. throat irritation
  6. wheezing

Adverse reactions less commonly associated with methacholine during clinical studies or postmarketing reports include headache, throat irritation, lightheadedness, and pruritus.

Monitoring Parameters

  • pulmonary function tests (PFTs)

Contraindications

  • accidental exposure
  • acute bronchospasm
  • aneurysm
  • asthma
  • breast-feeding
  • children
  • chronic lung disease (CLD)
  • chronic obstructive pulmonary disease (COPD)
  • cystic fibrosis
  • geriatric
  • hypertension
  • infants
  • influenza
  • myocardial infarction
  • neonates
  • peptic ulcer disease
  • pregnancy
  • requires a specialized care setting
  • requires an experienced clinician
  • respiratory infection
  • sarcoidosis
  • seizure disorder
  • seizures
  • stroke
  • thyroid disease
  • tobacco smoking
  • tuberculosis
  • urinary tract obstruction
  • vaccination

Methacholine is contraindicated in patients with hypersensitivity to methacholine or other parasympathomimetic agents

Interactions

  • Acebutolol
  • Aclidinium
  • Aclidinium; Formoterol
  • Albuterol
  • Albuterol; Ipratropium
  • Anticholinergics
  • Arformoterol
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine; Fluticasone
  • Beclomethasone
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benztropine
  • Beta-blockers
  • Betamethasone
  • Betaxolol
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Brimonidine; Timolol
  • Budesonide
  • Budesonide; Formoterol
  • Carteolol
  • Carvedilol
  • Chlordiazepoxide; Clidinium
  • Ciclesonide
  • Corticosteroids
  • Cortisone
  • Deflazacort
  • Dexamethasone
  • Dicyclomine
  • Dorzolamide; Timolol
  • Esmolol
  • Flavoxate
  • Fludrocortisone
  • Flunisolide
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol
  • Formoterol; Mometasone
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocortisone
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Ipratropium
  • Labetalol
  • Levalbuterol
  • Levobetaxolol
  • Levobunolol
  • Long-acting beta-agonists
  • Mepenzolate
  • Metaproterenol
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methscopolamine
  • Methylprednisolone
  • Metoprolol
  • Mometasone
  • Nadolol
  • Nebivolol
  • Nebivolol; Valsartan
  • Olodaterol
  • Oxybutynin
  • Penbutolol
  • Pindolol
  • Pirbuterol
  • Prednisolone
  • Prednisone
  • Propantheline
  • Propranolol
  • Salmeterol
  • Scopolamine
  • Short-acting beta-agonists
  • Sotalol
  • Terbutaline
  • Theophylline, Aminophylline
  • Timolol
  • Tiotropium
  • Tiotropium; Olodaterol
  • Triamcinolone
  • Trihexyphenidyl
  • Umeclidinium
  • Umeclidinium; Vilanterol