Toludil

Indications

Tulobuterol is a bronchodilator, a medicine that opens up the airways. It is used to relieve and prevent breathing difficulty, wheezing and chest tightness caused by narrowing of the airways in bronchial asthma, acute and chronic bronchitis, and chronic obstructive pulmonary disease (COPD).

How It Works

Tulobuterol stimulates beta-2 receptors on the smooth muscle that lines the airways. This makes the muscle relax, so the airways widen and air can move in and out more easily. It has a longer action than many older reliever medicines, which helps control symptoms through the day and night.

Dosage and Administration

Take as prescribed by your doctor. For adults, the usual tablet dose is 1 mg twice a day. Children's doses (for example as syrup) depend on age and body weight and are set by the doctor or shown on the label. Where a skin patch is prescribed, adults usually apply one 2 mg patch once a day to clean, dry skin on the chest, back or upper arm, changing the site each time. Do not take more than prescribed. It does not replace an inhaled reliever for a sudden severe attack.

Interactions

• Beta blockers such as Propranolol (including some eye drops) can block its effect and may worsen asthma.
• Theophylline, corticosteroids such as Prednisolone, and diuretics can increase the risk of low potassium.
• Other sympathomimetic medicines such as Salbutamol or Adrenaline can add to side effects like a fast heartbeat.
• Monoamine oxidase inhibitors and tricyclic antidepressants may increase effects on the heart and blood pressure.

Contraindications

• Allergy to Tulobuterol or any ingredient.

Side Effects

Common side effects include trembling of the hands, palpitations (feeling the heartbeat), fast heartbeat, headache, nervousness, dizziness, nausea and muscle cramps. Patches can cause redness or itching at the application site. High doses can lower blood potassium.

Get urgent medical help if you have chest pain, a very fast or irregular heartbeat, severe muscle weakness, fainting, signs of a serious allergic reaction such as swelling of the face or difficulty breathing, or if your breathing gets worse instead of better after using it.

Pregnancy and Lactation

Safety in pregnancy is not fully established. Well-controlled asthma is important for both mother and baby, so your doctor will decide whether it is suitable. It is not known whether it passes into breast milk; ask your doctor before using it while breastfeeding.

Precautions and Warnings

• Use with care in people with heart disease, high blood pressure, overactive thyroid or diabetes (it may raise blood sugar).
• In asthma it should be used together with an anti-inflammatory controller medicine (such as an inhaled steroid) if the doctor prescribes one.
• If you need it more often than usual, or it works less well, see your doctor, as your asthma may be getting worse.
• Your doctor may check potassium levels in severe asthma.

Overdose

Overdose may cause severe trembling, a fast or irregular heartbeat, chest pain, agitation, low potassium and high blood sugar. Get emergency medical help straight away; remove any patch.

Therapeutic Class

Bronchodilator, selective beta-2 adrenergic agonist.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.