Adult: For the relief of dyspnoea or other symptoms caused by respiratory obstructive disturbance: As dry powder inhaler: Usual dose: 20 mcg (2 puffs) as directed up to 4 times daily. Dosage may be adjusted according to the severity of symptoms and patient age. Elderly: Dosage adjustment may be required.
Adult: For the relief of dyspnoea or other symptoms caused by respiratory obstructive disturbance: As tab or syr: 50 mcg once daily before bedtime, or 50 mcg bid (in the morning and before bedtime). Dosage must be adjusted according to the severity of symptoms and patient age. Child: May refer to specific product guideline. Elderly: Dosage adjustment may be required.
Administration
May be taken with or without food.
Special Precautions
Patient with heart disease, hypertension, hyperthyroidism, diabetes mellitus. Not a substitute for inhaled corticosteroids or other anti-inflammatory agents. Elderly. Pregnancy and lactation.
Adverse Reactions
Significant: May exacerbate hyperthyroidism or diabetes mellitus; increased blood pressure, acute asthma episodes (during prolonged use for bronchial asthma); palpitations, exacerbated heart disease; shock, anaphylactoid reactions; decreased serum K levels. Ear and labyrinth disorders: Tinnitus. Gastrointestinal disorders: Nausea, vomiting, dry mouth, gastric discomfort. General disorders and administration site conditions: Generalised malaise or fatigue. Musculoskeletal and connective tissue disorders: Muscle spasticity. Nervous system disorders: Headache or dull headache, tremors, dizziness, numbness of limbs, drowsiness. Psychiatric disorders: Insomnia. Respiratory, thoracic and mediastinal disorders: Nasal congestion, tracheopharyngeal abnormal feeling. Skin and subcutaneous tissue disorders: Rash, pruritus, cold sweat. Vascular disorders: Facial flushing. Potentially Fatal: Cardiac arrhythmias or arrest (continuous excessive doses).
Monitoring Parameters
Closely monitor serum K levels (particularly in hypoxic patients); signs and symptoms of shock or anaphylactoid reactions.
Overdosage
Oral: Symptoms: Tachycardiac arrhythmia, hypotension, tremor, nervousness, hypokalaemia, hyperglycaemia. Management: Perform gastric lavage, if necessary. Provide emergency treatment and general maintenance therapy, if necessary. In case of serious tachycardiac arrhythmia, careful administration of β-blockers (e.g. propranolol) may be considered.
Drug Interactions
May result in aggravated decrease in serum K levels and cardiac adverse effects with corticosteroids (e.g. betamethasone, hydrocortisone), xanthine derivatives (e.g. theophylline), and diuretics (e.g. furosemide). Potentially Fatal: Catecholamines (e.g. epinephrine, isoprenaline) potentiate the adrenoceptor stimulating effects of procaterol, which may lead to arrhythmias or cardiac arrest.
Lab Interference
May suppress skin reactions in allergen testing.
Action
Description: Procaterol, a direct-acting sympathomimetic with predominantly β-adrenoceptor stimulant action selective to β2-adrenergic receptors, is a bronchodilator with similar activity to salbutamol. Onset: Within 5 minutes (inhalation). Duration: Up to 8 hours (inhalation). Pharmacokinetics: Absorption: Time to peak plasma concentration: 1.3±0.7 hours (oral); 15 minutes (inhalation). Excretion: Via urine (oral: 9.93% or 11.65%; inhalation: 14.36%).
Chemical Structure
Procaterol Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4916, Pro-Air. https://pubchem.ncbi.nlm.nih.gov/compound/Pro-Air. Accessed Mar. 26, 2021.
R03AC16 - procaterol ; Belongs to the class of adrenergic inhalants, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases. R03CC08 - procaterol ; Belongs to the class of adrenergics for systemic use, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
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