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bitolterol mesylate, Tornalate: Drug Side Effects and Dosing

What is bitolterol mesylate, and how does it work (mechanism of action)?

Bitolterol is a bronchodilator used in the
treatment of
asthma. It is similar to
(Ventolin). Asthma is a disorder of breathing in which there is narrowing of the
airways that carry air to the lungs including the bronchi. This narrowing is
caused by muscle spasm and inflammation within the airways. Bitolterol relaxes
the smooth muscles surrounding these airways, increasing the diameter and thus
easing the flow of air through the airways. Bitolterol probably does not affect
inflammation in the lung either with asthma or other inflammatory lung disorders
such as
bronchitis. Nevertheless, if spasm of the airways occurs because of
bronchitis, bitolterol may be useful therapy for the asthmatic component of the
illness. Bitolterol is unique in that it is a "prodrug;" It must first be
converted by the body into its active form. Bitolterol has a rapid onset of
action (2-5 minutes), and its effects may last up to 6-8 hours. The FDA approved
bitolterol in December 1984.

What brand names are available for bitolterol mesylate?

(Tornalate: This brand no longer is available in the U.S. and
there are no generic versions.)

Is bitolterol mesylate available as a generic drug?


Do I need a prescription for bitolterol mesylate?


What are the side effects of bitolterol mesylate?

Side effects of bitolterol include nervousness,

palpitations, fast heart rate,

elevated blood pressure,
dizziness, and

heartburn. Throat irritation and
nosebleeds can
also occur. Allergic reactions may occur rarely and may manifest as
hives, swelling,
anaphylaxis, or
shock. Worsening of
and lowering of potassium have also been reported. In rare patients, inhaled
bitolterol can paradoxically precipitate life-threatening bronchospasm.

What is the dosage for bitolterol mesylate?

The recommended adult dose for treating asthma is 2 inhalations every
8 hours. Maximum dose is 2 inhalations every 4 hours or 3 inhalations every 6
hours. This drug was not approved for use in children under 12 years old.

Which drugs or supplements interact with bitolterol mesylate?

Tricyclic antidepressants
(for example,
amitriptyline [Elavil, Endep]),
monoamine oxidase inhibitors (for example, tranylcypromine) should not be combined with bitolterol because of their
additive effects on the vascular system (increased blood pressure, heart rate,
etc.). A period of two weeks should elapse between treatment with bitolterol and
tricyclic antidepressants or monoamine oxidase inhibitors.

Use of bitolterol with other stimulant medications is discouraged because of
their combined effects on heart rate, blood pressure, and the potential for
causing chest pain
in patients with underlying
coronary heart disease.

for example,
propranolol (Inderal, Inderal LA), block the effect of bitolterol and may
induce bronchospasm in asthmatics. Bitolterol may cause
hypokalemia (low
potassium). Therefore, combining bitolterol with loop diuretics, for
example, furosemide
(Lasix), which lowers potassium levels in the blood, may increase the likelihood
of hypokalemia.

Is bitolterol mesylate safe to take if I’m pregnant or breastfeeding?

It's not known if bitolterol is excreted in
breast milk.

What else should I know about bitolterol mesylate?

What preparations of bitolterol mesylate are available?

Inhaler: 0.37 mg/Inhalation; Solution for Inhalation: 0.2%

How should I keep bitolterol mesylate stored?

Bitolterol should be stored at room temperature, 15 C to 30 C (59 F
to 86 F).


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