Alupent Side Effects

Generic Name: metaproterenol

Note: This page contains information about the side effects of metaproterenol. Some of the dosage forms included on this document may not apply to the brand name Alupent.

Not all side effects for Alupent may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to metaproterenol: inhalation aerosol liquid, inhalation aerosol powder, inhalation solution, oral syrup, oral tablet

In addition to its needed effects, some unwanted effects may be caused by metaproterenol (the active ingredient contained in Alupent). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking metaproterenol:

More common
  • Fast, pounding, or irregular heartbeat or pulse
Less common
  • Shakiness in the legs, arms, hands, or feet
  • trembling or shaking of the hands or feet
  • worsening of asthma
Rare
  • Blurred vision
  • chest pain
  • chills
  • cough
  • diarrhea
  • dizziness
  • fainting
  • fever
  • general feeling of discomfort or illness
  • headache
  • increased sweating
  • joint pain
  • loss of appetite
  • muscle aches and pains
  • nausea
  • nervousness
  • pounding in the ears
  • puffiness of the face and fingers
  • runny nose
  • shivering
  • slow or fast heartbeat
  • sore throat
  • sweating
  • swelling
  • trouble sleeping
  • unusual tiredness or weakness
  • vomiting

If any of the following symptoms of overdose occur while taking metaproterenol, get emergency help immediately:

Symptoms of overdose
  • Arm, back, or jaw pain
  • chest discomfort
  • chest tightness or heaviness
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • general feeling of discomfort or illness
  • shortness of breath
  • sleeplessness
  • unable to sleep

Some of the side effects that can occur with metaproterenol may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common
  • Abdominal or stomach pain
Rare
  • Bad, unusual, or unpleasant (after) taste
  • change in appetite
  • drowsiness
  • dry mouth or throat
  • itching skin
  • pain
  • raised red swellings on the skin, lips, tongue, or in the throat
  • tightening of the muscles
  • weakness

For Healthcare Professionals

Applies to metaproterenol: compounding powder, inhalation aerosol, inhalation aerosol with adapter, inhalation solution, oral syrup, oral tablet

General

Metaproterenol (the active ingredient contained in Alupent) has been usually well-tolerated and adverse effects that occurred were consistent with its pharmacological activity. Additionally, partial or complete tolerance may develop to these side effects. In general, the severity of these effects are dependent on the dose and the route of administration. Metaproterenol given by metered dose inhaler (MDI) is associated with less systemic effects than administration of higher dosages orally or by nebulizer.[Ref]

Cardiovascular

Cardiovascular side effects have included palpitations and peripheral vasodilation, commonly resulting in reflex tachycardia. This may be caused by the interaction of metaproterenol (the active ingredient contained in Alupent) with beta-1 and beta-2 receptors. Blood pressure may increase or decrease. Metaproterenol in higher dosages may rarely aggravate angina, myocardial ischemia, or cause atrial or ventricular arrhythmias.[Ref]

Musculoskeletal

Musculoskeletal side effects have included tremors. Tolerance often develop to the tremorogenic effects following prolonged use of this medication. Severe muscle cramping may occur infrequently.[Ref]

Metabolic

The hypokalemic effect is due to the stimulation of beta-2 receptors that are linked to sodium-potassium ATPase in skeletal muscles, resulting in an intracellular influx of potassium.[Ref]

Metabolic side effects have included hypokalemia, hypophosphatemia, hyperglycemia, and elevations in plasma insulin.[Ref]

Nervous system

Nervous system side effects have included restlessness, nervousness, anxiety, irritability, headache, dizziness, and insomnia.[Ref]

Other

Other side effects have included the development of tachyphylaxis to the bronchodilating effects of metaproterenol (the active ingredient contained in Alupent) Although conflicting data exist, complete clinical tolerance has not been observed.[Ref]

Hypersensitivity

A 25-year-old woman respiratory therapist with a history of an itchy dermatitis on the face, neck, and upper extremities showed a positive reaction to metaproterenol (the active ingredient contained in Alupent) on skin patch testing.[Ref]

Hypersensitivity side effects have included rare reports of dermatitis.[Ref]

Respiratory

Respiratory side effects have included pulmonary edema in pregnant patients receiving the drug intravenously.[Ref]

References

1. Maguire GP, Emirgil C "Bronchodilator and side effects of different modes of administration of metaproterenol: inhaled, oral, and in combination." Am J Med Sci 291 (1986): 168-74

2. Larsson S "Long-term treatment with beta2-adrenostimulants in asthma. Side effects, selectivity, tolerance, and routes of administration." Acta Med Scand Suppl 608 (1977): 1-40

3. Wolfe JD, Yamate M, Biedermann AA, Chu TJ "Comparison of the acute cardiopulmonary effects of oral albuterol, metaproterenol, and terbutaline in asthmatics." JAMA 253 (1985): 2068-72

4. Sanders JP, Potter DE, Ellis S, Bee DE, Grant JA "Metabolic and cardiovascular effects of carbuterol and metaproterenol." J Allergy Clin Immunol 60 (1977): 174-9

5. Ence TJ, Tashkin DP, Ho D, Child JS "Acute bronchial and cardiovascular effects of oral pirbuterol and metaproterenol." Ann Allergy 43 (1979): 229-36

6. Young TE, Mangum OB. "NeoFax: a Manual of Drugs Used in Neonatal Care. 9th ed." Raleigh, NC: Acorn Publishing (1996):

7. "Metaproterenol." Med Lett Drugs Ther 16 (1974): 45-6

8. Ozog D, Lerner C "An exaggerated response to beta-adrenergics." Ann Allergy 62 (1989): 11-3

9. Gelmont DM, Balmes JR, Yee A "Hypokalemia induced by inhaled bronchodilators." Chest 94 (1988): 763-6

10. Chervinsky P "The development of drug tolerance during long-term beta2-agonist bronchodilator therapy." Chest 73 (1978): 1001-2

11. Sadai J, Civen M, Nagaya H, Pascual H "Paradoxical effects of oral metaproterenol on leukocyte adenosine 3',5'-monophosphate (cyclic AMP) levels in vivo." Ann Allergy 38 (1977): 116-8

12. van Schayck CP, Dompeling E, van Herwaarden CL, et al. "Bronchodilator treatment in moderate asthma or chronic bronchitis: continuous or on demand? A randomised controlled study." BMJ 303 (1991): 1426-31

13. Hyde JS, Yamshon D, Isenberg PD, Schur S "Metaproterenol in children with chronic asthma." Clin Pharmacol Ther 20 (1976): 207-12

14. Galant SP, Groncy CE, Duriseti S, Strick L "The effect of metaproterenol in chronic asthmatic children receiving therapeutic doses of theophylline." J Allergy Clin Immunol 61 (1978): 73-9

15. Svedmyr N, Lofdahl CG "The use of beta(2)-adrenoceptor agonists in the treatment of bronchial asthma." Pharmacol Toxicol 78 (1996): 3-11

16. Swarts CL, Hyde JS "Long-term efficacy and safety of nebulized metaproterenol solution in bronchial asthma." Chest 70 (1976): 617-20

17. Sears MR, Taylor DR, Print CG, et al. "Regular inhaled beta-agonist treatment in bronchial asthma." Lancet 336 (1990): 1391-5

18. Sackner MA, Silva G, Zucker C, Marks MB "Long-term effects of metaproterenol in asthmatic children." Am Rev Respir Dis 115 (1977): 945-53

19. Drazen JM, Israel E, Boushey HA, et al. "Comparisons of regularly scheduled with as-needed use of albuterol in mild asthma." N Engl J Med 335 (1996): 841-7

20. Shapiro GG, Furukawa CT, Pierson WE, Chapko MK, Sharpe M, Bierman CW "Double-blind, dose-response study of metaproterenol inhalant solution in children with acute asthma." J Allergy Clin Immunol 79 (1987): 378-86

21. Cockcroft DW, Swystun VA "Functional antagonism: tolerance produced by inhaled beta(2) agonists." Thorax 51 (1996): 1051-6

22. Fung MA, Geisse JK, Maibach HI "Airborne contact dermatitis from metaproterenol in a respiratory therapist." Contact Dermatitis 35 (1996): 317-8

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