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Bitolterol Side Effects

Applies to bitolterol: inhalation aerosol, inhalation solution.


Tachycardia has been reported in 3.7% of patients, palpitations in 3.1% of patients, and irregular pulse in 1.2% of patients. Higher dosages of bitolterol should be used with caution in patients with cardiac disease, arrhythmias, or hypertension.[Ref]

Cardiovascular side effects have included palpitations and peripheral vasodilation, commonly resulting in reflex tachycardia. Changes in blood pressure, both increases and decreases, have been reported. Higher dosages have rarely aggravated angina and myocardial ischemia or caused atrial or ventricular arrhythmias.[Ref]


Metabolic side effects have rarely included hyperglycemia and hyperthyroidism.[Ref]

Nervous system

Nervous system side effects have included tremors (26.6%), nervousness (11.1%), headache (8.4%), lightheadedness (6.8%), dizziness (4%), paresthesia (1.5%), and somnolence (1.2%).[Ref]

The incidence of tremors has been reported to decrease from 22% to 9% during the third month of therapy with bitolterol.[Ref]


Respiratory side effects have included coughing (2.5%), bronchospasm (1.5%), chest discomfort (1.5%), and rhinitis (1.5%).[Ref]


Gastrointestinal side effects have included throat irritation (2.5%), mouth irritation (1.9%), and nausea (1.9%).[Ref]


1. "Product Information. Tornalate (bitolterol)." Apothecon Inc (2022):

2. Nathan RA, Bronsky EA, Dockhorn RJ, Kemp JP "Multicenter dose-ranging study of bitolterol mesylate solution for nebulization in children with asthma." Ann Allergy 72 (1994): 209-16

3. Bierman CW, Kemp JP, Nathan RA "Efficacy and safety of inhaled bitolterol mesylate via metered-dose inhaler in children with asthma." Ann Allergy Asthma Immunol 76 (1996): 27-35

4. Pinnas JL, Bhatt BD, Campbell SC, Kemp JP, Tinkelman DG "Dose-response study of nebulized bitolterol mesylate solution in asthmatic patients." Chest 91 (1987): 533-9

5. "Bitolterol--a new bronchodilator." Med Lett Drugs Ther 27 (1985): 46-7

6. Walker SB, Bierman CW, Pierson WE, Shapiro GG, Furukawa CT, Mingo TS "Bitolterol mesylate in exercise-induced asthma." J Allergy Clin Immunol 77 (1986): 32-6

7. Orgel HA, Kemp JP, Tinkelman DG, Webb DR Jr "Bitolterol and albuterol metered-dose aerosols: comparison of two long-acting beta 2-adrenergic bronchodilators for treatment o asthma." J Allergy Clin Immunol 75 (1985): 55-62

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.