Olodaterol (Striverdi Respimat) is a long-acting beta-adrenergic receptor agonist that acts on the smooth muscles of the airways resulting in bronchodilation. It is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease.

Olodaterol Uses:

• Chronic obstructive pulmonary disease:

  • To maintain airway flow in long run in Chronic Obstructive Pulmonary Disease.

Read: Indacterol

Olodaterol (Striverdi Respimat) Dose in Adults

Olodaterol (Striverdi Respimat) Dose in the treatment of Chronic obstructive pulmonary disease:

• Soft mist inhaler:

  • Oral inhalation: Two inhalations once daily (up to 2 inhalations per day.)

Use in Children:

Not studied in children.

Olodaterol (Striverdi Respimat) Pregnancy Risk Category: C

• Side effects of animal-based research have been shown, especially in relation to the contractility of the uterus.

Use during breastfeeding:

• Safety is not guaranteed for mothers who are lactating. Use when the benefits are clear and outweigh the risks.

Dose in Kidney Disease:

No dosage adjustment is necessary.

Dose in Liver Disease:

• Mild to moderate impairment:
  • No dosage adjustment is necessary.
• Severe impairment:
  • No dosage adjustment recommended or studied.

Common Side Effects of Olodaterol (Striverdi Respimat):

• Respiratory:

  • Nasopharyngitis

Less Common Side Effects of Olodaterol (Striverdi Respimat):

• Dermatologic:

  • Skin rash

• Genitourinary:

  • Urinary tract infection

• Neuromuscular & skeletal:

  • Back pain
  • Arthralgia

• Respiratory:

  • Bronchitis

Contraindications to Olodaterol (Striverdi Respimat):

• Avoid in Asthma management as a sole treatment.
• Hypersensitivity to any drug component or drug ingredient
• There is a little chance of cross-reactivity between sympathomimetics and sympathomimetics.

Warnings and precautions

• Asthma-related Deaths:

  • As a single therapy for asthma, long-acting beta-2 antagonist (LABA), is not recommended. It has been associated with an increase of asthma-related deaths.
  • Current guidelines recommend that an inhaled corticosteroid be used before adding a LABA.
  • Recent studies favor the use of steroids in combination with asthma treatment. They have been shown to reduce exacerbations and increase safety.

• Bronchospasm

  • Paradoxical bronchoconstriction can be a side effect. Underdosing can cause paradoxical bronchospasm.

• Hypersensitivity

  • If hypersensitivity symptoms are present, it is recommended to discontinue therapy.

• Deaths and serious effects:

  • Limit your use of LABAs in combination with any other medications.

• Cardiovascular disease

  • Caution is advised for cardiac patients. Beta-agonist use can cause an increase in blood pressure and heart beat.
  • LABA may cause electrophysiological changes in the heart (eg T-wave flattening or prolongation of QTc, ST-segment depression).

• COPD:

  • It is not recommended to be used in acute exacerbation.

• Diabetes:

  • May exacerbate preexisting Diabetes or Ketoacidosis.

• Hyperthyroidism:

  • Patients with hyperthyroidism should be cautious; it may stimulate thyroid activity.

• Hypokalemia

  • Patients with hypokalemia should be taken seriously, as the drug could cause hypokalemia.

• Seizures:

  • To be given with care in patients with seizure disorders; beta-2 agonists may result in CNS stimulation/excitation.

Olodaterol: Drug Interaction

Monitoring Parameters:

• FEV1
• FVC
• pulmonary function tests
• serum potassium
• serum glucose
• blood pressure 
• heart rate
• Observe for CNS stimulation.
• Monitor for increased use of short-acting beta-agonist inhalers.

How to administer Olodaterol (Striverdi Respimat)?

Oral inhalation:

• Soft mist inhaler:
  • It is indicated for oral inhalation use only and should be given at the same time every day.
  • The inhaler must be prepared for use if not used for 3 weeks by pressing the trigger until cloudy mist seen.
  • The procedure may be repeated three times.
  • The dose release button to be pressed during inhalation with lips tightly sealing the inhaler mouth; inhalation to be continued after drug delivery, then breath to be held for 10 seconds.

Mechanism of action of Olodaterol (Striverdi Respimat):

• It acts as a beta-receptor agonist that is long-acting and activates beta-adrenergic cells in the airways. 
• It activates the adenyl-cyclase pathway, which increases cAMP levels and results in relaxation of smooth muscle cells. It also has some affinity for beta-adrenergic receptors.

The onset of action:

• 5 minutes

Duration:

• 24 hours

Protein binding:

• ~60%

Metabolism:

• Direct glucuronidation (UGT2B7, UGT1A1, 1A7, and 1A9) and O-demethylation (primarily CYP2C9 and 2C8)

Bioavailability:

• 30% (inhalation)

Half-life elimination:

• 7.5 hours

Time to peak:

• 10 to 20 minutes

Excretion:

• Urine (5% to 7% unchanged);
• feces

International Brand Names of Olodaterol:

• Striverdi Respimat

Olodaterol Brand Names in Pakistan:

No Brands Available in Pakistan.