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Contraindications

Hypersensitivity

All long-acting beta2-adrenergic agonists (LABAs) are contraindicated in patients with asthma without use of a long-term asthma control medication

Cautions

Do not initiate in acutely deteriorating COPD patients

Do not use for relief of acute symptoms; prescribe concomitant short-acting beta2-agonists for acute exacerbations

Do not exceed recommended daily dose; excessive doses may result in cardiovascular effects and may be fatal

Life-threatening paradoxical bronchospasm can occur; discontinue use immediately

Immediate hypersensitivity reactions reported; discontinue immediately and initiate alternate therapy

Data from a large placebo-controlled study in asthma patients showed that long-acting beta2-adrenergic agonists may increase the risk of asthma-related death (see Black Box Warnings)

Caution with CV disease, epilepsy, thyrotoxicosis, or sensitivity to sympathomimetics

Contains trace levels of milk protein

Tolerance to the effects of inhaled beta-agonists can occur with regularly-scheduled, chronic use

Increased sympathomimetic effects may occur if coadministered with other adrenergic drugs

May cause hypokalemia; this effect may be potentiated if coadministered with xanthine derivatives, corticosteroids, or diuretics

ECG changes or hypokalemia that may result from non-potassium sparing diuretics (eg, thiazides or loop diuretics) can be acutely worsened by beta-agonists, especially with high doses; use caution

Caution with coadministration of MOAIs, TCAs, and drugs that prolong QTc interval

Beta blockers may antagonize the effect of indacaterol

Strong dual inhibitors of CYP3A4 and P-gp (ie, ketoconazole, erythromycin, verapamil, ritonavir) may delay systemic clearance of indacaterol (AUC increased 1.9-fold); no dose adjustment is warranted with 75 mcg/day

Beta2 agonists may increase serum glucose; use caution in patients with diabetes mellitus

Use caution in patients with seizure disorders


Source: http://reference.medscape.com/drug/arcapta-neohaler-indacaterol-inhaled-999669


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