ABSTRACT
Indacaterol is an ultra-long-acting ß2-adrenoceptor agonist that is indicated for the maintenance treatment of chronic obstructive pulmonary disease. We present a patient with severe chronic constipation and abdominal pain most probably induced by this medicament. Symptoms rapidly disappeared within 2 days after the drug withdrawal. As far as we know, no reports describing severe chronic constipation associated with indacaterol have been published. The Naranjo algorithm score and the Edwards and Aronson scale for causality assessment of suspected adverse drug reactions indicated a probable relationship between indacaterol use and constipation. Indacaterol-induced constipation is an unusual event that could be accounted for the high intrinsic activity of the drug on colonic ß3-adrenoreceptors, resulting in an inhibitory control of smooth muscle function and intestinal secretion. Clinicians should monitor such a possibility when prescribing this drug and maybe avoid its use in patients with a history of difficult bowel evacuation.
Subject(s)
Abdominal Pain/chemically induced , Adrenergic beta-2 Receptor Agonists/adverse effects , Colon/drug effects , Constipation/chemically induced , Indans/adverse effects , Muscle, Smooth/drug effects , Quinolones/adverse effects , Receptors, Adrenergic/metabolism , Abdominal Pain/metabolism , Aged , Bronchodilator Agents/adverse effects , Bronchodilator Agents/therapeutic use , Constipation/metabolism , Humans , Indans/therapeutic use , Male , Pulmonary Disease, Chronic Obstructive/drug therapy , Quinolones/therapeutic useSubject(s)
Cellulitis/microbiology , Meningococcal Infections/microbiology , Neisseria meningitidis/isolation & purification , Adult , Anti-Bacterial Agents/therapeutic use , Cellulitis/diagnosis , Cellulitis/drug therapy , Cellulitis/pathology , Child , Child, Preschool , Female , Humans , Male , Meningococcal Infections/diagnosis , Meningococcal Infections/drug therapy , Meningococcal Infections/pathology , Neisseria meningitidis/drug effectsSubject(s)
Tuberculosis/diagnosis , Adult , Antitubercular Agents/therapeutic use , Biopsy , Diagnosis, Differential , Female , Humans , Mycobacterium tuberculosis , Tuberculosis/drug therapy , Tuberculosis, Ocular/diagnosis , Tuberculosis, Ocular/drug therapy , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Spinal/diagnosis , Tuberculosis, Spinal/drug therapySubject(s)
Hypertension, Portal/etiology , Liver/pathology , Anti-Bacterial Agents/therapeutic use , Duodenal Ulcer/complications , Duodenal Ulcer/microbiology , Esophageal and Gastric Varices/etiology , Helicobacter Infections/complications , Helicobacter Infections/drug therapy , Humans , Hypersplenism/etiology , Hypertension, Portal/diagnostic imaging , Hypertension, Portal/pathology , Liver/diagnostic imaging , Male , Middle Aged , Remission Induction , Sclerosis , Tomography, Spiral ComputedABSTRACT
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