Olodaterol
STRIVERDI RESPIMAT
Pronunciation: oe-loe-DA-ter-ol (STRI-ver-dee RES-pe-mat)
What it isLong-acting beta-2 agonist; COPD maintenance.
Why this oneIts Respimat soft-mist device and fixed combination with tiotropium distinguish it from dry-powder LABAs.
What limits itNever as monotherapy in asthma. Tachycardia and hypokalemia at high dose; maintenance only, not rescue.
FDA-approved for
- COPD maintenance (2014)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| COPD (incl. chronic bronchitis/emphysema), long-term maintenance bronchodilation | Adults | 2 inhalations QD at the same time of day | 2 inhalations QD | 2 inhalations/24 h |
Renal No adjustment needed
Hepatic No adjustment for mild/moderate impairment; no data in severe impairment
Do not use more than 2 inhalations every 24 hours
Instructions
- For oral inhalation only
- Prime before first use: actuate toward ground until aerosol cloud visible, then repeat 3 more times
- Re-prime: 1 actuation if unused >3 days; full 4-actuation priming if unused >21 days
- Not for acute symptoms — use a concomitant inhaled short-acting beta2-agonist for acute relief
Available strengths
- spray 2.5 mcg/inh
Contraindications
- Use of a LABA without an inhaled corticosteroid in patients with asthma (Striverdi is not indicated for asthma)
Cautions
- LABA monotherapy for asthma increases risk of serious asthma-related events including death (class effect)
- Do not initiate in acutely deteriorating COPD; not for relief of acute symptoms
- Excessive use or use with other LABA-containing medicines can cause clinically significant, potentially fatal cardiovascular effects
- Life-threatening paradoxical bronchospasm — discontinue immediately
- Caution in cardiovascular disorders, convulsive disorders, thyrotoxicosis, QT prolongation, and sensitivity to sympathomimetic amines
- Be alert to hypokalemia and hyperglycemia
Adverse reactions
- Nasopharyngitis
- Upper respiratory tract infection
- Bronchitis
- Urinary tract infection
- Cough
- Dizziness
- Rash
- Diarrhea
- Back pain
- Arthralgia
Pregnancy No adequate human data; restrict use during labor to cases where benefit clearly outweighs risk (beta-agonist interference with uterine contractility)
Lactation No data on presence in human milk; olodaterol/metabolites present in rat milk
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 2.5 mcg/inh | spray | per unit | — | $65.94/g | not offered |
Generic entry2030 est.
NO BOXED WARNINGS
Principal riskNever as monotherapy in asthma
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityTremor, tachycardia or anticholinergic effects; excessive beta-agonist exposure can cause hypokalemia and arrhythmia.