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In COPD patients single doses of 10 times the maximum recommended therapeutic dose were associated with a moderate increase in pulse rate, systolic blood pressure increase and QTc interval.
Acute intoxication following inadvertent oral ingestion of Onbrez Breezhaler capsules is unlikely because the bioavailability of indacaterol is low.
An overdose of indacaterol is likely to lead to exaggerated effects typical of beta2-adrenergic stimulants i.e., tachycardia, tremor, palpitations, headache, nausea, vomiting, drowsiness, ventricular arrhythmias, metabolic acidosis, hypokalemia and hyperglycemia.
Supportive and symptomatic treatment is indicated. In serious cases, patients should be hospitalized. Use of cardioselective beta-blockers may be considered, but only under the supervision of a physician and with extreme caution since the use of beta-adrenergic blockers may provoke bronchospasm.
