⚡ Quick Answer — What is Orcibest?
Orcibest indeholder orciprenaline (metaproterenol), en non-selective β-agonist bronchodilator used historically for asthma and COPD bronchospasm. Orciprenaline activates both β1 (cardiac) and β2 (bronchial) adrenergic receptors — providing bronchodilation but also more cardiac side effects than selective β2-agonists like salbutamol or levosalbutamol. Modern asthma management has largely replaced orciprenaline with selective β2 agonists. Orcibest remains available in some markets where the older drug is still preferred or where selective agents are unavailable. Used for short-term symptomatic relief of bronchospasm.
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What Is Orcibest?
Orcibest is an oral orciprenaline preparation — orciprenaline (also known as metaproterenol in the US) was an early bronchodilator introduced in the 1960s. It pre-dates selective β2 agonists. Modern asthma guidelines do not include orciprenaline as first-line; selective β2 agonists (salbutamol, levosalbutamol) are preferred because of their better cardiac safety profile.
How Does Orciprenaline Work?
Orciprenaline is a non-selective β-adrenergic agonist with affinity for both β1 (cardiac) and β2 (bronchial smooth muscle) receptors. β2 effect produces bronchodilation; β1 effect produces tachycardia and palpitations. Onset is around 15 minutes (oral); duration 4 hours.
— det forstærker den normale fysiologiske respons snarere end at udløse en kunstigt.
- Bronchospasm in asthma and COPD — short-term symptomatic relief
- Patients in whom selective β2 agonists are unavailable or not tolerated
Orcibest Dosage
| Patient | Dosis | Hyppighed |
|---|---|---|
| Adults | 10–20 mg | Three to four times daily |
| Children 6–12 yr | 10 mg | Three times daily |
Side Effects of Orcibest
- Tremor (more than salbutamol at equivalent bronchodilation)
- Tachycardia, palpitations (β1 spillover)
- Hovedpine
- Nausea
- Insomnia
- Hypokalaemia at high doses
Serious — stop and seek help:
- Severe palpitations, chest pain
- Cardiac arrhythmias
- Severe allergic reaction
Advarsler og forholdsregler
- Cardiovascular disease: use cautiously — non-selective β-agonism produces more tachycardia and palpitations than selective agents.
- Hyperthyroidism: caution; exaggerated sympathetic effects.
- Diabetes: monitor glucose at higher doses.
- Modern alternatives — salbutamol (Asthalin) and levosalbutamol (Levolin) are preferred for most patients.
- Frequent use signals poor asthma control — step up controller therapy.
Kontraindikationer
- Hypersensitivity to orciprenaline or other β-agonists
- Severe tachyarrhythmias
- Severe coronary artery disease (relative)
Lægemiddelinteraktioner
| Interacting drug | Effekt | Hvad skal der gøres |
|---|---|---|
| Non-selective beta-blockers (propranolol, timolol drops) | Block β2 effect — can precipitate severe bronchospasm | Avoid; switch to cardioselective beta-blocker if essential |
| Loop or thiazide diuretics | Additive hypokalaemia | Monitor serum potassium with high doses |
| Systemic corticosteroids | Additive hypokalaemia + hyperglycaemia | Monitor electrolytes and glucose |
| Theophylline / aminophylline | Additive tachycardia and hypokalaemia | Monitor heart rate and potassium |
| MAOIs and tricyclic antidepressants | Potentiate cardiovascular effects | Caution — monitor BP/HR |
| Digoxin | Hypokalaemia increases digoxin toxicity risk | Monitor potassium; check digoxin level if symptomatic |
Opbevaring
- Store below 25°C in a cool, dry place away from direct sunlight.
- Keep in original packaging until use to protect from moisture and light.
- Do not use after the expiry date printed on the strip.
- Keep out of reach of children.
Relaterede alternativer på MedsBase
- Asthalin Inhaler — salbutamol reliever
- Budecort Inhaler — budesonide ICS preventer
- Foracort Inhaler — budesonide + formoterol ICS-LABA
- Montair — montelukast LTRA tablet
- Tiova Inhaler — tiotropium LAMA for COPD
Ofte stillede spørgsmål
Why is salbutamol preferred over orciprenaline?
Salbutamol is selective for β2 receptors — it produces bronchodilation with much less tachycardia, tremor, and cardiac side effect than non-selective orciprenaline. Modern asthma guidelines uniformly prefer selective β2 agents.
When is Orcibest still used?
Mainly in markets where selective β2 agonists are unavailable or where the patient has been stable on orciprenaline for years and prefers not to switch.
How fast does Orcibest work?
Oral onset around 15 minutes; duration 4 hours.
Will Orcibest control my asthma long-term?
No — it relieves symptoms but does not address inflammation. Modern asthma management requires inhaled corticosteroids alongside reliever therapy.
Can I switch to salbutamol?
Yes — discuss with your prescriber. Most patients tolerate the switch well and have fewer cardiac side effects.
Is Orcibest safe in pregnancy?
Not preferred — selective β2 agonists (salbutamol) have more pregnancy data and are first-line.
What if I run out of selective inhalers?
Orcibest is not an emergency substitute — its slow onset and side-effect profile make it suboptimal for acute attacks. Source a SABA inhaler (Asthalin, Ventorlin) as soon as possible.
Why am I shaky and racing on Orcibest?
Non-selective β-agonism amplifies tremor and tachycardia compared to salbutamol. These are dose-related effects.
Can children take Orcibest?
In age-appropriate doses; selective β2 agonists are preferred.


























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