⚡ Quick Answer — What is Bambudil?
Bambudil bevat bambuterol, een long-acting prodrug of terbutaline taken as a once-daily evening tablet for asthma and COPD. Bambuterol is slowly hydrolysed by plasma cholinesterase to release active terbutaline (a β2 agonist) over 24 hours — providing sustained bronchodilation without the multiple-daily dosing of short-acting agents. Used as add-on bronchodilator therapy alongside an inhaled corticosteroid in patients who prefer oral over inhaled therapy or have difficulty with inhaler technique. Each tablet contains 10 mg, geproduceerd door Cipla.
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What Is Bambudil?
Bambudil contains bambuterol — a bis-dimethylcarbamate ester prodrug of terbutaline. The carbamate structure is hydrolysed slowly by butyrylcholinesterase (plasma pseudocholinesterase) to release active terbutaline gradually over 24 hours, achieving once-daily oral β2-agonism. Internationally sold as Bambec (AstraZeneca) and Oxeol.
How Does Bambudil Work?
- Slow hydrolysis by plasma butyrylcholinesterase converts bambuterol to active terbutaline.
- Terbutaline activates bronchial β2-adrenergic receptors, raising cyclic AMP and producing sustained bronchodilation.
- 24-hour duration from a single evening dose — useful for nocturnal symptoms.
- Less dependent on patient inhaler technique than inhaled β2 agonists — a benefit for elderly or coordination-impaired patients.
Toepassingen en Indicaties
- Persistent asthma — add-on bronchodilator alongside ICS, especially when nocturnal symptoms predominate
- COPD with reversible component — adjunct bronchodilator
- Patients who cannot use inhalers reliably — elderly, severe arthritis, cognitive impairment
- Nocturnal asthma — once-daily evening dose covers overnight period
Bambudil Dosage
| Patiënt | Dosering | Frequentie |
|---|---|---|
| Adults — initial | 10 mg | Once daily in the evening |
| Adults — maintenance | 10–20 mg | Once daily in the evening |
| Children >6 yr | 10 mg | Once daily — specialist supervision |
| Hepatic impairment / pseudocholinesterase deficiency | Reduce dose 50% | Eénmaal daags |
Side Effects of Bambudil
- Fine tremor (β2 effect)
- Palpitations, mild tachycardia
- Hoofdpijn
- Muscle cramps
- Hypokalaemia at high doses (with diuretics, theophylline, oral steroids)
- Insomnia (less common with evening dosing)
Ernstig — stop en zoek hulp:
- Severe palpitations or arrhythmia
- Ernstige allergische reactie
- Paradoxale bronchospasmen
Waarschuwingen en voorzorgsmaatregelen
- {$brand} is a controller, not a reliever. Keep a SABA for acute attacks.
- Cardiovasculaire aandoeningen: caution with arrhythmias, severe coronary artery disease, hyperthyroidism.
- Pseudocholinesterase deficiency — reduces hydrolysis; bambuterol accumulates and effect prolongs. Halve dose.
- Drug interaction with cholinesterase inhibitors (donepezil, rivastigmine, pyridostigmine, suxamethonium) — bambuterol prolongs their action; suxamethonium-induced apnoea has been reported.
- Zwangerschap en borstvoeding: limited data; inhaled β2-agonists are first-line.
Contra-indicaties
- Hypersensitivity to bambuterol or terbutaline
- Ernstige leverfunctiestoornis
- Concurrent suxamethonium (depolarising muscle relaxant) — relative; warn anaesthetist
Geneesmiddelinteracties
| Interagerend geneesmiddel | Effect | Wat te doen |
|---|---|---|
| Niet-selectieve bètablokkers (propranolol, timolooldruppels) | Blokkeren β2-effect — kan ernstige bronchospasmen veroorzaken | Vermijd; schakel indien noodzakelijk over op een cardioselectieve bètablokker |
| Lis- of thiazidediuretica | Additieve hypokaliëmie | Controleer het serumkalium bij hoge doseringen |
| Systemische corticosteroïden | Additieve hypokaliëmie + hyperglykemie | Controleer elektrolyten en glucose |
| Theofylline / aminofylline | Additieve tachycardie en hypokaliëmie | Controleer hartslag en kalium |
| MAO-remmers en tricyclische antidepressiva | Versterken cardiovasculaire effecten | Voorzichtigheid — controleer bloeddruk/hartslag |
| Digoxine | Hypokaliëmie verhoogt digoxine-toxiciteitsrisico | Controleer kalium; meet digoxinespiegel bij symptomen |
Opslag
- Bewaren beneden 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.
- Buiten bereik van kinderen houden.
Gerelateerde alternatieven op MedsBase
- Asthalin Inhaler — salbutamol verlichter
- Budecort Inhaler — budesonide ICS-preventer
- Foracort Inhaler — budesonide + formoterol ICS-LABA
- Tiova Inhaler — tiotropium LAMA voor COPD
- Montair — montelukast LTRA-tablet
Veelgestelde vragen
How is Bambudil different from salbutamol or terbutaline tablets?
Bambudil contains bambuterol — a slow-release prodrug of terbutaline. It provides 24-hour bronchodilation from a single evening dose. Standard terbutaline or salbutamol tablets last 4–6 hours and require 3–4 daily doses.
When is Bambudil useful?
For nocturnal asthma (overnight cover from evening dose), for patients who cannot reliably use inhalers (elderly, severe arthritis, cognitive impairment), or as add-on long-acting β2 agonism alongside ICS.
Is Bambudil a reliever?
No — slow onset (~2 hours to peak). Keep a SABA (Asthalin, Levolin) for acute attacks.
Can I take it during the day instead of evening?
Evening dosing is recommended — covers the overnight period when nocturnal asthma symptoms are common, and timing the side effects (mild tremor) when you are sleeping.
Why warn the anaesthetist?
Bambuterol inhibits plasma butyrylcholinesterase. Suxamethonium (a depolarising muscle relaxant used in anaesthesia) is broken down by the same enzyme — combination can prolong suxamethonium-induced apnoea. Tell any anaesthetist before surgery.
Is Bambudil safe in pregnancy?
Limited data; inhaled β2 agonists are first-line.
Can I take Bambudil with my ICS?
Yes — typically used as oral add-on to ICS (Budecort, Beclate). Modern practice prefers inhaled ICS-LABA combinations (Foracort, Seretide), but oral bambuterol remains useful when inhaler use is impractical.
How fast does Bambudil work?
Onset begins around 2 hours after dose; sustained bronchodilation over 24 hours.
Is Bambudil habit-forming?
No — no dependence or tolerance. Frequent need for additional reliever indicates poor asthma control, not addiction.


























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