⚡ Quick Answer — What is Orcibest?
Orcibest bevat orciprenaline (metaproterenol), een 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.
Toepassingen en Indicaties
- Bronchospasm in asthma and COPD — short-term symptomatic relief
- Patients in whom selective β2 agonists are unavailable or not tolerated
Orcibest Dosage
| Patiënt | Dosering | Frequentie |
|---|---|---|
| Adults | 10–20 mg | Three to four times daily |
| Kinderen 6–12 jaar | 10 mg | Three times daily |
Side Effects of Orcibest
- Tremor (more than salbutamol at equivalent bronchodilation)
- Tachycardia, palpitations (β1 spillover)
- Hoofdpijn
- Misselijkheid
- Slapeloosheid
- Hypokaliëmie bij hoge doseringen
Ernstig — stop en zoek hulp:
- Severe palpitations, chest pain
- Hartritmestoornissen
- Ernstige allergische reactie
Waarschuwingen en voorzorgsmaatregelen
- Cardiovasculaire aandoeningen: 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.
Contra-indicaties
- Hypersensitivity to orciprenaline or other β-agonists
- Severe tachyarrhythmias
- Severe coronary artery disease (relative)
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
- Montair — montelukast LTRA-tablet
- Tiova Inhaler — tiotropium LAMA voor COPD
Veelgestelde vragen
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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