Orciprenaline
| Evidence Level: L5 | Predicted Indications: 6 |
Table of Contents
Orciprenaline: Respiratory malformation
One-Sentence Summary
Orciprenaline (metaproterenol) is a non-selective beta-adrenergic agonist bronchodilator, originally used for asthma, bronchitis and pulmonary emphysema. This prediction is essentially an umbrella term for the drug’s existing indications rather than a true repurposing.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Respiratory malformation |
| TxGNN Prediction Score | 0.9998 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (1 of 1) – CDSCO approval status is not included in this data |
| Number of Listed Products | 1 (valid: 1) |
| Recommended Decision | Proceed with Guardrails |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Based on known information, orciprenaline is a non-selective beta-adrenergic agonist that relaxes bronchial smooth muscle. Its efficacy in asthma, bronchitis and emphysema is established.
The mechanism, bronchodilation through beta-receptor stimulation, applies directly to airway obstruction.
The main caveats are cardiac effects from beta-1 stimulation (a faster heart rate and higher blood pressure than salbutamol in a paediatric comparison) and the availability of more selective beta-2 agonists. Current guidelines generally favour those agents.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 6248395 | 1980 | Double-blind crossover trial | J Int Med Res | Oral orciprenaline 10 mg vs fenoterol 5 mg in 44 asthma patients; FEV1 rose over 4 hours with both drugs, peaking at 3 hours |
| 7047707 | 1982 | Randomised double-blind crossover | J Pediatr | Oral metaproterenol vs theophylline in 34 children with chronic asthma; no serious adverse effects, tremor more frequent with metaproterenol |
| 45195 | 1979 | Double-blind crossover | Br J Clin Pharmacol | Four beta-2 aerosols (fenoterol, orciprenaline, salbutamol, terbutaline) compared in 9 patients with reversible airway obstruction |
| 4888877 | 1969 | Double-blind trial | Br Med J | In 24 chronic asthma patients, salbutamol acted longer than isoprenaline and slightly more intensely and longer than orciprenaline |
| 5565461 | 1971 | Comparative study | Arch Dis Child | In 12 asthmatic children, all three aerosols relieved bronchoconstriction similarly; orciprenaline raised heart rate 26% vs 13% for salbutamol |
| 13895 | 1976 | Comparative study | Bull Eur Physiopathol Respir | Five oral beta-agonists in reversible obstructive chronic bronchitis; carbuterol and fenoterol were more potent than orciprenaline |
| 2975286 | 1987 | Clinical pharmacology | J Asthma | Bronchodilators including orciprenaline work better at night or in the morning, when bronchial patency is low |
| 3335167 | 1988 | Cohort | Chest | In 59 patients with emphysema and chronic bronchitis, airway reversibility after inhaled orciprenaline was examined in relation to 4-year survival |
| 29906501 | 2018 | Review | Adv Drug Deliv Rev | Historical overview of repurposing drugs as inhaled asthma therapies |
| 2991865 | 1985 | Review | Pharmacotherapy | Review of fenoterol, a close chemical relative of orciprenaline, which has higher bronchodilating potency |
India Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 161670 | Orcibest Tablet (Zydus Cadila) | Strip of 15 tablets | Not listed |
Safety Considerations
- Disease-related cautions (from the knowledge graph, not label text): The drug is linked to contraindication or caution signals in hypertension, epilepsy, diabetes mellitus, diabetic ketoacidosis, coronary artery disease, myocardial ischaemia, hyperthyroidism, Graves disease and thyrotoxicosis.
- Drug Interactions: 374 interactions are recorded. Examples include:
- Major: dolasetron.
- Moderate: epinephrine, isometheptene, diethylpropion, clarithromycin, famotidine, and several antidiabetic agents (acarbose, metformin, chlorpropamide, alogliptin, canagliflozin, dapagliflozin, albiglutide, dulaglutide).
- Minor: corticosteroids (hydrocortisone, dexamethasone, triamcinolone, betamethasone, budesonide, beclomethasone).
- Cardiovascular caution: Tachycardia and arrhythmia are the main concerns, particularly in older patients with COPD.
Please also refer to the package insert for label warnings and contraindications.
Conclusion and Next Steps
Decision: Proceed with Guardrails
Rationale: Orciprenaline’s bronchodilator effect in obstructive airway disease is supported by consistent historical comparative studies, and the predicted indication overlaps with its approved uses. However, the evidence is old and has no registered trials. Newer selective beta-2 agonists are preferred in current practice.
To proceed, the following is needed:
- The package insert for Orcibest Tablet (warnings, contraindications, approved indication), which is a blocking gap for safety screening
- Detailed mechanism of action data
- A cardiovascular safety plan for older patients and those with the comorbidities listed above
- A comparison with current standard bronchodilators (selective beta-2 agonists, antimuscarinics)
Other predictions reviewed (all Hold, except COPD):
- Chronic obstructive pulmonary disease: Proceed with Guardrails (L3). It overlaps with the existing bronchitis and emphysema indications and rests on 1964-1988 studies only.
- Anaphylaxis (L4, Hold): only animal and tissue studies exist, and epinephrine is the standard of care.
- Interstitial emphysema (L4, Hold): the single linked item is an indirect Cochrane review in preterm infants.
- Respiratory malformation, Rienhoff syndrome, bronchial neoplasm, food-dependent exercise-induced anaphylaxis, compensatory emphysema, hyperlucent lung (L5, Hold): there is no credible mechanistic link or direct evidence, so these predictions appear to be TxGNN model (deep learning) artifacts.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.