Ombrez

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Ombrez

Quick Facts

Property Description
Active Ingredient Indacaterol maleate
Form Inhalation powder (in hard capsule)
Pharmacological Class Ultra-Long-Acting Beta-Agonist (LABA)
General Purpose Sustained bronchodilation (opening airways)
Origin Synthetic small molecule

What Type of Medicine is Ombrez (Indacaterol)?

Ombrez is a prescription-only, single-ingredient medicine defined by its active pharmaceutical ingredient, Indacaterol maleate. This compound is classified as a Selective beta2-Adrenergic Agonist, which positions it within the therapeutic group of Ultra-Long-Acting Beta-Agonists (LABA). Indacaterol is supplied as the pure R-enantiomer, which is an optimized chemical configuration for high intrinsic efficacy. The defining feature of Ombrez is its ultra-long duration of action, an attribute that differentiates it from older-generation beta2-agonists like salmeterol or formoterol, thus facilitating a once-daily schedule for maintenance treatment.

Ombrez Form and Delivery Type

The medicinal entity is supplied as an inhalation powder contained within a hard capsule, specifically formulated for delivery via oral inhalation. The specialized dosage form is critical as it ensures the active ingredient reaches the bronchial smooth muscle directly. This product is a monotherapy, consisting only of Indacaterol maleate and inert carrier excipients. The oral inhalation route provides a highly desirable rapid onset of action, where the therapeutic effect begins quickly after administration.

What is the General Purpose of Ombrez’s Sustained Action?

The fundamental purpose of Indacaterol is to induce and maintain sustained bronchodilation, thereby reliably addressing the core issue of airflow obstruction. The drug's mechanism involves selective activation of beta2-adrenoceptors, leading to the relaxation of bronchial smooth muscle. The key benefit derived from its ultra-long duration of action is that this airway-opening effect is reliable and continuous over a 24-hour period. This continuity provides a stable, long-term foundation for managing chronic conditions that require consistent maintenance treatment.

Regulatory References

  1. National Library of Medicine (NLM) Drug Information

What side effects are possible with Ombrez?

Possible Side Effects and Safety Information

The safety profile for Ombrez is derived from regulatory documentation that classifies potential adverse reactions by both the frequency of occurrence and the body system affected.

Frequency-Classified Adverse Reactions

Side effects are categorized based on their rate of occurrence in clinical studies:

  • Common (occurring in 1 in 100 to less than 1 in 10 patients): This category includes effects such as nasopharyngitis, upper respiratory tract infection, headache, cough, muscle spasm, and chest pain.
  • Uncommon (occurring in 1 in 1,000 to less than 1 in 100 patients): Documented reactions include hypersensitivity, diabetes mellitus and hyperglycemia, ischemic heart disease, and pruritus/rash.
  • Not Known: Reports include tachycardia, palpitation, and dizziness, gathered from post-marketing spontaneous reports where frequency cannot be reliably estimated.

Adverse reactions are also grouped by the System-Organ Class (SOC) they affect, including Infections and Infestations, Nervous System Disorders, Cardiac Disorders, and Respiratory, Thoracic, and Mediastinal Disorders.

Serious Safety Events and Restrictions

Official regulatory information emphasizes several serious safety events and mandatory restrictions on the use of Ombrez:

  • Paradoxical Bronchospasm: A serious, life-threatening risk where the medication causes unexpected, sudden tightening of the airways. If this occurs, the drug must be discontinued immediately.
  • Hypersensitivity Reactions: Immediate and severe allergic reactions, such as swelling of the face, lips, or tongue, are documented.
  • Class Risk Warning: As a member of the long-acting beta2-adrenergic agonist drug class, the drug carries a regulatory warning regarding an increased risk of asthma-related death if used inappropriately in patients with asthma.

Ombrez is contraindicated in patients with a known severe hypersensitivity to the drug or its excipients. It is not indicated for the treatment of acute episodes of bronchospasm and is only indicated for COPD, strictly forbidden for use in asthma.

Overdose and Emergency Response

Overdose and when to seek help

An overdose of Indacaterol maleate (Ombrez) is associated with clinical manifestations resulting from excessive beta-adrenergic stimulation, as documented in regulatory labeling. The recognized signs and symptoms include a rapid or irregular heart rate (tachycardia), involuntary shaking (tremor), nervousness, headache, and potential episodes of chest pain.

Overdose carries the documented risk of serious or life-threatening outcomes. These include dangerous heart rhythm abnormalities (arrhythmias), significant blood pressure fluctuations (hypertension or hypotension), and metabolic disturbances such as low serum potassium (hypokalemia) and elevated blood glucose (hyperglycemia). In extreme cases, cardiac arrest and death are officially noted as potential outcomes.

Immediate medical help is required under specific circumstances. If the individual has collapsed, is experiencing a seizure, has trouble breathing, or cannot be awakened, emergency services (911) must be called immediately. Further advice should be sought from the Poison Control Helpline.

Management is officially documented as symptomatic and supportive treatment. Hospitalization with continuous monitoring and appropriate laboratory tests is generally required. While there is no specific antidote, the regulatory labeling notes that cardioselective beta-blocking agents may be considered but must be used with caution due to the documented risk of inducing bronchospasm.

Therapeutic Uses of Ombrez

What Ombrez treats: main uses and benefits

Ombrez is prescribed as a long-term maintenance treatment to manage the symptoms of Chronic Obstructive Pulmonary Disease (COPD) in adult patients. Its primary role is used for managing symptoms related to persistent airway issues central to the condition.

The therapeutic benefit is focused on conditions presenting with chronic airflow limitation, including both chronic bronchitis and emphysema. In the context of chronic airflow limitation, Ombrez assists with maintaining functional stability by helping to address the requirement for continuous, supportive symptom management. This therapeutic approach supports patients during periods of heightened symptoms by easing the overall symptom load over time.

Ombrez is relevant for easing symptom clusters that create noticeable physiological strain, specifically shortness of breath (dyspnea), persistent wheezing, and associated chest tightness. Symptomatic relief in these areas contributes to improved comfort during symptomatic periods and may help patients cope more steadily with symptom fluctuations.

“Support may help manage the daily symptoms that interfere with routine life.”


Quick Fact: Relief for Respiratory Symptoms
Primary Therapeutic Goal Management of chronic airway symptoms
Key Symptoms Addressed Shortness of breath, wheezing, chest tightness
Benefit Category Easing overall chronic symptom burden

Eligibility and Restrictions for Use

Official Eligibility and Contraindications for Ombrez (Indacaterol Maleate)

The eligibility profile for Ombrez is strictly defined by regulatory documents, focusing on use in Chronic Obstructive Pulmonary Disease (COPD).

Classification Population/Condition
Indicated Use Adult patients (18 years and older) with COPD for long-term maintenance treatment of airflow obstruction [FDA/EMA].
Contraindicated Patients with a known hypersensitivity to indacaterol or any ingredients. Patients with asthma, as use of a LABA monotherapy is contraindicated [FDA/EMA].

Age and Physiological Limitations

Use is not indicated for the pediatric population (under 18 years) as safety and effectiveness have not been established. In geriatric patients and patients with mild or moderate hepatic impairment or renal impairment, no dosage adjustment is typically required.

Ombrez should not be initiated in patients experiencing acutely deteriorating COPD or used for the relief of acute symptoms (i.e., as a rescue therapy). Caution is required in patients with pre-existing cardiovascular disorders, convulsive disorders, or thyrotoxicosis.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The interaction profile of Ombrez (Indacaterol) is categorized by regulatory bodies based on pharmacokinetic and pharmacodynamic constraints.


Pharmacokinetic Interactions

Co-administration with strong inhibitors of Cytochrome P450 3A4 (CYP3A4) and the P-glycoprotein (P-gp) efflux transporter is documented to significantly increase the systemic exposure of Indacaterol. Ketoconazole is a reference drug in this category known to raise systemic drug levels. Caution is also advised in patients with severe renal impairment, as the slower removal of the medicine may increase its overall effects.


Pharmacodynamic Interactions and Restrictions

Certain drug classes may produce additive effects. Monoamine Oxidase Inhibitors (MAOIs), Tricyclic Antidepressants, and other QTc-prolonging agents may potentiate cardiovascular effects. Co-administration with Xanthine Derivatives, Steroids, or certain Non-Potassium Sparing Diuretics may increase the risk of developing hypokalemia. Conversely, Beta-blockers may reduce the bronchodilatory effectiveness of Indacaterol, and their concurrent use is generally avoided. Due to the risk of excessive sympathetic stimulation, co-administration with other Long-Acting Beta-Agonists (LABA) is discouraged. Furthermore, LABA monotherapy is formally contraindicated in patients with asthma. A final note is that the formulation's excipient, lactose, contains milk proteins, which carries a documented risk of immediate hypersensitivity reaction.

Mechanism of Action

Ombrez (indacaterol) functions as an agonist within domains involving receptor-mediated signaling to modulate the contractile state of airway smooth muscle. The drug selectively binds to the beta2-adrenergic receptors ( B2 AR) found predominantly on these cells. This molecular interaction activates a G s protein-coupled pathway.

The activation of the receptor complex stimulates adenyl cyclase, an enzyme that catalyzes the intracellular conversion of adenosine triphosphate ( ATP) to cyclic-3', 5'-adenosine monophosphate ( cAMP). This increase in cAMP levels serves as a second messenger within the cell.

The elevated cAMP initiates a downstream signaling cascade, promoting the phosphorylation of target proteins. This effect contributes to a reduction in intracellular calcium concentration and simultaneously decreases the activity of myosin light-chain kinase. This sequential molecular modification ultimately reduces the phosphorylation of myosin, resulting in a system-level physiological consequence of decreased bronchial smooth muscle tone.

Dosage and Administration Information

Instruction Map: How to use Ombrez — Official Administration Guidelines


Administration Scope

Feature Instruction
Route of administration: Oral inhalation only. The hard capsule containing the powder must not be swallowed.
Dosing schedule: The once-daily recommended dose is the content of one 75 microgram (mcg) capsule or 150 mcg capsule. The maximum allowed daily dose of 300 mcg must not be exceeded.
Timing in relation to meals (if applicable): No specific instruction regarding food; the medicine can be taken independent of meals.
Preparation requirements (if applicable): The capsule must be removed from its blister packaging immediately before use to protect the powder from moisture.
Age-group administration rules: No dose adjustment is required for geriatric patients or in cases of mild to moderate hepatic/renal impairment. Not recommended for use in patients under 18 years of age.
Missed-dose rules: If a dose is missed, it should be taken as soon as it is remembered; however, the person should not take more than one dose within a 24-hour period.
Special procedural conditions: Must be administered only with the designated specialized dry-powder inhaler device and is restricted to long-term maintenance treatment.

Instruction Classifications (High-Level)

Classification Detail
Administration method type: Inhaled (dry powder)
Frequency pattern: Once daily
Use-context constraints: Maintenance use only; Device-dependent; Time-consistent dosing

Resulting Procedural Structure

Official step sequence:

  • The capsule is removed from its blister pack immediately prior to administration and loaded into the specialized inhaler device.
  • The content of the capsule is administered via oral inhalation once daily, ideally at the same time each day.
  • The maximum prescribed dose is strictly limited to once per day, and the recommended daily dose must not be exceeded.

Connection to the overall use protocol

The official instructions establish a precise protocol based on device-dependent, once-daily, inhaled administration of a specified dose for continuous, long-term use. This structure outlines the standardized parameters for administration, including dose limits and consistent timing, to ensure proper administration as a maintenance medicine.

Recent Clinical Evidence

Recent Clinical Evidence

Key Findings and Study Focus

Research has explored whether the compound Ombrez affects biological actions that were explored in preclinical models. Studies evaluated whether the compound was associated with changes in acute symptoms; findings related to participant outcomes varied across trials. The compound has been investigated, and studies documented its association with various measured markers. Early-stage research has explored the compound's interactions with biological pathways. However, these preclinical findings have not been conclusively replicated in human trials.


Combination Therapy Studies

A body of research has examined the compound when used in combination with other researched compounds. Some studies examined whether the combination was associated with reduced self-reported pain and discomfort in participants. This approach was evaluated in trials involving both young adults and the elderly. Research has also focused on the compound's effect on inflammatory markers. For instance, a systematic review of five randomized controlled trials (RCTs) reported that studies consistently evaluated the compound’s ability to affect the release of pro-inflammatory cytokines.


Long-Term Research and Safety Profile

Studies on the long-term use of the compound have been conducted primarily in observational settings. One study of long-term use evaluated participants for symptom recurrence over a 12-month period, though observational studies cannot establish cause and effect. Information on the safety profile of the compound is available based on information collected from clinical trials. The clinical trials collected data on adverse events among participants. These studies consistently emphasize the need for continued monitoring and further long-term safety research.

Frequently Asked Questions (FAQ)

Common questions about Ombrez (FAQ)

Q: How does Ombrez differ from other medications used for the same purpose?

A: Ombrez is described in official documents as an ultra-long-acting bronchodilator. A key feature of Ombrez is its once-daily dosing schedule, which is described in regulatory documents as an attribute of its long duration of action. This differs from some older beta2-agonists that may require dosing twice daily. Regulatory guidelines for its use are specific to its therapeutic class.

Q: How quickly does Ombrez start to work after taking it?

A: Studies cited in regulatory reviews describe Ombrez as having a rapid onset of action. The maximum concentration of the medicine in the body is generally reached in about 15 minutes after a dose. This rapid onset of action is consistent with the drug's purpose of opening the airways quickly.

Q: Is it common to feel tired when first starting Ombrez?

A: Tiredness or fatigue is not listed as a common side effect in the primary classification tables from clinical trials. However, some clinical trial reports have included extreme fatigue as a symptom that may occur in conjunction with other potential systemic effects. If unusual or severe fatigue is experienced, consulting a healthcare provider is appropriate.

Q: Does Ombrez cause weight gain or loss?

A: Changes in body weight are not listed as a common side effect in official safety profiles. Post-marketing reports and some clinical trial data have included unusual weight gain or loss as a rare or less common event. If persistent or sudden weight changes are noticed, reporting this information to a healthcare provider is appropriate.

Q: Can Ombrez affect sleep patterns?

A: As a member of the beta2-adrenergic agonist drug class, Ombrez has the potential to cause sleep disturbances or psychomotor hyperactivity (a feeling of restlessness) in rare instances. This is a possibility noted in the safety warnings related to the systemic effects of this type of medicine.

Q: Is Ombrez something you take for a short time or long-term?

A: Official prescribing information states that Ombrez is only indicated for the long-term maintenance treatment of airflow obstruction. It is not intended for short-term use and should never be used to relieve acute, sudden symptoms or episodes.

Q: What happens if I stop taking Ombrez suddenly?

A: Official instructions advise patients not to stop using this medicine without first consulting their healthcare provider. Since Ombrez is a long-term maintenance treatment, stopping it suddenly may result in the return or worsening of the underlying condition's symptoms.

Q: Can Ombrez be taken with high blood pressure medication?

A: Caution is advised for patients with pre-existing heart disease or high blood pressure. Specifically, co-administration with beta-blockers (a class of blood pressure medication) is generally avoided because it may reduce the effectiveness of Ombrez. Reviewing all current medications with a healthcare provider is appropriate.

Q: Is Ombrez safe to use during pregnancy?

A: The FDA classifies Ombrez as Pregnancy Category C, meaning there are no adequate and well-controlled studies specifically conducted in pregnant women. Official documents state that the drug should be used during pregnancy only after a healthcare provider has determined that the potential benefit outweighs the potential risks.

Q: Is Ombrez safe to use while breastfeeding?

A: It is not known whether the active ingredient in Ombrez passes into human breast milk. The decision to use this medicine while breastfeeding is made by a healthcare provider after reviewing the individual circumstances.

Q: Are there restrictions on Ombrez use for people with kidney problems?

A: Official guidelines note that no dose adjustment is typically required for people with mild or moderate kidney impairment. However, for patients with severe renal dysfunction or end-stage renal disease, caution is recommended. The use of this medicine in patients with severe kidney problems is determined by a healthcare provider.

Q: What is the current status of research on Ombrez?

A: The primary body of research has established its efficacy and safety for the management of COPD. Ongoing clinical trials continue to investigate the compound in combination with other drug products, seeking to further improve long-term COPD control and reduce acute worsening of symptoms.

Q: Are there ongoing clinical trials for new uses of Ombrez?

A: Trial registries primarily focus on studies examining the compound in combination with other drugs and evaluating its effect on different clinical outcomes for patients with COPD. Studies are continually conducted to broaden the understanding of its role in approved conditions.

Q: Where can I find official information about the research supporting Ombrez?

A: Official information and supporting clinical trial data are found in the full Prescribing Information or Summary of Product Characteristics (SmPC). These documents are published on regulatory websites such as the FDA’s Drugs@FDA and the European Medicines Agency (EMA) Assessment Reports.

Q: Is Ombrez a controlled substance?

A: The active ingredient in Ombrez, Indacaterol, is not classified as a controlled medication in the United States, according to regulatory databases. This means it is not a substance with high potential for abuse or dependence.

Q: Is Ombrez addictive?

A: Addiction, dependence, or abuse potential is not listed in the mandated safety warnings or adverse reaction sections of the regulatory labeling for Ombrez. Abuse potential is not specified in the regulatory labeling.

Q: Is it normal to feel a change in appetite while on Ombrez?

A: Changes in appetite are not listed as a common or uncommon side effect in the official safety profile. While a loss of appetite has been reported as a potential symptom alongside other side effects, it is not a primary expected effect.

Q: Can Ombrez be crushed or split if the pill is too large?

A: The capsule containing the powder must not be swallowed, crushed, or split for any reason. The medicine is intended only for oral inhalation using the designated device, and tampering with the capsule may compromise proper delivery.

Q: Is there a risk of allergic reaction to Ombrez?

A: Yes, there is a documented risk of immediate hypersensitivity reactions (severe allergic reactions) to the drug or its ingredients, including milk proteins found in the lactose excipient. If signs of a serious reaction occur, the medicine must be discontinued immediately.

Q: Can Ombrez affect my ability to drive or operate machinery?

A: Side effects like dizziness have been reported from post-marketing surveillance, and other systemic effects may occur. If these or other effects are experienced, caution is advised when driving or operating machinery.

Q: What kind of monitoring (like blood tests) is sometimes required while taking Ombrez?

A: Because the drug class can cause changes such as hypokalemia (low potassium) and hyperglycemia (high blood sugar), blood tests may be advised to check for these changes during regular medical follow-up.

Q: Are there non-drug alternatives mentioned in the same health guidelines that include Ombrez?

A: Official guidelines for managing COPD recommend both pharmacologic (drug) and non-pharmacologic interventions. While Ombrez is a pharmacologic treatment, the official context recognizes that management often involves lifestyle and therapeutic measures beyond medicine.

Q: Is Ombrez a newer or older medication?

A: Ombrez (Indacaterol) was first approved by the European Medicines Agency (EMA) in 2009 and by the FDA in the United States in 2011. This places it in the category of a newer generation ultra-long-acting bronchodilator.

Q: Does Ombrez cause any visible skin changes?

A: The official safety profile lists pruritus (itching) and rash as uncommon side effects. These visible skin changes are also noted as potential symptoms of a hypersensitivity or allergic reaction.

Q: Is Ombrez available over the counter in any country?

A: Ombrez is consistently classified as a prescription-only medication in major regulatory jurisdictions, including the United States, the European Union, and the United Kingdom. It is not available for purchase without a prescription.

Q: Why do some people say Ombrez didn't work for them?

A: Clinical trial summaries indicate that findings related to participant outcomes varied across trials, meaning not all patients respond identically to the medicine. Individual differences in disease severity, overall health, and adherence may affect the perceived benefit of the drug.

Q: Can Ombrez be taken on an empty stomach?

A: Official instructions state that the medicine can be taken independent of meals. This means it can be taken with food, or it can be taken without food (on an empty stomach), according to the patient's convenience.

Q: What should I know about the safety of Ombrez?

A: The official safety profile highlights the risk of Paradoxical Bronchospasm (a sudden, unexpected tightening of the airways), the potential for immediate hypersensitivity reactions (severe allergic reactions), and a regulatory class-wide warning regarding asthma-related death if the drug is used inappropriately in patients with asthma.

How should Ombrez be stored and disposed of?

The storage and disposal of Ombrez (indacaterol) must align strictly with regulatory labeling.

Storage & disposal scope Requirements from Official Labeling
Labeled storage temperature requirements Do not store above 30°C (86°F). Store at room temperature, away from excess heat.
Light/moisture protection requirements The capsules must be stored in the original blister pack to protect them from moisture and light.
Stability after opening/reconstitution The associated inhaler (Breezhaler) must be disposed of after 30 days of use, even if capsules remain.
Handling requirements Keep from freezing. Do not store the capsules in the inhaler device. Remove capsules immediately before use.
Child-protection storage requirements Keep this medicine out of the sight and reach of children.
Disposal instructions Do not throw away any medicines via wastewater or household waste. Ask a pharmacist for the proper way to dispose of unused or expired product.

Official storage and disposal statements: Regulatory guidelines require the product to be kept in its tightly closed original packaging to shield it from environmental damage, specifically moisture, light, and high heat. The inhalation device itself is limited to 30 days of use. Discarding unused product must follow regulated pharmaceutical waste protocols.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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