{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:50Z","timestamp":1756425830482,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Indacaterol is an ultra-long-acting \u03b2<jats:sub>2<\/jats:sub>-adrenoceptor agonist that is indicated for the maintenance treatment of chronic obstructive pulmonary disease. We present a patient with severe chronic constipation and abdominal pain most probably induced by this medicament. Symptoms rapidly disappeared within 2\u2005days after the drug withdrawal. As far as we know, no reports describing severe chronic constipation associated with indacaterol have been published. The Naranjo algorithm score and the Edwards and Aronson scale for causality assessment of suspected adverse drug reactions indicated a probable relationship between indacaterol use and constipation. Indacaterol-induced constipation is an unusual event that could be accounted for the high intrinsic activity of the drug on colonic \u03b2<jats:sub>3<\/jats:sub>-adrenoreceptors, resulting in an inhibitory control of smooth muscle function and intestinal secretion. Clinicians should monitor such a possibility when prescribing this drug and maybe avoid its use in patients with a history of difficult bowel evacuation.<\/jats:p>","DOI":"10.1136\/bcr-2013-009568","type":"journal-article","created":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T01:52:36Z","timestamp":1368150756000},"page":"bcr2013009568","source":"Crossref","is-referenced-by-count":2,"title":["Indacaterol-induced severe constipation and abdominal pain: is there a role for colonic \u03b2<sub>3<\/sub>-adrenoceptors?"],"prefix":"10.1136","volume":"2013","author":[{"given":"Miguel F","family":"Carrascosa","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Hospital of Laredo, Laredo, Cantabria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M Isabel","family":"Lucena","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department, School of Medicine, Virgen de la Victoria University Hospital, University of M\u00e1laga, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), Centro de Investigaci\u00f3n Biom\u00e9dica en Red en el \u00c1rea tem\u00e1tica de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inmaculada","family":"Bellido","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department, School of Medicine, Virgen de la Victoria University Hospital, University of M\u00e1laga, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), Centro de Investigaci\u00f3n Biom\u00e9dica en Red en el \u00c1rea tem\u00e1tica de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Ram\u00f3n","family":"Salcines-Caviedes","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital of Laredo, Laredo, Cantabria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,5,9]]},"reference":[{"key":"2025082803423821000_2013.may09_1.bcr2013009568.1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1378\/chest.10-1830","article-title":"Long-term safety and efficacy of indacaterol, a long-acting \u03b22-agonist, in subjects with COPD: a randomized, placebo-controlled study","volume":"2013","author":"Chapman","year":"2011","journal-title":"Chest"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.2","first-page":"23","article-title":"Indacaterol add-on therapy improves lung function, exercise capacity and life quality of COPD patients","volume":"2013","author":"Mroz","year":"2012","journal-title":"Adv Exp Med Biol"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1471-2466-12-29","article-title":"Efficacy of once-daily indacaterol 75-\u03bcg relative to alternative bronchodilators in COPD: a study level and a patient level network meta-analysis","volume":"2013","author":"Cope","year":"2012","journal-title":"BMC Pulm Med"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.4","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1185\/03007990903143143","article-title":"24-hour bronchodilator efficacy of single doses of indacaterol in patients with persistent asthma: comparison with placebo and formoterol","volume":"2013","author":"LaForce","year":"2009","journal-title":"Curr Med Res Opin"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.5","doi-asserted-by":"crossref","first-page":"477","DOI":"10.2147\/COPD.S23816","article-title":"Safety of indacaterol in the\u00a0 treatment of patients with COPD","volume":"2013","author":"Donohue","year":"2011","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.6","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1002\/j.1875-9114.2012.01025.x","article-title":"Indacaterol: a novel long-acting \u03b22-agonist","volume":"2013","author":"Ray","year":"2012","journal-title":"Pharmacotherapy"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.7","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0140-6736(04)16855-4","article-title":"Burden and clinical features of chronic obstructive pulmonary disease (COPD)","volume":"2013","author":"Pauwels","year":"2004","journal-title":"Lancet"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.8","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.bpg.2010.11.001","article-title":"What is necessary to diagnose constipation?","volume":"2013","author":"Rao","year":"2011","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.9","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/j.1440-1843.2011.02107.x","article-title":"Efficacy and safety of indacaterol 150 and 300\u2005\u00b5g in chronic obstructive pulmonary disease patients from six Asian areas including Japan: a 12-week, placebo-controlled study","volume":"2013","author":"Kinoshita","year":"2012","journal-title":"Respirology"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.10","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions","volume":"2013","author":"Naranjo","year":"1981","journal-title":"Clin Pharmacol Ther"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.11","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/S0140-6736(00)02799-9","article-title":"Adverse drug reactions: definitions, diagnosis, and management","volume":"2013","author":"Edwards","year":"2000","journal-title":"Lancet"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.12","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1053\/j.gastro.2007.05.009","article-title":"Demonstration of functional neuronal \u03b23-adrenoceptors within the enteric nervous system","volume":"2013","author":"Cellek","year":"2007","journal-title":"Gastroenterology"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.13","first-page":"762","article-title":"In vitro and in vivo pharmacological characterization of 5-[(R)-2-(5,6-diethyl-indan-2-ylamino)-1-hydroxy-ethyl]-8-hydroxy-H-quinolin-2-one (indacaterol), a novel inhaled \u03b22 adrenoceptor agonist with a 24-h duration of action","volume-title":"J Pharmacol Exp Ther","volume":"2013","author":"Battram","year":"2006"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.14","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/j.1476-5381.2010.00754.x","article-title":"The selectivity of beta-adrenoceptor agonists at human beta1-, beta2-, and beta3-adrenoceptors","volume":"2013","author":"Baker","year":"2010","journal-title":"Br J Pharmacol"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.15","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.2165\/11203960-000000000-00000","article-title":"Indacaterol in chronic obstructive pulmonary disease","volume":"2013","author":"Moen","year":"2010","journal-title":"Drugs"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.16","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1124\/jpet.107.129296","article-title":"Pharmacological characterization of indacaterol, a novel once daily inhaled \u03b22-adrenoceptor agonist, on small airways in human and rat precision-cut lung slices","volume":"2013","author":"Sturton","year":"2008","journal-title":"J Pharmacol Exp Ther"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.17","unstructured":"European Medicines Agency. Assessment report for Onbrez Breezhaler [online]. http:\/\/www.ema.europa.eu\/humandocs\/PDFs\/EPAR\/onbrez_breezhaler\/H-1114-en6.pdf (accessed 15 Jan 2013)."},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.18","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/S0022-3565(24)29289-2","article-title":"Colitis-induced alterations in adrenergic control of circular smooth muscle in vitro in rats","volume":"2013","author":"Zhao","year":"2001","journal-title":"J Pharmacol Exp Ther"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.19","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1038\/ajg.2011.164","article-title":"Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis","volume":"2013","author":"Suares","year":"2011","journal-title":"Am J Gastroenterol"},{"key":"2025082803423821000_2013.may09_1.bcr2013009568.20","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2147\/COPD.S4802","article-title":"Tiotropium HandiHaler in the treatment of COPD: a safety review","volume":"2013","author":"Kesten","year":"2009","journal-title":"Int J Chron Obstruct Pulmon Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-009568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:42:51Z","timestamp":1756377771000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-009568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,9]]},"references-count":20,"alternative-id":["10.1136\/bcr-2013-009568"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-009568","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,5,9]]}}}