Spiropent (clenbuterol): another choice for patients with chronic reversible airways obstruction

Oral administration of spiropent (clenbuterol), 20 mcg on waking in the morning and 40 mcg before sleep, daily for 2 months, was studied in 34 patients, 19 males and 15 females, aged between 27 to 73 years (mean 47.8 +/- 17.5), who had chronic reversible airways obstruction as defined by the A.T.S.'s criteria. Assessments were made before and after the trial by monitoring lung function parameters and patient's comment on efficacy, side effects and comfort. Except 5 patients, 2 suffering from severe headache and 3 from poor control of asthma who had withdrawn from this study after one week of treatment, all patients completed the trial. Six out of 29 patients who completed the trial needed additional steroid treatment and 9 needed beta 2-agonist inhalation during the treatment period. The results showed improvement of FEV1 more than 15% in 21 patients (72%), FVC in 17 patients (59%) and PEFR in 20 patients (69%). These increases were significant (p less than 0.0001). However, only 12 patients (41%) had marked subjective improvement at the end of treatment. Cough (21%), headache (10%), nausea (7%) and dizziness (3%) were the commonest side-effects. No clinical or statistical difference was found in changes of vital signs and laboratory parameters. In conclusion, clenbuterol was effective and well-tolerated in the majority of patients enrolled in this study with minimal side-effects and good compliance. It may be used for long-term treatment of chronic reversible airways obstruction at lower cost.