An oral long-acting bronchodilator
Bambuterol
An oral once-daily medicine for asthma that turns into terbutaline; not a quick reliever.
What is Bambuterol?
Bambuterol is a long-acting bronchodilator taken as a tablet once a day, usually at night, to help keep the airways open in asthma. It is a prodrug, meaning the body slowly turns it into terbutaline, giving a steady effect over the day. Because it works gradually, it is not a quick reliever and should not be used to treat a sudden attack — you still need a separate fast-acting reliever for that. Like other beta agonists it can cause shaky hands and a faster heartbeat.
Education and reference only. This is a plain-language guide to Bambuterol — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Bambuterol is a long-acting bronchodilator taken by mouth as a tablet, used to help control asthma. It is a prodrug of terbutaline, which means it is inactive until the body gradually converts it into terbutaline, giving a longer, steadier effect than a reliever inhaler. It is taken once a day, usually in the evening, so its effect carries through the night and following day. It is an oral alternative when an inhaled long-acting bronchodilator is not suitable.
How it works
After it is swallowed, bambuterol is slowly broken down in the body into terbutaline, which relaxes the muscle around the airways so they stay more open. Because the conversion is gradual, the airway-opening effect builds up steadily and lasts around a day, which is why it is taken once daily. This slow onset also means it cannot relieve a sudden attack — for that you need a fast-acting reliever. Like all beta agonists, it can affect the heart and muscles, causing a faster heartbeat and tremor.
Company & origin
Originated / developed by: Generic (long-established).
An oral once-daily bronchodilator used in the UK for asthma, taken as a prodrug that turns into terbutaline in the body.
What it treats
Conditions Bambuterol is used for
Practical use
How to take Bambuterol
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take one tablet once a day, usually in the evening, or exactly as your prescriber tells you.
- Keep using your separate fast-acting reliever for sudden symptoms, as bambuterol works too slowly for an attack.
- Use it alongside your preventer inhaler if you have one, rather than instead of it.
- Tell your prescriber about any kidney or liver problems, as your treatment may need adjusting.
- Report a persistent fast or pounding heartbeat, marked tremor or muscle cramps to your prescriber.
Weighing it up
Advantages & disadvantages of Bambuterol
Advantages
- A convenient once-daily tablet that gives steady, long-lasting airway opening.
- An oral option when inhaled long-acting bronchodilators are unsuitable or hard to use.
- Turns into terbutaline gradually, so its effect lasts through the night and day.
Disadvantages
- It is not a reliever, so it cannot treat a sudden asthma attack.
- As a tablet it is more likely than an inhaler to cause shaky hands and a faster heartbeat.
- May need dose changes or avoidance in kidney or liver problems.
Practical use
Good to know
The key point with bambuterol is that it is a regular, once-daily controller-type bronchodilator, not a rescue medicine, so you must still have a fast-acting reliever for sudden symptoms. It is usually taken at night so its effect covers you overnight and into the day. As an oral medicine it can be useful when inhalers are difficult to use, but being a tablet it is more likely to cause whole-body effects such as shaky hands, a faster heartbeat or muscle cramps than an inhaler. In asthma it should generally be used alongside a preventer inhaler that treats the underlying inflammation, rather than on its own. People with kidney or liver problems may need a different approach, so tell your prescriber.
Who should not take it / use with caution
- People with significant kidney or liver impairment may need a different medicine or careful adjustment.
- Used cautiously in certain heart-rhythm problems, overactive thyroid, diabetes and low potassium.
- Anyone who has reacted badly to terbutaline or similar bronchodilators should tell their prescriber.
Monitoring
- Reviewing asthma control and making sure a fast-acting reliever is also being used appropriately.
- Watching for tremor, palpitations and muscle cramps, especially when starting.
- Checking kidney and liver function where relevant, as these affect how it is handled.
Side effects
- Shaky hands (tremor) and a faster or pounding heartbeat are common, especially at first.
- Headache, restlessness or muscle cramps in some people.
- Rarely, it can lower potassium or cause an irregular heartbeat.
Key interactions
- Beta-blockers (including some glaucoma eye drops) can block its effect and may worsen asthma.
- Other medicines that lower potassium, such as some water tablets and steroids, can add to that effect.
- It can affect how the body handles certain medicines such as suxamethonium used in anaesthesia, so tell your team.
Available as: Tablets taken by mouth.
Answers
Bambuterol: frequently asked questions
Can I use bambuterol for a sudden asthma attack?
No. It works too slowly, so it is not a reliever; you still need a separate fast-acting reliever inhaler for sudden symptoms.
Why is it taken at night?
It is usually taken in the evening so its slow-building, long-lasting effect covers you overnight and into the following day.
How is it related to terbutaline?
Bambuterol is a prodrug that the body slowly turns into terbutaline, which is what actually opens the airways.
Why does it make my hands shake?
Tremor and a faster heartbeat are common effects of beta agonists; as a tablet, bambuterol is a little more likely to cause them than an inhaler.
Should I stop my preventer inhaler if I take this?
No. In asthma you should usually keep your preventer inhaler, which treats the underlying inflammation, alongside bambuterol.
The wider class
About Long-acting beta agonist (oral)
Bambuterol belongs to the long-acting beta agonist (oral) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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