Provocholine® is the commercial brand name of methacholine chloride, a direct‑acting cholinergic agonist developed by Methapharm Inc. It stimulates muscarinic receptors on bronchial smooth muscle to induce reversible bronchoconstriction, which is applied for bronchial provocation testing. Tianqing Suxin® is its domestic generic product available in China.
Main Indications
Bronchial provocation test to assist the diagnosis of bronchial asthma in patients with suspected asthma whose baseline FEV1 is ≥70% of the predicted value.
Clinical Research
Clinical studies demonstrated that methacholine challenge test has high sensitivity for detecting airway hyperresponsiveness. A positive test result is defined as a ≥20% reduction in FEV1 after inhalation of cumulative graded doses. This test helps differentiate asthma from other disorders presenting with non-specific respiratory symptoms, and resuscitation equipment and rescue medication must be readily available during testing. The domestic generic development referenced the clinical data of Provocholine®.
Common Side Effects
Systemic reactions: hypotension, palpitations;
Common mild adverse reactions: cough, headache, throat irritation, dyspnea. Rare but severe: severe bronchospasm, serious hypersensitivity reactions.
Approval Status in China
Original drug Provocholine® has not been approved for marketing in mainland China. The domestic generic drug TianqingSuxin® (Methacholine Chloride Powder for Solution for Inhalation) was officially approved for marketing in China in 2023, with the specification of 100mg per vial, 1 vial per box. It is currently a prescription diagnostic drug.
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