Bronchodilators, Adrenergic (Inhalation)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For inhalation adrenergic bronchodilators, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to albuterol, bitolterol, epinephrine, fenoterol, formoterol, isoetharine, isoproterenol, metaproterenol, pirbuterol, procaterol, salmeterol, terbutaline, or other inhalation medicines. Also tell your health care professional if you are allergic to sulfites, which may be used as a preservative in some of these medicines or to lactose, contained in powders for inhalation.

Pregnancy -

• For albuterol, bitolterol, formoterol, metaproterenol, and salmeterol : These medicines are used to treat asthma in pregnant women. Although there are no studies on birth defects in humans, problems have not been reported. Some studies in animals have shown that they cause birth defects when given in doses many times higher than the human dose.
• For epinephrine : Women given epinephrine subcutaneously (under the skin) during pregnancy have been studied. The babies of these women had more birth defects than expected, although the severity of the mother's asthma may have contributed to this result.
• For fenoterol, isoproterenol, pirbuterol, procaterol, and terbutaline : These medicines are used to treat asthma in pregnant women. Although there are no studies on birth defects in humans, problems have not been reported. These medicines have not been shown to cause birth defects in animal studies when given in doses many times higher than the human dose.
• For isoetharine : Studies on birth defects have not been done in either humans or animals.

Breast-feeding -

• It is not known whether these medicines pass into the breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using these medicines and who wish to breast-feed should discuss this with their doctor.

Children - Appropriate studies performed to date have not demonstrated pediatrics-specific problems that would limit the usefulness of these medicines in children. However, isoetharine is not recommended for use in children.

Older adults -

• For albuterol, bitolterol, epinephrine, fenoterol, isoetharine, isoproterenol, metaproterenol, pirbuterol, procaterol, and terbutaline : These medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of inhalation adrenergic bronchodilators in the elderly with use in other age groups.
• For salmeterol : This medicine has been tested in a limited number of patients 65 years of age or older. It has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using inhalation adrenergic bronchodilators, it is especially important that your health care professional know if you are taking any of the following:

• Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Sotacor], timolol [e.g., Blocadren]) - These medicines may make your condition worse and prevent the adrenergic bronchodilators from working properly
• Disopyramide,
• Quinidine,
• Phenothiazines, or
• Procainamide - These medicines may increase the risk of heart problems

Other medical problems - The presence of other medical problems may affect the use of inhalation adrenergic bronchodilators. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart or blood vessel disease - These medicines may make these conditions worse

• High blood pressure, not well controlled - Epinephrine may make this condition worse

• Overactive thyroid or
• Pheochromocytoma, diagnosed or suspected - The chance of side effects may be increased