Bronchodilators, Adrenergic (Oral/Injection)

Proper Use of This Medicine

Use this medicine only as directed . Do not use more of it and do not use it more often than your doctor ordered, do not use more than recommended on the label unless otherwise directed by your doctor. To do so may increase the chance of side effects.

If you are using this medicine for asthma, you should use another medicine that works faster than this one for an asthma attack that has already started. If you do not have another medicine to use for an attack or if you have any questions about this, check with your doctor.

For patients taking albuterol extended-release tablets :

• Swallow the tablet whole.
• Do not crush, break, or chew before swallowing.

For patients using epinephrine injection :

• This medicine is for injection only. If you will be giving yourself the injections, make sure you understand exactly how to give them. If you have any questions about this, check with your health care professional.
• When injected into the muscle (intramuscular) this medicine should be injected into the thigh. It should not be injected into the buttocks.
• Do not use the epinephrine solution or suspension if it turns pinkish to brownish in color or if the solution becomes cloudy.
• Keep this medicine ready for use at all times. Also, keep the telephone numbers for your doctor and the nearest hospital emergency room readily available.
• Check the expiration date on the injection regularly. Replace the medicine before that date.

For patients using epinephrine injection for an allergic reaction emergency :

• If a severe allergic reaction occurs, use the epinephrine injection immediately .
• After using the epinephrine injection, notify your doctor immediately or go to the nearest hospital emergency room. Be sure to tell your doctor that you have used the epinephrine injection.
• If you have been stung by an insect, remove the insect's stinger with your fingernails, if possible. Be careful not to squeeze, pinch, or push it deeper into the skin. Ice packs or sodium bicarbonate (baking soda) soaks, if available, may then be applied to the area stung.
• If you are using the epinephrine auto-injector (automatic injection device):
  • The epinephrine auto-injector comes with patient directions. Read them carefully before you actually need to use this medicine. Then, when an emergency arises, you will know how to inject the epinephrine.
  • It is important that you do not remove the safety cap on the auto-injector until you are ready to use it. This prevents accidental activation of the device during storage and handling.
  • To use the epinephrine auto-injector:
    • Remove the gray safety cap.
    • Place the black tip on the thigh, at a right angle (90-degree angle) to the leg.
    • Press hard into the thigh until the auto-injector functions. Hold in place for several seconds. Then remove the auto-injector and discard.
    • Massage the injection area for 10 seconds.

Dosing - The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets or teaspoonfuls of solution or syrup that you take, or the amount of injection that you use, depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking it .

For albuterol
• For symptoms of asthma, chronic bronchitis, emphysema, or other lung disease:
  • For oral dosage form (solution):
    • Adults and children 12 years of age and older - 2 to 4 milligrams (mg) (1 to 2 teaspoonfuls) three or four times a day.
    • Children 6 to 12 years of age - 2 mg (1 teaspoonful) three or four times a day.
    • Children 2 to 6 years of age - Dose is based on body weight and must be determined by your doctor. The usual dose is 0.1 mg per kg (0.045 mg per pound) of body weight up to a maximum dose of 2 mg (1 teaspoonful) three or four times a day..
    • Children up to 2 years of age - Use and dose must be determined by your doctor.
  • For oral dosage form (syrup):
    • Adults and children 14 years of age and older - 2 to 4 mg (1 to 2 teaspoonfuls) three or four times a day. Then your doctor may increase your dose, if needed.
    • Children 6 to 14 years of age - At first, 2 mg (1 teaspoonful) of albuterol three or four times a day. Then your doctor may increase your dose, if needed.
    • Children 2 to 6 years of age - Dose is based on body weight and must be determined by your doctor. The usual dose is 0.1 mg per kg (0.045 mg per pound) of body weight up to a maximum dose of 2 mg (1 teaspoonful) three or four times a day.
    • Children up to 2 years of age - Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • Adults and children 12 years of age and older - At first, 2 to 4 mg three or four times a day. Then your doctor may increase your dose, if needed.
    • Children 6 to 12 years of age - 2 mg three or four times a day.
    • Children up to 6 years of age - Use and dose must be determined by your doctor.
  • For oral dosage form (extended-release tablets):
    • Adults and children 12 years of age and older - 4 to 8 mg every twelve hours.
    • Children 6 to 12 years of age - 4 mg every twelve hours.
    • Children up to 6 years of age - Use and dose must be determined by your doctor.
  • For injection dosage form:
    • Dose is usually based on body weight and must be determined by your doctor. Depending on your condition, this medicine is injected into either a muscle or vein or injected slowly into a vein over a period of time.

For epinephrine
• For injection dosage form:
  • For allergic reactions:
    • Adults - At first, 300 to 500 micrograms (mcg) (0.3 to 0.5 mg) injected into a muscle or under the skin. Then the dose may be repeated, if needed, every ten to twenty minutes for up to three doses. In some cases, it may be necessary for 100 to 250 mcg to be injected slowly into a vein by your doctor instead of injecting the dose into a muscle or under the skin.
    • Children - Dose is based on body weight and must be determined by your doctor. The usual dose is 10 mcg per kg (4.5 mcg per pound) of body weight, up to 300 mcg (0.3 mg) a dose, injected into a muscle or under the skin. The dose may be repeated, if needed, every fifteen minutes for up to three doses.
  • For symptoms of bronchial asthma, chronic bronchitis or other lung disease:
    • Adults - Dose is based on body weight and must be determined by your doctor. The usual dose is 10 mcg per kg (4.5 mcg per pound) of body weight, up to 300 to 500 mcg (0.3 to 0.5 mg) a dose, injected under the skin. The dose may be repeated, if needed, every twenty minutes for up to three doses.
    • Children - Dose is based on body weight and must be determined by your doctor. The usual dose is 10 mcg per kg (4.5 mcg per pound) of body weight, up to 300 mcg (0.3 mg) a dose, injected under the skin. The dose may be repeated, if needed, every fifteen minutes for three or four doses or every four hours.

For isoproterenol
• For injection dosage form:
  • For symptoms of asthma, chronic bronchitis, emphysema, or other lung disease:
    • Isoproterenol is given by intravenous injection in a doctor's office or hospital.

For metaproterenol
• For oral dosage forms (syrup or tablets):
  • For symptoms of asthma, chronic bronchitis, emphysema, or other lung disease:
    • Adults and children 9 years of age and older or weighing 27 kilograms (kg) (59 pounds) or more - 20 milligrams (mg) three or four times a day.
    • Children 6 to 9 years of age or weighing up to 27 kg (59 pounds) - 10 mg three or four times a day.
    • Children up to 6 years of age - Dose must be determined by your doctor.

For terbutaline
• For symptoms of asthma, chronic bronchitis, emphysema, or other lung disease:
  • For oral dosage form (tablets):
    • Adults and adolescents 15 years of age and older - 5 milligrams (mg) three times a day. The medicine may be taken about every six hours while you are awake, until three doses have been taken.
    • Children 12 to 15 years of age - 2.5 mg three times a day, taken about every six hours.
    • Children 6 to 11 years of age - Dose is based on body weight and must be determined by your doctor.
    • Children up to 6 years of age - Use and dose must be determined by your doctor.
  • For injection dosage form:
    • Adults and children 12 years of age or older - 250 micrograms (mcg) injected under the skin. The dose may be repeated after fifteen to thirty minutes, if needed. However, not more than 500 mcg should be taken within a four-hour period.
    • Children 6 to 12 years of age - Dose is based on body weight and must be determined by your doctor. The usual dose is 5 to 10 mcg per kg (2.3 to 4.5 mcg per pound) of body weight injected under the skin. The dose may be repeated after fifteen to twenty minutes for up to a total of three doses.
    • Children up to 6 years of age - Use and dose must be determined by your doctor.

Missed dose - If you are using this medicine regularly and you miss a dose, use it as soon as possible. Then use any remaining doses for that day at regularly spaced intervals. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the injection or syrup form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.