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Bronchodilators, Adrenergic  (Inhalation)

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Contents of this page:

Brand Names

Some commonly used brand names are:

In the U.S.—

  • Adrenalin Chloride3
  • Airet1
  • Alupent7
  • Arm-a-Med Isoetharine5
  • Arm-a-Med Metaproterenol7
  • Asthmahaler Mist3
  • AsthmaNefrin3
  • Beta-25
  • Brethaire11
  • Bronkaid Mist3
  • Bronkaid Suspension Mist3
  • Bronkometer5
  • Bronkosol5
  • Dey-Lute Isoetharine5
  • Dey-Lute Metaproterenol7
  • Foradil12
  • Isuprel6
  • Isuprel Mistometer6
  • Maxair8
  • Maxair Autohaler8
  • Medihaler-Iso6
  • microNefrin3
  • Nephron3
  • Primatene Mist3
  • Proventil1
  • Proventil HFA1
  • S-23
  • Serevent Diskus10
  • Vaponefrin3
  • Ventolin1
  • Ventolin HFA1
  • Ventolin Nebules1
  • Ventolin Rotacaps1

In Canada—

  • Alupent7
  • Apo-Salvent1
  • Berotec4
  • Bricanyl Turbuhaler11
  • Bronkaid Mistometer3
  • Foradil12
  • Gen-Salbutamol Sterinebs P.F.1
  • Isuprel6
  • Isuprel Mistometer6
  • Maxair8
  • Novo-Salmol1
  • Oxeze Turbuhaler12
  • Pro-Air9
  • Serevent10
  • Serevent Diskhaler10
  • Serevent Diskus10
  • Vaponefrin3
  • Ventodisk1
  • Ventolin1
  • Ventolin Nebules P.F.1
  • Ventolin Rotacaps1

Note:

For quick reference, the following adrenergic bronchodilators are numbered to match the corresponding brand names.

Other commonly used names are: Adrenaline Orciprenaline Salbutamol

This information applies to the following medicines:
1.  Albuterol (al-BYOO-ter-ole)
2.  Bitolterol (bye-TOLE-ter-ole)*
3.  Epinephrine (ep-i-NEF-rin)
4.  Fenoterol (fen-OH-ter-ole)*
5.  Isoetharine (eye-soe-ETH-a-reen)
6.  Isoproterenol (eye-soe-proe-TER-e-nole)
7.  Metaproterenol (met-a-proe-TER-e-nole)
8.  Pirbuterol (peer-BYOO-ter-ole)
9.  Procaterol (proe-KAY-ter-ole)*
10.  Salmeterol # (sal-ME-te-role)*
11.  Terbutaline (ter-BYOO-ta-leen)
12.  Formoterol (for-MOH-ter-ol))
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in Canada

Category


Description

Adrenergic bronchodilators are medicines that are breathed in through the mouth to open up the bronchial tubes (air passages) of the lungs. Some of these medicines are used to treat the symptoms of asthma, chronic bronchitis, emphysema, and other lung diseases, while others are used to prevent the symptoms.

Salmeterol is a long-acting bronchodilator that is used with anti-inflammatory medication to prevent asthma attacks. Salmeterol is different from the other adrenergic bronchodilators because it does not act quickly enough to relieve an asthma attack that has already started.

Some of these medicines are also breathed in through the mouth to prevent bronchospasm (wheezing or difficulty in breathing) caused by exercise. Also, epinephrine may be used in the treatment of croup.

All of these medicines, except some epinephrine preparations, are available only with your doctor's prescription. Although some of the epinephrine preparations are available without a prescription, your doctor may have special instructions on the proper dose of epinephrine for your medical condition.

These medicines are available in the following dosage forms:



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—

Breast-feeding—

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—

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:

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:


Proper Use of This Medicine

These medicines come with patient directions. Read them carefully before using the medicine. If you do not understand the directions or if you are not sure how to use the medicine, ask your health care professional to show you what to do. Also, ask your health care professional to check regularly how you use the medicine to make sure you are using it properly.

Use this medicine only as directed. Do not use more of it and do not use it more often than recommended on the label, unless otherwise directed by your doctor. Using the medicine more often may increase the chance of serious unwanted effects. Deaths have occurred when too much inhalation bronchodilator medicine was used.

Keep the spray away from your eyes because it may cause irritation.

Salmeterol and formoterol are used to prevent asthma attacks. They are not used to relieve an attack that has already started. For relief of an asthma attack that has already started, you should use another medicine (not formoterol) that starts working faster than salmeterol does. If you do not have another medicine to use for an attack or if you have any questions about this, check with your doctor. Because the effects of salmeterol and formoterol usually last about 12 hours, doses should never be taken more than two times a day or less than 12 hours apart.

Some epinephrine preparations are available without a doctor's prescription. However, do not use this medicine unless you are seeing a doctor about asthma. Do not use this medicine if you have been hospitalized for asthma treatment or if you are taking a prescription medicine for asthma, unless you have been told to do so by a doctor.

When you use the inhaler for the first time, or if you have not used it in a while, the inhaler may not deliver the right amount of medicine with the first puff. Therefore, before using the inhaler, you may have to test or prime it.

Your doctor, nurse, or pharmacist may want you to use a spacer or holding chamber with the inhaler. A spacer helps get the medicine into the lungs and reduces the amount of medicine that stays in your mouth and throat.

To use a spacer with the inhaler:

For patients using the powder for inhalation dosage form:

For patients using the inhalation solution dosage form :

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 inhalations or the amount of medicine 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 the adrenergic bronchodilator.

Missed dose—

Storage—

To store this medicine:


Precautions While Using This Medicine

It is important that your doctor check your progress at regular intervals to make sure that your medicine is working properly.

If you still have trouble breathing after using one of these medicines, or if your condition becomes worse, check with your doctor at once.

You may also be taking an anti-inflammatory medicine for asthma along with this medicine. Do not stop taking the anti-inflammatory medicine even if your asthma seems better, unless you are told to do so by your doctor.

For patients using salmeterol or formoterol, check with your doctor:

For patients using any of these medicines except salmeterol and formoterol, check with your doctor:


Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the adrenergic bronchodilators are similar, so any of the above side effects may occur with any of these medicines.

While you are using an adrenergic bronchodilator, you may notice an unusual or unpleasant taste. This may be expected and will go away when you stop using the medicine.

Isoproterenol may cause the saliva to turn pinkish to red. This is to be expected while you are taking this medicine.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.


Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, some of the adrenergic bronchodilators are used in certain patients with the following medical conditions:

Revised: 06/25/2003

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