Drug Profile

Pregnancy Warning

Albuterol caused malformations in human infants including cleft palate and limb defects. There is no human data for pirbuterol, but it caused abortions and fetal death in animal studies. Because of the potential for serious adverse effects to the fetus, these drugs should not be used by pregnant women.

Breast-feeding Warning

No information is available from either human or animal studies. However, it is likely that these drugs, like many others, are excreted in human milk, and because of the potential for adverse effects in nursing infants, including the potential for cancer with albuterol, you should not take these drugs while nursing.

Do not stop any asthma medication without first consulting your physician. Abruptly stopping a medication may result in acutely deteriorating asthma control.

Additional Precautions for Asthma

Avoid exposure to things that trigger your allergies or asthma, such as animals, bedding, chemicals, cosmetics, drugs, dust, mold, foods, pollens, or smoke. Wearing a mask reduces inhalation of drugs, pollens, and smoke.

Aspirin can trigger asthma in people who are aspirin-allergic, as can beta-blockers. Infections aggravate lung problems. During epidemics of respiratory illnesses, avoid crowded places and wash your hands frequently to help prevent infection. If you have asthma, get a flu vaccination.

Note: The information in this profile addresses the care of asthma that is not serious enough to need emergency treatment.

This drug can cause or worsen high blood pressure. It is especially dangerous for people who have high blood pressure, heart disease, diabetes, or thyroid disease. People over 60 are more likely than younger people to experience effects on the heart and blood pressure, restlessness, nervousness, and confusion.

Tell your doctor if you have or have had:

• allergies to drugs
• an allergy to other sympathomimetic drugs such as the decongestants pseudoephedrine and phenylpropanolamine (PPA)
• heart or blood vessel disease
• pheochromocytoma
• high blood pressure
• heart rhythm problems
• pregnancy or are breast-feeding
• enlarged thyroid

Tell your doctor about any other drugs you take, including aspirin, herbs, vitamins, and other nonprescription products.

• Check with your doctor immediately if breathing problem persists or if condition becomes worse. Call your doctor if you do not feel better after taking the usual dose, if you still have trouble breathing one hour after a dose, if symptoms return within four hours, or if your condition worsens.
• Check with your doctor immediately if more than your usual inhalations are needed to relieve an acute attack.
• If you plan to have any surgery, including dental surgery, tell your doctor that you take an asthma drug.
• Check with your doctor about anti-inflammatory drug use.
• Do not take other drugs without talking to your doctor first, especially nonprescription drugs for appetite control, asthma, colds, coughs, hay fever, or sinus problems.

• Read patient instructions first.
• If you miss a dose, take it as soon as you remember, then space remaining doses for the day at regular intervals. Do not take more often than prescribed.
• Do not share your medication with others.
• Be careful not to get medicine in your eyes.
• If using an anti-inflammatory drug, check with your doctor before stopping or reducing amount.
• Do not store in the bathroom. Do not expose to heat, moisture, or strong light. Do not allow inhaled form to freeze. Keep out of reach of children.

For the aerosol for oral inhalation:

• Invert the can, then shake well.
• Exhale as completely as possible.
• Place mouthpiece into the mouth. Close lips loosely around it. Tilt inhaler upward and head backward, then inhale slowly and deeply while actuating the inhaler. (Some physicians recommend placing inhaler about two inches from the front of the open mouth.) Remove inhaler from mouth. Hold breath a few seconds, then exhale slowly.
• Avoid contact with the eyes. If you do get drug in your eyes, flush immediately with cool water.
• Clean the inhaler and plastic mouthpiece with warm water. Save inhaler, as refill canister may be available.
• Do not puncture, burn, or incinerate the container.

The following drugs, biologics (e.g., vaccines, therapeutic antibodies), or foods are listed in Evaluations of Drug Interactions 2003 as causing “highly clinically significant” or “clinically significant” interactions when used together with any of the drugs in this section. In some sections with multiple drugs, the interaction may have been reported for one but not all drugs in this section, but we include the interaction because the drugs in this section are similar to one another. We have also included potentially serious interactions listed in the drug’s FDA-approved professional package insert or in published medical journal articles. There may be other drugs, especially those in the families of drugs listed below, that also will react with this drug to cause severe adverse effects. Make sure to tell your doctor and pharmacist the drugs you are taking and tell them if you are taking any of these interacting drugs:

flecainide, FLUOTHANE, GLUCOPHAGE, GLUCOVANCE, halothane, imipramine, INDERAL, INDERAL LA, METAGLIP, metformin, propranolol, TAMBOCOR, TOFRANIL.

Call your doctor immediately if you experience:

• hives
• increased shortness of breath
• skin rash
• swelling of face, lips, or eyelids
• tightness in chest or wheezing
• trouble breathing

Call your doctor if these symptoms continue:

• irregular heartbeat
• headache
• nervousness
• trembling
• coughing or other bronchial irritation
• dizziness or lightheadedness
• dryness or irritation of mouth or throat
• low potassium
• chest discomfort or pain
• drowsiness or weakness
• muscle cramps or twitching
• nausea and/or vomiting
• restlessness
• trouble sleeping

Signs of overdose:

• dizziness or lightheadedness
• continuing trembling
• vomiting
• agitation
• hallucinations or paranoia with nebulized albuterol
• seizures
• fast and irregular heartbeat

If you suspect an overdose, call this number to contact your poison control center: (800) 222-1222.