Adult Dose
Inhalation
Chronic obstructive pulmonary disease
Adult: Inhalation: 100 mcg/20 mcg (1 actuation of metered-dose inhaler) q6hr; not to exceed 6 actuations/day
Nebulizer solution: Initially, 3 ml every 6 hr. Max: 3 ml every 4 hr.
One ampoule as required for the relief of symptoms or as directed. Up to three to four ampoules daily.
Precaution
May cause paradoxical bronchospasm. Caution when used in patients who are sensitive to sympathomimetic agents. Caution when used in patients with CV disease as beta-agonists may increase BP, heart rate and risk of arrhythmias. Monitor blood glucose in diabetics. Monitor serum potassium levels especially in patients who are on concurrent treatment with xanthine derivatives, steroids or diuretics. Caution when used in patients with narrow angle glaucoma, hyperthyroidism, prostatic hyperplasia, bladder neck obstruction, seizure disorders, renal or hepatic impairment. Safety and efficacy have not been established in children <12 yr. Increased risk of GI motility disturbance in patients with cystic fibrosis. Pregnancy and lactation.
Lactation: Unknown whether drug is excreted in breast milk
Side Effect
>10%
Bronchitis (2-12%)
1-10%
Upper respiratory tract infection (1-10%),Lung disease (6%),Headache (3-6%),Dyspnea (2-5%),Nasopharyngitis (4%),Cough (3-4%),Pharyngitis (2-4%),Pain (1-3%),Chest pain (2.6%),Sinusitis (2.3%),Nausea (1-2%),Diarrhea (1.8%),Urinary tract infection (1.6%),Influenza (1.4%),Leg cramps (1.4%),Nausea (1.4%),Pneumonia (1.4%),Rhinitis (1.1%)
<1%
Allergic-type reactions, such as skin reactions (eg, rash, pruritus, urticaria [including giant urticaria]), angioedema (eg, of tongue, lips, face), laryngospasm, and anaphylaxis
Angina,Arrhythmia,Arthralgia,Dizziness,Dry mouth,Dyspepsia,Dysphonia,Edema,Fatigue,Hypertension,Insomnia,Nervousness,Palpitation,Paresthesia,Tachycardia,Tremor,Vomiting
Potentially Fatal: Anaphylactic reactions such as angioedema of tongue, lips or face and laryngospasm.
Interaction
May have additive anticholinergic effects when used with psychotropics; may decrease effect of propranolol. Increased CV effects (tachycardia, palpitations) when used with MAOIs, TCAs and amphetamines.