Bronchodilators, Adrenergic (Oral/Injection)
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 adrenergic bronchodilators
taken by mouth or given by injection, the following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to albuterol, ephedrine, epinephrine, isoproterenol, metaproterenol,
or terbutaline. Also, tell your doctor if you are allergic to any other substances,
such as foods, preservatives, or dyes.
Pregnancy - Some of these medicines can increase blood sugar,
blood pressure, and heart rate in the mother, and may increase the heart rate
and decrease blood sugar in the infant. Before taking any of these medicines,
make sure your doctor knows if you are pregnant or may become pregnant.
Some of these medicines also relax the muscles of the uterus and may delay
: Albuterol has not been
studied in pregnant women. Studies in animals have shown that albuterol causes
birth defects when given in doses many times the usual human dose.
: Ephedrine has not been
studied in pregnant women or in animals.
: Epinephrine has been
shown to cause birth defects in humans. However, this medicine may be needed
during allergic reactions that threaten the mother's life.
: Studies on birth defects
with isoproterenol have not been done in humans. However, there is some evidence
that it causes birth defects in animals.
: Metaproterenol has
not been studied in pregnant women. However, studies in animals have shown
that metaproterenol causes birth defects and death of the animal fetus when
given in doses many times the usual human dose.
: Terbutaline has not been
shown to cause birth defects in humans using recommended doses or in animal
studies when given in doses many times the usual human dose.
For albuterol, isoproterenol, and metaproterenol
: It is not known whether albuterol, isoproterenol, or metaproterenol
passes into 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 taking this medicine and who wish to breast-feed should discuss this
with their doctor.
: Ephedrine passes into breast
milk and may cause unwanted side effects in babies of mothers using ephedrine.
: Epinephrine passes into
breast milk and may cause unwanted side effects in babies of mothers using
: Terbutaline passes into
breast milk but has not been shown to cause harmful effects in the infant.
Mothers who are taking this medicine and who wish to breast-feed should discuss
this with their doctor.
Children - There is no specific information comparing use of
isoproterenol, metaproterenol, or terbutaline in children with use in other
Excitement and nervousness may be more common in children 2 to 6 years
of age who take albuterol than in adults and older children.
Infants and children may be especially sensitive to the effects of epinephrine.
Older adults - Older adults may be more sensitive to the side effects
of these medicines, such as trembling, high blood pressure, or fast or irregular
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 taking
adrenergic bronchodilators, it is especially important that your health care
professional know if you are taking any of the following:
For all adrenergic bronchodilators
Appetite suppressants (diet pills) or
Medicine for colds, sinus problems, or hay fever or other allergies
(including nose drops or sprays) or
Other medicines for asthma or other breathing problems - The
chance for side effects may be increased
Beta-adrenergic blocking agents taken orally or by injection (acebutolol
[e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], bisoprolol
[e.g., Zebeta], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol
[e.g., Lopressor, Toprol XL], 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 prevent the adrenergic bronchodilators from working properly
Beta-adrenergic blocking agents used in the eye (betaxolol [e.g.,
Betoptic], levobunolol [e.g., Betagan], metipranolol [e.g., OptiPranolol],
timolol [e.g., Timoptic] - Enough of these medicines may be absorbed from
the eye into the blood stream to prevent the adrenergic bronchodilators from
Cocaine - Unwanted effects of both medicines on the heart may
Digitalis medicines (e.g., Lanoxin) or
Quinidine (e.g., Quinaglute Dura-Tabs, Quinidex) - The risk of
heart rhythm problems may be increased
Monoamine oxidase (MAO) inhibitor activity (isocarboxazid
[e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane],
selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Taking
adrenergic bronchodilators while you are taking or within 2 weeks of taking
monoamine oxidase (MAO) inhibitors may dramatically increase the effects of
Thyroid hormones - The effect of this medicine may be increased
Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine
[e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Norpramin],
doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g.,
Aventyl, Pamelor], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - The
effects of these medicines on the heart and blood vessels may be increased
Other medical problems - The presence of other medical
problems may affect the use of these medicines. Make sure you tell your doctor
if you have any other medical problems, especially:
Convulsions (seizures) - These medicines may make this condition
Diabetes mellitus (sugar diabetes) - These medicines may increase
blood sugar, which could change the amount of insulin or other diabetes medicine
Enlarged prostate - Ephedrine may make the condition worse
Gastrointestinal narrowing - Use of the extended-release dosage
form of albuterol may result in a blockage in the intestines.
Glaucoma - Ephedrine or epinephrine may make the condition worse
High blood pressure or
Overactive thyroid - Use of ephedrine or epinephrine may cause
severe high blood pressure and other side effects may also be increased
Parkinson's disease - Epinephrine may make stiffness and trembling
Psychiatric problems - Epinephrine may make problems worse
Reduced blood flow to the brain - Epinephrine further decreases
blood flow, which could make the problem worse
Reduced blood flow to the heart or
Heart rhythm problems - These medicines may make these conditions