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How should this medicine be used?

Albuterol comes as a solution (liquid) to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled) and as an aerosol to inhale by mouth using an inhaler. When the inhalation aerosol is used to treat or prevent symptoms of lung disease, it is usually used every 4 to 6 hours as needed. When the inhalation aerosol is used to prevent breathing difficulty during exercise, it is usually used 15 to 30 minutes before exercise. The nebulizer solution is usually used three or four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use albuterol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Call your doctor if your symptoms worsen or if you feel that albuterol inhalation no longer controls your symptoms. If you were told to use albuterol as needed to treat your symptoms and you find that you need to use the medication more often than usual, call your doctor.

Albuterol controls symptoms of asthma and other lung diseases but does not cure them. Do not stop using albuterol without talking to your doctor.

If you are using the inhaler, your medication will come in canisters. Each canister of albuterol aerosol is designed to provide 200 inhalations. After the labeled number of inhalations has been used, later inhalations may not contain the correct amount of medication. Throw away the canister after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed.

Your inhaler may come with an attached counter that keeps track of the number of sprays you have used. If you have this type of inhaler, you should not try to change the numbers or remove the counter from the canister. When the number that shows on the counter is 020, you should call your doctor or pharmacist to refill your prescription. When the number that shows on the counter is 000, you should not use that canister anymore. Throw away the empty canister.

If your inhaler does not come with an attached counter, you will need to keep track of the number of inhalations you have used. You can divide the number of inhalations in your inhaler by the number of inhalations you use each day to find out how many days your inhaler will last. Do not float the canister in water to see if it still contains medication.

The inhaler that comes with albuterol aerosol is designed for use only with a canister of albuterol. Never use it to inhale any other medication, and do not use any other inhaler to inhale albuterol.

Be careful not to get albuterol inhalation into your eyes.

Do not use your albuterol inhaler when you are near a flame or source of heat. The inhaler may explode if it is exposed to very high temperatures.

Before you use albuterol for the first time, read the written instructions that come with the inhaler or nebulizer. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler or nebulizer while he or she watches.

If your child will be using the inhaler, be sure that he or she knows how to use it. Watch your child each time he or she uses the inhaler to be sure that he or she is using it correctly.

Clean your inhaler or nebulizer regularly. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your inhaler or nebulizer.If you do not clean your inhaler properly, the inhaler may become blocked and may not spray medication. If this happens, follow the manufacturer's directions for cleaning the inhaler and removing the blockage.

Other uses for this medicine

Inhaled albuterol is also sometimes used to treat or improve muscle paralysis (inability to move parts of the body) in patients with a condition that causes attacks of paralysis. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using albuterol inhalation,

• tell your doctor and pharmacist if you are allergic to albuterol (Vospire ER, in Combivent, in Duoneb), levalbuterol (Xoponex), or any other medications.
• tell your doctor and pharmacist what prescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); digoxin (Lanoxin); diuretics ('water pills'); epinephrine (Epipen, Primatene Mist); other inhaled medications used to relax the air passages such as metaproterenol (Alupent) and levalbuterol (Xoponex); and medications for colds. Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past 2 weeks: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); and monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had an irregular heartbeat, heart disease, high blood pressure, hyperthyroidism (condition in which there is too much thyroid hormone in the body), diabetes, or seizures.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using albuterol, call your doctor.
• you should know that albuterol inhalation sometimes causes wheezing and difficulty breathing immediately after it is inhaled. If this happens, call your doctor right away. Do not use albuterol inhalation again unless your doctor tells you that you should.

What should I do if I forget a dose?

If you have been told to use albuterol inhalation on a regular schedule, use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

What side effects can this medication cause?

Albuterol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• uncontrollable shaking of a part of the body
• nervousness
• headache
• nausea
• vomiting
• cough
• throat irritation
• muscle, bone, or back pain

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• fast, pounding, or irregular heartbeat
• chest pain
• rash
• hives
• itching
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• increased difficulty breathing
• difficulty swallowing
• hoarseness

Albuterol may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Keep unused vials of nebulizer solution in the foil pouch until you are ready to use them. Store the medication at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. If you are using the nebulizer solution, throw away vials one week after you remove them from the foil pouch. If you are using the inhaler with an attached counter, throw away the inhaler 2 months after you remove it from the foil pouch. Talk to your pharmacist about the proper disposal of your medication. Do not puncture the aerosol canister, and do not discard it in an incinerator or fire.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• seizures
• chest pain
• fast, irregular or pounding heartbeat
• nervousness
• headache
• uncontrollable shaking of a part of the body
• dry mouth
• nausea
• dizziness
• excessive tiredness
• lack of energy
• difficulty falling asleep or staying asleep

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies

Brand Names

• Accuneb®
• Airet®
• Arm-A-Med®
• ProAir HFA®
• Proventil®
• Respirol®
• Ventolin®

Brand Names of Combination Products

• Combivent (containing Albuterol and Ipratropium)
• Combivent 20/100 (containing Albuterol and Ipratropium)
• DuoNeb (containing Albuterol and Ipratropium)