Pirbuterol

Pirbuterol is a prescription medication used to treat and prevent asthma attacks. It is also used to treat bronchospasm (narrowing of airways) caused by chronic bronchitis, emphysema, and other lung diseases. Pirbuterol belongs to a group of drugs called beta agonists, or bronchodilators, which cause the smooth muscle of the airways to relax, making it easier to breathe.

Pirbuterol comes in a special inhaler for oral (by mouth) inhalation. As you inhale through the inhaler mouthpiece, the medication is released into the lungs. It is usually taken as 1 to 2 puffs every 4 to 6 hours as needed to relieve symptoms or every 4 to 6 hours to prevent symptoms.

Common side effects include fast heartbeat, shakiness, headache, and nervousness.

Pirbuterol is a prescription medication used to prevent and treat bronchospasm in patients 12 years of age and older with reversible bronchospasm including asthma. It may be used in combination with other medications.

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

Pirbuterol may be found in some form under the following brand names:

• Maxair

Pirbuterol may cause serious side effects. See "Drug Precautions" section.

The most common side effects include:

• your heart feels like it is pounding or racing (palpitations)
• shakiness
• nervousness
• headache
• dizziness
• cough
• nausea

Tell your doctor if you have any side effect that bothers you or that does not go away.

These are not all of the possible side effects of pirbuterol. For more information, ask your doctor or pharmacist.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Pirbuterol and other medicines may affect each other and cause side effects. Especially tell your doctor if you take:

• other inhaled medicines or asthma medicines
• beta blocker medicines
• diuretics
• digoxin
• monoamine oxidase inhibitors
• tricyclic antidepressants

This is not a complete list of pirbuterol drug interactions. Ask your doctor or pharmacist for more information.

Pirbuterol may cause serious side effects, including:

• worsening trouble breathing, coughing and wheezing (paradoxical bronchospasm). If this happens stop using pirbuterol and call your doctor or get emergency help right away. Paradoxical bronchospasm is more likely to happen with your first use of a new canister of medicine.
• heart problems including faster heart rate and higher blood pressure
• possible death in people with asthma who use too much pirbuterol
• worsening of other medical problems in people who also use pirbuterol including increases in blood sugar

Do not use pirbuterol if you are allergic to any of the ingredients in it. 

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of pirbuterol there are no specific foods that you must exclude from your diet when receiving this medication.

Before you use pirbuterol, tell your doctor if you:

• have heart problems
• have high blood pressure (hypertension)
• have convulsions (seizures)
• have thyroid problems
• have diabetes
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant. 

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Pirbuterol falls into category C. There are no good studies that have been done in humans with pirbuterol. But in animal studies, pregnant animals were given pirbuterol, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed. 

It is not known if pirbuterol crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using pirbuterol.

• Use pirbuterol exactly as your doctor tells you to use it.
• If your child needs to use pirbuterol, watch your child closely to make sure your child uses the inhaler correctly. Your doctor will show you how your child should use pirbuterol.
• Each dose should last up to 4 hours to 6 hours.
• Do not increase your dose or take extra doses of pirbuterol without first talking to your doctor.
• Get medical help right away if pirbuterol no longer helps your symptoms.
• Get medical help right away if your symptoms get worse or if you need to use your inhaler more often.
• While you are using pirbuterol, do not use other inhaled rescue medicines and asthma medicines unless your doctor tells you to do so.
• Call your doctor if your asthma symptoms like wheezing and trouble breathing become worse over a few hours or days. Your doctor may need to give you another medicine (for example, corticosteroids) to treat your symptoms.

The special inhaler to be used with pirbuterol should be primed (tested) before you use it the first time and any time it has not been used for 48 hours. To prime the inhaler, follow these steps:

1. Remove the mouthpiece cover by pulling down the lip on the back of the cover.

2. Point the mouthpiece away from yourself and other people so that the priming sprays will go into the air.

3. Push the lever up so it stays up.

4. Push the white test fire slide on the bottom of the mouthpiece in the direction indicated by the arrow on the test fire slide. A priming spray will be released.

5. To release a second priming spray, return the lever to its down position and repeat steps 2-4.

6. After the second priming spray is released, return the lever to its down position.

To use the inhaler, follow these steps:

1. Remove the mouthpiece cover by pulling down the lip on the back of the cover. Make sure there are no foreign objects in the mouthpiece.

2. Hold the inhaler upright so that the arrows point up. Then raise the lever so that it snaps into place and stays up.

3. Hold the inhaler around the middle and shake gently several times.

4. Continue to hold the inhaler upright and exhale (breathe out) normally.

5. Seal your lips tightly around the mouthpiece and inhale (breathe in) deeply through the mouthpiece with steady force. You will hear a click and feel a soft puff when the medicine is released. Do not stop when you hear and feel the puff; continue to take a full, deep breath.

6. Take the inhaler away from you mouth, hold your breath for 10 seconds, then exhale slowly.

7. Continue to hold the inhaler upright while lowering the lever. Lower the lever after each inhalation.

8. If your doctor has told you to take more than one inhalation, wait 1 minute and then repeat steps 2-7.

9. When you have finished using the inhaler, make sure the lever is down and replace the mouthpiece cover.

Inhalers require regular cleaning. Once a week, remove the mouthpiece cover, turn the inhaler upside down and wipe the mouthpiece with a clean dry cloth. Gently tap the back of the inhaler so the flap comes down and the spray hole can be seen. Clean the surface of the flap with a dry cotton swab.

If you miss a dose, take 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 take two doses at once to make up for a missed dose.

Take pirbuterol exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you.

The usual dose for adults and children 12 years and older is two inhalations (400 mcg) repeated every 4-6 hours. One inhalation (200 mcg) repeated every 4-6 hours may be sufficient for some patients.

A total daily dose of 12 inhalations should not be exceeded.

Do not increase your dose or take extra doses of pirbuterol without first talking to your doctor.

If you take too much pirbuterol, call your local Poison Control Center or seek emergency medical attention right away.

Store at room temperature between 15° and 30°C (59° to 86°F).

Keep this and all medications out of the reach of children.