Maxair (Pirbuterol Acetate)

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Pirbuterol is used to prevent and treat wheezing, shortness of breath, coughing, and chest tightness caused by asthma, chronic bronchitis, emphysema, and other lung diseases. Pirbuterol is in a class of medications called beta-agonist bronchodilators. It works by relaxing and opening air passages in the lungs, making it easier to breathe.

Pirbuterol comes as an aerosol to inhale by mouth. 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. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use pirbuterol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Do not use more than 12 puffs in 24 hours. Pirbuterol controls symptoms of asthma and other lung diseases but does not cure them. Do not stop using pirbuterol without talking to your doctor. Before you use the pirbuterol inhaler the first time, read the written instructions that come with it. Ask your doctor, pharmacist, or respiratory therapist to demonstrate the proper technique. Practice using the inhaler while in his or her presence. The pirbuterol inhaler 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:

• Remove the mouthpiece cover by pulling down the lip on the back of the cover.
• Point the mouthpiece away from yourself and other people so that the priming sprays will go into the air.
• Push the lever up so it stays up.
• 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.
• To release a second priming spray, return the lever to its down position and repeat steps 2-4.
• After the second priming spray is released, return the lever to its down position.

To use the inhaler, follow these steps:

• 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.
• Hold the inhaler upright so that the arrows point up. Then raise the lever so that it snaps into place and stays up.
• Hold the inhaler around the middle and shake gently several times.
• Continue to hold the inhaler upright and exhale (breathe out) normally.
• 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.
• Take the inhaler away from you mouth, hold your breath for 10 seconds, then exhale slowly.
• Continue to hold the inhaler upright while lowering the lever. Lower the lever after each inhalation.
• If your doctor has told you to take more than one inhalation, wait 1 minute and then repeat steps 2-7.
• When you have finished using the inhaler, make sure the lever is down and replace the mouthpiece cover.

Before using pirbuterol,
• tell your doctor and pharmacist if you are allergic to pirbuterol or any other drugs.
• tell your doctor and pharmacist what prescription medications you are taking, especially atenolol (Tenormin); carteolol (Cartrol); labetalol (Normodyne, Trandate); metoprolol (Lopressor); nadolol (Corgard); phenelzine (Nardil); propranolol (Inderal); sotalol (Betapace); theophylline (Theo-Dur); timolol (Blocadren); tranylcypromine (Parnate); other medications for asthma, heart disease, or depression.
• tell your doctor and pharmacist what nonprescription medications and vitamins you are taking, including ephedrine, phenylephrine, phenylpropanolamine, or pseudoephedrine. Many nonprescription products contain these drugs (e.g., diet pills and medications for colds and asthma), so check labels carefully. Do not take any of these medications without talking to your doctor (even if you never had a problem taking them before).
• tell your doctor if you have or have ever had an irregular heartbeat, increased heart rate, glaucoma, heart disease, high blood pressure, an overactive thyroid gland, diabetes, or seizures.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using pirbuterol, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using pirbuterol.

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 take a double dose to make up for a missed one.

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

• tremor
• nervousness
• dizziness
• weakness
• headache
• upset stomach
• diarrhea
• cough
• dry mouth
• throat irritation

If you experience any of the following symptoms, call your doctor immediately:

• increased difficulty breathing
• rapid or increased heartbeat
• irregular heartbeat
• chest pain or discomfort

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Avoid puncturing the container, and do not discard it in an incinerator or fire. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to pirbuterol. To relieve dry mouth or throat irritation, rinse your mouth with water, chew gum, or suck sugarless hard candy after using pirbuterol. Inhalation devices 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. Do not let anyone else use 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.