Xopenex

What you should know before using

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatrics

There is no specific information comparing use of isoproterenol, metaproterenol, or terbutaline in children with use in other age groups.

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.

Geriatric

Older adults may be more sensitive to the side effects of these medicines, such as trembling, high blood pressure, or fast or irregular heartbeats.

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 labor.

For albuterol:

• 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.

For ephedrine:

• Ephedrine has not been studied in pregnant women or in animals.

For epinephrine:

• 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.

For isoproterenol:

• Studies on birth defects with isoproterenol have not been done in humans. However, there is some evidence that it causes birth defects in animals.

For metaproterenol:

• 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.

For terbutaline:

• 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.

Breast Feeding

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.

For ephedrine:

• Ephedrine passes into breast milk and may cause unwanted side effects in babies of mothers using ephedrine.

For epinephrine:

• Epinephrine passes into breast milk and may cause unwanted side effects in babies of mothers using epinephrine.

For terbutaline:

• 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.

Drug Interactions

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

• Thioridazine

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acebutolol
• Alprenolol
• Arotinolol
• Atenolol
• Atomoxetine
• Befunolol
• Betaxolol
• Bevantolol
• Bisoprolol
• Bopindolol
• Bucindolol
• Bupranolol
• Carteolol
• Carvedilol
• Celiprolol
• Clorgyline
• Dilevalol
• Entacapone
• Esmolol
• Furazolidone
• Iproniazid
• Isocarboxazid
• Labetalol
• Landiolol
• Levobetaxolol
• Levobunolol
• Mepindolol
• Metipranolol
• Metoprolol
• Moclobemide
• Nadolol
• Nebivolol
• Nialamide
• Nipradilol
• Oxprenolol
• Pargyline
• Penbutolol
• Phenelzine
• Pindolol
• Procarbazine
• Propranolol
• Selegiline
• Sotalol
• Talinolol
• Tertatolol
• Timolol
• Toloxatone
• Tranylcypromine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Convulsions (seizures)—These medicines may make this condition worse.

• Type 2 diabetes mellitus—These medicines may increase blood sugar, which could change the amount of insulin or other diabetes medicine you need.

• 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.

• 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 worse.

• 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 worse.