When This Medicine Should Not Be Used:
You should not use if you have had an allergic reaction to metaproterenol or if you have certain heart rhythm problems.

How to Use This Medicine:
Spray, Aerosol

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• You will inhale this medicine using either a metered-dose inhaler or a nebulizer.
• A nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer.
• A metered-dose inhaler fits on the medicine canister and turns the medicine into a fine spray that you breathe in through your mouth and to your lungs. You may be told to use a spacer, which is a tube that is placed between the inhaler and your mouth. Your caregiver will show you how to use your inhaler and the spacer (if needed).
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions about how to use the inhaler.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using digoxin (Lanoxin®), or any blood pressure medicines or diuretics (water pills). Tell your doctor if you have used medicine for depression such as amitriptyline or an MAO inhibitor (Eldepryl®, Marplan®, Nardil®, Parnate®) within the past 2 weeks.
• This medicine should not be used together with similar inhaled medicines such as levalbuterol (Xopenex™), isoproterenol (Isuprel®), albuterol (Proventil®, Ventolin®), pirbuterol (Maxair®), or terbutaline (Brethaire®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have diabetes, heart disease, heart rhythm problems, high blood pressure, overactive thyroid, or seizures.
• Your doctor may order other medicines for you to take to treat and control your asthma. Take all of your medicines as your doctor ordered. If you use any type of corticosteroid medicine to control your asthma, keep using it as ordered by your doctor. This includes corticosteroid medicines that are taken by mouth or inhaled (such as prednisone, Azmacort®, Deltasone®, Flovent®).
• If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in face or hands, swelling or tingling in the mouth or throat, tightness in chest, trouble breathing
• Fast, pounding, or irregular heartbeat
• Lightheadedness or fainting
• Tremors or shaking
• Worsening asthma symptoms

If you notice these less serious side effects, talk with your doctor:

• Dryness or unpleasant taste in mouth
• Headache, dizziness, nervousness
• Nausea, vomiting

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088