When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use this medicine if you have had an allergic reaction to pirbuterol.

How to Use This Medicine:
Powder Under Pressure

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• You will use this medicine with a metered-dose inhaler. The 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.
• Prime the inhaler before you use it the first time and if you have not used it for more than 48 hours. Your doctor should show you how to use the test fire slide to prime the spray.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
  
  • Make sure the arrows on the inhaler are pointing up. Raise the lever on the top of the inhaler. Gently shake the inhaler.
  • The inhaler automatically releases medicine when you put your mouth on it and breathe in. You should hear a click and feel a soft spray of medicine. Keep breathing in after you hear the click and feel the spray. This will get the medicine all the way to your lungs.
  • Hold your breath for about 10 seconds. Then breathe out slowly. Lower the lever on the inhaler.
• Do not use more than 12 sprays in 1 day, unless your doctor tells you to.
• Carefully follow the patient instructions about how to clean and care for your inhaler.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.

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

• Some foods and medicines can affect how pirbuterol works. Tell your doctor if you are also using any of the following:
  
  • Blood pressure medicine (a beta-blocker)
  • Diuretic (water pill)
  • Medicine for depression (tricyclic medicine), within the past 2 weeks
  • MAO inhibitor (MAOI), within the past 2 weeks

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have diabetes, heart disease, heart rhythm problems, high blood pressure, overactive thyroid, or seizures.
• This medicine may cause the following problems:
  
  • Paradoxical bronchospasm (more breathing problems)
  • Blood pressure changes
• Keep using all other medicine that your doctor has prescribed for your breathing problems, especially if you also use a steroid medicine.
• 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.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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 your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Dry mouth, increased thirst, muscle cramps, nausea or vomiting, uneven heartbeat
• Pounding, uneven, or very fast heartbeat
• Increased trouble breathing

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

• Mild nervousness, shaking

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