Usual Adult Dose for Chronic Obstructive Pulmonary Disease - Maintenance

Inhalation aerosol: 2 inhalations (34 mcg) orally four times a day, or as needed up to 12 inhalations in 24 hours

Nebulizer inhalation solution: 500 mcg three or four times a day by oral nebulization, with doses 6 to 8 hours apart

Use:

• Maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema

Usual Pediatric Dose for Chronic Obstructive Pulmonary Disease - Maintenance

Nebulizer inhalation solution:
Less than 12 years: Safety has not been established.

12 years or older: 500 mcg three or four times a day by oral nebulization, with doses 6 to 8 hours apart

Use:

• Maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema

Renal Dose Adjustments

Use with caution.

Liver Dose Adjustments

Use with caution.

Precautions

Inhalation aerosol:
Safety and efficacy have not been established in patients younger than 18 years.

Nebulizer inhalation solution:
Safety and efficacy have not been established in patients younger than 12 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For oral Inhalation only.
• Drug should be used consistently as prescribed throughout the course of therapy.
• The manufacturer product information should be consulted for instructions of use.

• The inhaler should be primed before using for the first time by releasing 2 test sprays into the air away from the face, or if it has not been used for more than 3 days.
• Avoid spraying this drug into the eyes while priming the inhaler.

• The use of a nebulizer with mouthpiece rather than face mask may be preferable, to reduce the likelihood of the nebulizer solution reaching the eyes.
• Inhalation solution can be mixed in the nebulizer with albuterol or metaproterenol if used within one hour but not with other drugs.
• Drug stability and safety of inhalation solution when mixed with other drugs in a nebulizer have not been established.

• This drug is not indicated for the initial treatment of acute episodes of bronchospasm where rescue therapy is required for rapid response

• Use only as directed by your physician.
• More frequent administration or higher doses are not recommended.
• If this drug is spayed into the eyes, consult your physician immediately if symptoms of blurry vision and other vision abnormalities, eye pain or discomfort, dilated pupils, or narrow-angle glaucoma or worsening of this condition develop while using this drug.