Pirbuterol (Inhalation)

Pirbuterol is a drug that is used to prevent bronchospasm in patients who suffer from asthma, emphysema, bronchitis and certain other respiratory illnesses.

Overview

In the US, pirbuterol is known by the brand names, Maxair Autohaler and Maxair. The medication comes as an aerosol powder and is only available on prescription from your GP.

Pirbuterol is used either by itself or in combination with other drugs in patients over 12 years of age who have emphysema, asthma, bronchitis and certain other lung conditions.

Pirbuterol is an adrenergic bronchodilator. The drug is inhaled through the patient's mouth in order to open up the bronchial tubes of the lungs. These medications are useful in relieving the shortness of breath, breathing difficulties and wheezing that a constricted air flow through these structures can cause.

The medication cannot cure your respiratory disease, but it may be very effective in helping to relieve some of the more troublesome symptoms.

Conditions treated

  • Bronchospasm symptomatic of respiratory diseases

Type of medicine

  • Adrenergic bronchodilator

Side effects

In addition to the effects it is designed to have, some medicines can cause a few unwanted side effects. Not every patient experiences side effects, but if you do, you may need to get further medical attention.

If you notice any of the effects listed below while you are using pirbuterol, you should mention them to your GP right away:

  • Unusual feelings of tiredness or weakness
  • Trembling or shaking of the feet or hands
  • Swelling
  • Sweating
  • Shakiness in the feet, legs, hands or arms
  • Redness of the arms, neck, face and sometimes the upper chest
  • Numbness in the legs or arms
  • Feelings of warmth
  • Fast, irregular, or pounding heartbeat or pulse
  • Fainting
  • Feelings of dizziness, lightheadedness, or faintness when getting rising abruptly from a lying or seated position
  • Confusion
  • Chest pain
  • Bruising
  • Blurred vision

In the event that someone takes an overdose of pirbuterol, the symptoms in the list below may become evident. In this case, you should summon emergency help straight away:

  • Unable to sleep
  • Trouble sleeping
  • Slow or fast heartbeat
  • Sleeplessness
  • Shortness of breath
  • Pounding in the ears
  • Numbness or tingling in the hands, feet or lips
  • Nervousness
  • Nausea or vomiting
  • Muscle pain or cramps
  • Mood changes
  • Loss of appetite
  • Increased thirst
  • Headache
  • Generally feeling ill or uncomfortable
  • Dry mouth
  • Decreased urine
  • Convulsions
  • Confusion
  • Chest tightness or heaviness
  • Arm, back, or jaw pain

You may find that some side effects vanish of their own accord without medical treatment, once you have been using pirbuterol for a week or so. Your GP may also be able to give you some advice on how you can mitigate or prevent these effects. However, if any of the following effects do not resolve themselves or are particularly troublesome, ask your GP for advice:

  • Weight loss
  • Weight gain
  • Weakness
  • Thinning of the hair
  • Swelling or inflammation of the mouth
  • Redness, swelling, or soreness of the tongue
  • Itching skin
  • Increase in body movements
  • Hair loss
  • Dizziness
  • Depression
  • Cough
  • Change in taste
  • Bad, unusual, or unpleasant (after) taste
  • Anxiety
  • Abdominal or stomach cramps

Some patients may experience side effects that are not mentioned here. If you notice any unusual or odd effects, speak to your GP right away.

Dosage

Pirbuterol for inhalation is supplied with a purpose-designed inhaler. You will also be given a leaflet containing guidelines on how to use the product. If you are unsure about any aspect of using the drug or device, ask your GP to give you a demonstration. It is also advisable to ask your GP to go over how to use the inhaler periodically to ensure that you are using it correctly.

You must use this drug only as you have been told to. Do not use larger or smaller amounts, do not use it more frequently than you have been told to or for a longer period. It is very important that you do not stop using the inhaler or any other asthma medications that you have been prescribed, without consulting your GP first, as this could cause an increased likelihood of side effects.

Note that on your first use of the inhaler, or if you have not used the device for in excess of 48 hours, it may not dispense the correct dose of pirbuterol with the first inhalation. You must, therefore, prime the device by giving two sprays of the drug into the air (not into your mouth), and shaking the device thoroughly before each dose.

Do not use the inhaler for any other form of medication.

Before using pirbuterol, you must tell your GP if you have ever noticed an allergy to this or to any other drug. It is also important that you tell your treating physician if you are allergic to food colors, preservatives, animal derivatives, or particular food groups.

For inhalation dose to prevent bronchospasm:

  • Adults and children aged over 12 years: Use two inhalations of the drug every four to six hours as required. You may use a total of 12 inhalations daily. Each puff dispenses 200 mcg of the medicine.
  • Pirbuterol should not be used to treat children aged under 12 years.

In the event that you forget to use your inhaler, try to use it as soon as you remember. If it is nearly time for your next dose of pirbuterol, miss out the one you forgot and go back to your usual dosage regimen.

Never take double the amount prescribed; this could lead to an increased risk of overdose. Do not share your inhaler with anyone else.

If you do not think that your condition is showing any signs of improvement, or if you think that you are actually getting worse because of the effects of the drug, you must speak to your treating physician as a matter of urgency.

Interactions

Some groups of drugs should not be used in combination with other medicines, as doing so could cause a dangerous interaction to take place. However, in some instances, it may be applicable to your treatment for you to use two different drugs at the same time. Your doctor may decide to change your dose or may recommend other precautions to control these interactions.

If you are taking any other forms of medication, you must tell your GP before you start using pirbuterol. This should include over the counter products, vitamin supplements, herbal remedies, and diet pills.

Some drugs must not be taken if you are eating or with particular food groups. The use of tobacco or alcohol with some medicines can also cause an interaction. You should talk about this aspect of your health care with your GP before you start to use pirbuterol.

Medical interactions

Some existing or historical health problems can affect how pirbuterol works. Be sure to mention to your doctor if you have any other health issues.

Pirbuterol should be used with extreme caution in patients who have a history of any of the following health conditions, as to do so could make these illnesses worse:

  • Seizures
  • Hypokalemia (low potassium in the blood)
  • Hyperthyroidism (overactive thyroid)
  • Hypertension (high blood pressure)
  • Heart rhythm problems (e.g. arrhythmia)
  • Heart or blood vessel disease
  • Diabetes

Warnings

Before you decide whether or not to use a particular medicine, you should discuss the benefits and risk of doing so with your GP or treating specialist.

If you have ever noticed any odd or allergic responses to this drug or to any other medication, you must tell your GP. You should also discuss any odd effects that you have had when taking over the counter products. Be sure to mention any allergies that you have to food preservatives, colors, animal by-products, or particular food groups.

Pediatric

Note that using pirbuterol in children under the age of 12 is not advised.

Pregnancy and breastfeeding

Studies to date have not revealed that pirbuterol causes any dangerous effects to the fetus. However, this does not guarantee that it is completely safe to use this drug during pregnancy. If you think you are pregnant, you should discuss the use of this drug with your GP.

There is nothing to show that pirbuterol finds its way into breast milk. However, you may prefer to err on the side of caution by changing to an alternative feeding method for your infant throughout the course of your treatment with this drug. Your midwife or GP will be able to advise you on other suitable feeding solutions.

In order to be sure that the drug is working effectively and to check for any unwanted side effects that it may be causing, it is imperative that you visit your GP for regular progress checks.

Some patients who are taking pirbuterol may experience a side effect called paradoxical bronchospasm. This is a potentially dangerous condition and should immediately be referred to your doctor if you notice coughing, wheezing, breathing difficulties or a shortness of breath, especially if these effects appear immediately following a dose of pirbuterol.

It is possible that you may be given an anti-inflammatory drug to take for your asthma, in addition to pirbuterol. Do not stop taking either drug, even if you think your condition has improved, unless your doctor tells you to.

A condition called hypokalemia may occur while you are taking pirbuterol. If one or more of the following signs are noted, you must check with your GP right away:

  • Seizures
  • Decreased urine output
  • Dry mouth
  • Increase in thirst
  • Irregular heartbeat
  • Poor appetite
  • Changes in mood
  • Muscle cramp or pain
  • Nausea or vomiting
  • Tingling or feelings of numbness in the lips, feet, or hands
  • Shortness of breath
  • Feeling very weak or tired

Storage

You must keep your canister of pirbuterol at room temperature and out of direct sunlight. Keep the medicine away from sources of heat. Do not freeze or refrigerate the medicine.

Never store the drug in a vehicle where it could be made extremely cold or hot.

When the canister is empty, dispose of it safely. Never throw the canister onto a bonfire or make holes in it as this could cause an explosion, even if the container is empty. Do not hold on to any out-of-date or unwanted pirbuterol; ask your pharmacist or GP how to dispose of it.

Do not use medication that has passed its use-by date. Do not use any inhaler device that appears to be faulty or that has been tampered with.

Be sure to keep your medication well away from children and pets. If a pet does gain access to your medication and consumes any of it, you must contact your emergency vet right away.

Summary

Pirbuterol is one of a class of drugs called adrenergic bronchodilators. The drug is used to help relieve the breathing problems that are experienced by patients who have certain respiratory diseases, including chronic bronchitis, asthma, and emphysema. The medication is often used in combination with other asthma medicines.

Pirbuterol is not suitable for use in children under the age of 12. The medicine will not provide a cure for your respiratory disease, but it may be very effective in helping to relieve some of the more troublesome symptoms, providing that you continue to use it regularly and as prescribed. You must not stop taking the medication, even if you feel much better.

Throughout the course of your treatment with pirbuterol you must attend your GP for regular updates. There are a number of other drugs and historical medical conditions that could preclude the use of pirbuterol as side effects or serious interactions could occur. For this reason, it is very important that you discuss your medical history in full before you begin using this medicine.