Adult Dosing

Bronchospasm

• 0.4 mg (2 puffs) INH q4-6 hrs; Alt: 0.2 mg (1 puff) q4-6 hrs
• Max: 2.4 mg (12 puffs)/day

Acute Asthma [Non-FDA Approved]

• 1-2 puffs q 4-6 hrs; Max dose: 12 puffs/day

Pediatric Dosing

Bronchospasm

Children >12 years

• 0.4 mg (2 puffs) INH q4-6 hrs; Alt: 0.2 mg (1 puff) q4-6 hrs
• Max: 2.4 mg (12 puffs)/day

[Outline]

• Adult Dosing
• Pediatric Dosing

• Prevention and reversal of bronchospasm in patients 12 yrs with reversible bronchospasm including asthma as monotherapy or with concurrent theophylline and/or corticosteroids

• Hypersensitivity to any of the ingredients of the product

• This product contains trichloromonofluoromethane and dichlorodifluoromethane, substances which harm the environment by destroying ozone in the upper atmosphere

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

See Supplemental Patient Information

• Therapy may produce significant cardiovascular effect in certain patients; discontinue therapy if such CV effects occur or if ECG changes are reported. Use cautiously in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, hypertension, hyperthyroidism, diabetes mellitus, convulsive disorders, and in patients who are unusually responsive to sympathomimetic amines
• Pirbuterol may cause life-threatening paradoxical bronchospasm that occurs commonly with the first use of a new canister or vial; promptly discontinue therapy and institute alternative therapy if such condition occurs
• Consider adding anti-inflammatory agents such as corticosteroids to pirbuterol to control asthma. Re-evaluate the patient and treatment regimen if deterioration of asthma is observed
• Clinically significant changes in systolic and diastolic BP and hypokalemia may occur in certain patients receiving pirbuterol
• Closely monitor pulse rate, BP, and ECG changes during therapy

Cautions: Use cautiously in

• Hypokalemia
• Cardiovascular disease
• Diabetes mellitus
• Hyperthyroidism
• Seizure disorder

Supplemental Patient Information

• Instruct patients not to use this product with any other inhalation aerosol canister or any other actuator. Advise to keep out of reach of children and avoid spraying in eyes
• Advise patients to prime before using for the first time and if not used for more than 2 weeks

Pregnancy Category:C

Breastfeeding: No published data exist on the use of pirbuterol by mouth or inhaler during lactation; however, data from the related drug, terbutaline, indicate that very little is expected to be excreted into breastmilk. Many authors and an expert panel agree that use of inhaled bronchodilators is acceptable during breastfeeding because of the low bioavailability and maternal serum levels after use. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 09 September 2011). Manufacturer recommends use during nursing only if the potential benefit justifies the possible risk to the newborn.

• CV: Palpitations, tachycardia, arrhythmias, angina, severe hypertension
• CNS: Tremor, headache, dizziness, vertigo
• PSYCHIATRIC: Nervousness
• GI: Nausea, vomiting, anorexia, diarrhea, taste changes
• RESP: Cough

• Beta-2 adrenergic bronchodilator; stimulates the intracellular adenyl cyclase and increases cAMP levels leading to relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from mast cells
• Metabolized by liver; CYP450: Unknown
• Minimal systemic absorption
• Excreted in urine (51%)
• Half-life: 2 hrs

US Trade Name(s)

• Maxair Autohaler

US Availability

Maxair Autohaler

• INH: 0.2 mg/metered inhalation

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Pulmonary

Bronchodilators

Beta-2 Adrenergic Agonists

Pricing data from www.DrugStore.com in U.S.A.

• Maxair Autohaler 200 MCG/INH AERB [Inhaler] (MEDICIS)
  14 inh = $149.99
  42 inh = $437.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.