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What should I discuss with my healthcare provider before taking metaproterenol (Alupent, Metaprel)?

Before taking this medication, tell your doctor if you have

• heart disease or high blood pressure;
• epilepsy or another seizure disorder;
• diabetes;
• an overactive thyroid (hyperthyroidism); or
• liver disease; or
• kidney disease.

You may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Metaproterenol is in the FDA pregnancy category C. This means that it is not known whether metaproterenol will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether metaproterenol passes into breast milk. Do not take metaproterenol without first talking to your doctor if you are breast-feeding a baby.

How should I take metaproterenol (Alupent, Metaprel)?

Take metaproterenol exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take the metaproterenol tablets with a full glass of water.

To ensure that you get a correct dose, measure the liquid forms of metaproterenol with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

To use the inhaler:

• Shake the inhaler several times and uncap the mouthpiece. Breathe out fully and place your lips around the mouthpiece. Take a deep, slow breath as you push down on the canister. Hold your breath for several seconds, then exhale slowly.
• If you take more than one dose at a time, wait for at least 1 full minute, then repeat the procedure.
• Keep the inhaler clean and dry. Keep the mouthpiece capped when not in use. Clean the inhaler as instructed by the manufacturer.

To use the solution for nebulization:

• Measure the correct amount of medication with the dropper provided or select the prescribed number of ampules. Transfer the liquid into the medication chamber of the nebulizer. If your medication has a dropper, do not allow the dropper to touch any surface including your hands or the chamber of the nebulizer. Dilute the medication with normal saline if prescribed by your doctor.
• Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright, in a comfortable position, and put the mouthpiece into your mouth or put the face mask on, covering the nose and mouth. Breathe slowly and evenly until all of the medicine has been inhaled (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.
• Clean the nebulizer after a treatment as directed by the manufacturer.

If you also use a steroid inhaler, use the metaproterenol inhaler or nebulization solution first to open up your airways, then use the steroid inhaler as directed unless otherwise directed by your doctor.

It is very important that you use the metaproterenol inhaler or nebulizer properly, so that the medicine gets into the lungs. Your doctor may want you to use a spacer with your inhaler. Talk to your doctor about proper inhaler and nebulizer use.

It is important to take metaproterenol regularly to get the most benefit.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

Your doctor may want you to have lung function tests or other medical evaluations during treatment with metaproterenol to monitor progress and side effects.

Store metaproterenol at room temperature away from moisture and heat.

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