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Before using this medication, tell your doctor if you are taking any of the following medicines:

• a beta-blocker (used to treat high blood pressure and other heart conditions) such as atenolol (Tenormin), metoprolol (Lopressor), or propranolol (Inderal). These medicines may greatly decrease the effects of pirbuterol and lead to an asthma attack.

• other commonly used beta-blockers, including acebutolol (Sectral), bisoprolol (Zebeta), carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), and pindolol (Visken).

• a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), or nortriptyline (Pamelor). Very high blood pressure and other effects harmful to the heart may occur if these medicines are taken with pirbuterol.

• other commonly used tricyclic antidepressants, including amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), and protriptyline (Vivactil).

• a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate). Very high blood pressure and other effects harmful to the heart may also occur if these medicines are taken with pirbuterol.

• another inhaled bronchodilator such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), isoetharine (Bronkometer, Bronkosol), isoproterenol (Isuprel, Medihaler-Iso), metaproterenol (Alupent, Metaprel), salmeterol (Servent), or terbutaline (Brethaire, Brethine, Bricanyl). Using other inhaled medicines to open up your lungs will increase the risk of damage to your heart when you are taking pirbuterol.

• caffeine, diet pills, or decongestants. These may also increase heart-related side effects.

Drugs other than those listed here may also interact with pirbuterol inhalation, or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Stop using pirbuterol and seek emergency medical attention if you experience any of the following serious side effects:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); or

• chest pain or irregular heartbeats.

Other, less serious side effects may be more likely to occur. Continue to use pirbuterol inhalation and talk to your doctor if you experience

• headache, dizziness, lightheadedness, or insomnia;

• tremor or nervousness;

• sweating;

• nausea, vomiting, or diarrhea; or

• dry mouth.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.