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What is bitolterol inhalation?
Bitolterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing. Bitolterol inhalation is used to treat asthma. Bitolterol is not currently availabe for use in the United States. Bitolterol inhalation may also be used for conditions other than those listed in this medication guide.

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What are the possible side effects of bitolterol inhalation?

Stop using bitolterol 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 bitolterol 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.

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How should I use bitolterol inhalation?
Use bitolterol inhalation exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. 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.

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What is the most important information I should know about bitolterol inhalation?
It is very important that you use your bitolterol inhaler or nebulizer properly, so that the medicine gets into your lungs. Your doctor may want you to use a spacer with your inhaler. Talk to your doctor about proper inhaler and nebulizer use. 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.

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What happens if I miss a dose?
Use the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.

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What other drugs will affect bitolterol?
Before using bitolterol inhalation, tell your doctor if you are taking any of the following medicines: a beta-blocker such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), propranolol (Inderal), and others; a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), and others; a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate); another inhaled bronchodilator; or

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Bitolterol has been assigned to pregnancy category C. Animal studies have demonstrated a teratogenic effect when given subcutaneously at several times the dosage used clinically. Bitolterol should only be given during pregnancy when benefit outweighs risk.

There are no data on the excretion of bitolterol in human milk.

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What does my medication look like?
Bitolterol is available under the brand name Tornalate. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is unfamiliar to you. Tornalate 16.4 grams

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What happens if I overdose?
Seek emergency medical attention. Symptoms of a bitolterol overdose include angina or chest pain, irregular heartbeats or a fluttering heart, seizures, tremor, weakness, headache, nausea, and vomiting.

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What should I discuss with my healthcare provider before using bitolterol inhalation?
Before using 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 any type of liver or kidney disease. You may require a lower dose or special monitoring during therapy with bitolterol inhalation if you have any of the conditions listed above. Bitolterol inhalation is in the FDA pregnancy category C. This means that it is not known whether bitolterol inhalation will harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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