Pronunciation:

rayse-ep-i-NEF-rin hye-droe-KLOR-ide

Brand Names:

• Asthmanefrin
• S2
• S-2 Inhalant
• Vaponefrin

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Bronchodilator

Pharmacologic—

Racepinephrine

Uses of This Medicine:

Racepinephrine inhalation is used as temporary relief for mild symptoms of a weak type of asthma, called intermittent asthma (eg, chest tightness, trouble breathing).

This medicine is available over the counter.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of racepinephrine inhalation in children younger 4 years of age. Safety and efficacy have not been established.

Older adults—

No information is available on the relationship of age to the effects of racepinephrine inhalation in geriatric patients.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Diabetes or
• Enlarged prostate or
• Glaucoma, narrow-angle or
• Heart disease, or history of or
• Hypertension (high blood pressure), or
• Seizures or
• Thyroid problems or
• Trouble urinating—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

Follow the instructions on the medicine label if you are using this medicine without a prescription. Do not use more medicine or use it more often than instructed.

You will use this medicine with an inhaler device called a nebulizer. The nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. If you do not understand the directions or you are not sure how to use the nebulizer, ask your doctor to show you what to do. Also, ask your doctor to check regularly how you use the nebulizer to make sure you are using it properly.

Do not use this medicine to treat other breathing problems, without first checking with your doctor.

Avoid food or drinks that contain caffeine.

Avoid supplements that contain, or claim to have, stimulant effects.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For inhalation dosage form:
  • For relief of asthma symptoms:
    • Adults and children 4 years of age and older—1 to 3 inhalations for each dose. Wait at least 3 hours between doses. Do not use more than 12 inhalations in 24 hours.
    • Children younger than 4 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Keep the vial in the foil pouch until you are ready to use it. Store this medicine in the refrigerator or at room temperature, away from heat and direct light. Do not freeze. An open vial of medicine must be used right away.

Precautions While Using This Medicine:

It is very important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Check with your doctor if your symptoms do not improve or if they get worse. Your asthma may be getting worse if:

• You are not better in 20 minutes.
• You need more than 12 inhalations in 24 hours.
• You use more than 9 inhalations in 24 hours for 3 or more days a week.
• You have more than 2 asthma attacks in a week.

Check with your doctor right away if you have trouble sleeping, fast heartbeat, tremors, nervousness, or seizures.

Do not use this medicine if you are using or have used an MAO inhibitor (MAOI) such as isocarboxazid [Marplan®], linezolid [Zyvox®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) within the past 14 days.

This medicine may cause high blood pressure, which may increase your risk for heart attack or stroke. Check with your doctor right away if you are having chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, slurred speech, or weakness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Blurred vision

chest pain or discomfort

confusion

difficulty in speaking

dizziness

double vision

headache

inability to move the arms, legs, or facial muscles

inability to speak

nausea

nervousness

pain or discomfort in the arms, jaw, back, or neck

pounding in the ears

seizures

slow or fast heartbeat

slow speech

sweating

tremors

vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.