A Methacholine (meth-a-KOLE-leen) Challenge Test is a breathing exam to evaluate your lungs. It is also called a Bronchial or Provocholine® Challenge Test. The test is used to check for asthma in patients who have a cough, shortness of breath, or other problems breathing. During the test you will breathe in small amounts of a drug called methacholine. You will inhale several doses into your lungs, which may affect your breathing. The test takes about 90 minutes. This booklet describes the test and how to get ready for it. Your doctor or nurse will review this information with you before the test.
Tell Your Doctor If You
- Have a history of hives, swelling of the upper airway, or both
- Are breast feeding, pregnant, or if there is any chance that you are pregnant
- Have heart problems. Your heart specialist must give you permission for this test
Though the test is safe, there is a small risk of having an asthma attack or severe coughing. You may also feel dizzy or uncomfortable, while breathing fast and forcefully. You will be watched closely during the test. Tell your doctor, nurse, or the technologist if you have any concerns.
Before Your Test
Your doctor or nurse will:
- Ask if you have had any lung infections, a cold, the flu, or immunizations in the 2 weeks before the test. If you have had any of these, the test results may not be accurate and it should be postponed.
- Review all medicines you take.
Stop Taking the Following Medicines on the Dates Below
- Call your doctor if you have any problem after you stop a medicine. Tell your doctor or nurse if you take any drug that is not listed below.
- Keep taking medicines that are not for breathing problems or for your lungs.
6 weeks before the test
At least 2 weeks before the test
fluticasone and salmeterol (Advair®)
flunisolide (AeroBid®, Nasalide®)
triamcinolone (Azmacort®, Nasacort®)
fluticasone (Flonase®, Flovent®)
mometasone furoate (Nasonex®)
budesonide (Pulmicort®, Rhinocort®)
beclomethasone (QVAR®, Vancenase®, Vanceril®)
At least 1 week before your test
4 days (96 hours) before the test
triprolidine and pseudoephedrine (Actifed®)
loratadine (Alavert®, Claritin®)
triamcinolone (Aristocort®, Azmacort®)
brompheniramine and pseudoephedrine (Bromfed®)
chlorpheniramine and pseudoephedrine (Chlor-Trimeton®)
acetaminophen, phenylpropanolamine hydrochloride, chlorpheniramine maleate, and dextromethorphan hydrobromide (Comtrex®)
pseudoephedrine and brompheniramine (Dristan®)
At least 2 days (48 hours) before the test
cromolyn (Intal®, Nasalcrom®)
hydroxyzine, theophylline, ephedrine (Marax®)
guaifenesin and theophylline(Quibron®)
theophylline (Elixophyllin®, Quibron®-T, Quibron®-T/SR, Slo-Bid®, Theochron®, T-Phyl®, Theo-24®, Theolair®, Theo-Dur®, Theolair-SR®, Uniphyl®)
At least 1 day (24 hours) before test
albuterol (AccuNeb®, Proventil®, Ventolin®, Volmax®)
epinephrine (Adrenalin®, MicroNefrin®, Primatene®)
terbutaline (Brethine®, Bricanyl®)
ipratropium and albuterol (Combivent®, DuoNeb®)
The Day of Your Test
- Do not eat immediately before the test. You may have a light meal, such as a sandwich, soup, or salad, up to 1 hour before the test.
- Do not wear tight or confining clothes.
- Do not put on lipstick, perfume, or cologne.
- Do not do any strenuous activity.
- Do not have caffeine (e.g., coffee, tea, cola, or chocolate) for 4 hours before the test.
The pulmonary lab is located on the third floor of the A elevator. The closest entrance is 425 East 67th Street. It is between York Avenue and First Avenue. Please arrive 15 minutes before your scheduled time.
There are 3 stages for the test. A technologist will guide you through each.
- The technologist will first measure how fast you breathe. He or she will also check how much air you can breathe before and after you inhale some salt-water mist.
- You will inhale different concentrations of methacholine as a mist from a machine. Up to 4 concentrations will be used. Your breathing will be measured after each concentration. Your breathing may feel better, worse or the same after inhaling the methacholine. Tell the technologist if you have any problem.
- At the end, you will get medicine that you will breathe in to reverse any effects of the methacholine. Your breathing will be measured to be sure it is normal.
After the Test
- Resume taking your medicines unless told not to.
- Go back to your usual diet and activities.
Test results will be available in about 2 days. Your lung specialist will discuss them with you. He or she will also answer any questions you have.
Please call us at (212) 639-8492 if
- You feel sick
- Must change your appointment
- Will be late
- Have any questions or concerns