This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.
Brand Names: US
Brand Names: Canada
What is this drug used for?
- It is used to treat COPD (chronic obstructive pulmonary disease).
- This drug is not to be used to treat intense flare-ups of shortness of breath. Use a rescue inhaler. Talk with the doctor.
What do I need to tell my doctor BEFORE I take this drug?
- If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have asthma.
- If you are using another drug like this one. If you are not sure, ask your doctor or pharmacist.
- If you take other drugs called anticholinergics, like ipratropium or oxybutynin. Ask your doctor if you are not sure if any of your drugs are anticholinergic.
- If the patient is a child. Do not give this drug to a child.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
What are some things I need to know or do while I take this drug?
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- Call your doctor right away if your breathing problems get worse, if your rescue inhaler does not work as well, or if you need to use your rescue inhaler more often.
- If you have high blood sugar (diabetes), this drug may sometimes raise blood sugar. Talk with your doctor about how to keep your blood sugar under control.
- Tell your doctor if you have signs of high blood sugar like confusion, feeling sleepy, unusual thirst or hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
- The chance of getting pneumonia is higher in people with COPD. This drug may raise the chance of getting pneumonia. Talk with the doctor.
- Do not take more of this drug or use it more often than you have been told. Deaths have happened when too much of this type of drug has been taken. Talk with your doctor.
- If this drug gets in the eyes, rinse with water right away. Call the doctor right away if this drug gets in the eyes and blurred eyesight, worsened glaucoma, or eye pain happens.
- Drugs like this one may raise the chance of asthma-related deaths in people with asthma who do not also use an inhaled steroid. It appears that this effect does not apply to people with COPD. If you have questions, talk with the doctor.
- This drug is not approved to treat asthma. Talk with your doctor.
- You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
- When changing from an oral steroid to another form of a steroid, there may be very bad and sometimes deadly side effects. Signs like weakness, feeling tired, dizziness, upset stomach, throwing up, not thinking clearly, or low blood sugar may happen. Call your doctor right away if you have any of these signs. If you have a bad injury, have surgery, or any type of infection, you may need extra doses of oral steroids. These extra steroids will help your body deal with these stresses. Carry a warning card saying that there may be times when you may need extra steroids.
- Chickenpox and measles can be very bad or even deadly in some people taking steroid drugs like this drug. Avoid being near anyone with chickenpox or measles if you have not had these health problems before. If you have been exposed to chickenpox or measles, talk with your doctor.
- This drug may cause weak bones (osteoporosis) with long-term use. Talk with your doctor to see if you have a higher chance of weak bones or if you have any questions.
- Long-term use may raise the chance of cataracts or glaucoma. Talk with the doctor.
- Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
- Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
- Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
- Signs of a weak adrenal gland like a severe upset stomach or throwing up, severe dizziness or passing out, muscle weakness, feeling very tired, mood changes, decreased appetite, or weight loss.
- Signs of Cushing’s disease like weight gain in the upper back or belly, moon face, very bad headache, or slow healing.
- Chest pain or pressure.
- Fast or abnormal heartbeat.
- Change in eyesight, eye pain, or severe eye irritation.
- Seeing halos or bright colors around lights.
- Red eyes.
- Trouble passing urine, pain when passing urine, passing urine in a weak stream or drips, or passing urine more often.
- Bone or joint pain.
- Redness or white patches in mouth or throat.
- This drug can cause very bad breathing problems right after you take a dose. Sometimes, this may be life-threatening. If you have trouble breathing, breathing that is worse, wheezing, or coughing after using this drug, use a rescue inhaler and get medical help right away.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Signs of a common cold.
- Back pain.
- Flu-like signs.
- Muscle spasm.
- Sinus pain.
- Feeling nervous and excitable.
- Trouble sleeping.
- Dizziness or headache.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
How is this drug best taken?
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- For breathing in only by an inhaler into the lungs.
- Prime before first use by spraying it 4 times away from your face. Shake well before each spray. If the inhaler has been dropped or has not been used for more than 7 days, prime again by spraying it 2 times away from your face.
- Shake well before use.
- Only use the device that comes with this drug. Do not use any other devices.
- Put the cap back on after you are done using your dose.
- Rinse out mouth after each use. Do not swallow the rinse water. Spit it out.
- If you are using more than 1 inhaled drug, ask the doctor which drug to use first.
- Follow how to clean the inhaler as you have been told. Do this at least every 7 days. You will need to prime again after cleaning.
- This inhaler has a dose indicator to keep track of how many doses are left. The pointer will move after every puff. When you are close to the end of puffs in your inhaler, the pointer will be in the yellow area. Throw away the inhaler when the pointer is at “0”, which is in the red area.
- Keep using this drug as you have been told by your doctor or other health care provider, even if you feel well.
- Have a bone density test as you have been told by your doctor. Talk with your doctor.
- Have your eye pressure checked if you are on this drug for a long time. Talk with your doctor.
- If you have been taking this drug for many weeks, talk with your doctor before stopping. You may want to slowly stop this drug.
What do I do if I miss a dose?
- Take a missed dose as soon as you think about it.
- If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
- Do not take 2 doses at the same time or extra doses.
How do I store and/or throw out this drug?
- Store at room temperature.
- Protect from heat and sunlight. Do not puncture or burn even if it seems empty.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
General drug facts
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
Consumer Information Use and Disclaimer
Last Reviewed Date
© 2023 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.