Isoproterenol (Isuprel)
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Isoproterenol (Isuprel)

ISUPREL
(isoproterenol hydrochloride) Injection, Solution
Sterile Injection 1:5000

DRUG DESCRIPTION

Isoproterenol hydrochloride is 3,4-Dihydroxy-a-[(isopropylamino)methyl] benzyl alcohol hydrochloride, a synthetic sympathomimetic amine that is structurally related to epinephrine but acts almost exclusively on beta receptors. The molecular formula is C11H17NO3• HCl. It has a molecular weight of 247.72 and the following structural formula:

Isuprel (isoproterenol hydrochloride) Structural Formula Illustration

Isoproterenol hydrochloride is a racemic compound.

Each milliliter of the sterile 1:5000 solution contains:

ISUPREL®, brand of isoproterenol hydrochloride injection, USP 0.2 mg

Lactic Acid 0.12 mg

Sodium Chloride 7.0 mg

Sodium Lactate 1.8 mg

Sodium Metabisulfite 1.0 mg

Water for Injection qs ad 1.0 mL

The pH is adjusted between 2.5 and 4.5 with hydrochloric acid.

The sterile 1:5000 solution is nonpyrogenic and can be administered by the intravenous, intramuscular, subcutaneous, or intracardiac routes.

What are the possible side effects of isoproterenol inhalation (Isuprel Mistometer)?

If you experience any of the following serious side effects, stop using isoproterenol inhalation and seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
  • chest pain or an irregular heartbeat.

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

  • headache, dizziness, lightheadedness, or...

Read All Potential Side Effects and See Pictures of Isuprel »

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

INDICATIONS

Isoproterenol hydrochloride injection is indicated:

  • For mild or transient episodes of heart block that do not require electric shock or pacemaker therapy.
  • For serious episodes of heart block and Adams-Stokes attacks (except when caused by ventricular tachycardia or fibrillation). (See CONTRAINDICATIONS.)
  • For use in cardiac arrest until electric shock or pacemaker therapy, the treatments of choice, is available. (See CONTRAINDICATIONS.)
  • For bronchospasm occurring during anesthesia.
  • As an adjunct to fluid and electrolyte replacement therapy and the use of other drugs and procedures in the treatment of hypovolemic and septic shock, low cardiac output (hypoperfusion) states, congestive heart failure, and cardiogenic shock. (See WARNINGS.)

DOSAGE AND ADMINISTRATION

ISUPREL injection 1:5000 should generally be started at the lowest recommended dose and the rate of administration gradually increased if necessary while carefully monitoring the patient. The usual route of administration is by intravenous infusion or bolus intravenous injection. In dire emergencies, the drug may be administered by intracardiac injection. If time is not of the utmost importance, initial therapy by intramuscular or subcutaneous injection is preferred.

Recommended dosage for adults with heart block, Adams-Stokes attacks, and cardiac arrest:

Route of Administration Preparation of Dilution Initial Dose Subsequent Dose Range*
Bolus intravenous injection Dilute 1 mL (0.2 mg) to 10 mL with Sodium Chloride Injection, USP, or 5% Dextrose Injection, USP 0.02 mg to 0.06 mg (1 mL to 3 mL of diluted solution) 0.01 mg to 0.2 mg (0.5 mL to 10 mL of diluted solution)
Intravenous infusion Dilute 10 mL (2 mg) in 500 mL of 5% Dextrose Injection, USP 5 mcg/min. (1.25 mL of diluted solution per minute)  
Intramuscular Use Solution 1:5000 undiluted 0.2 mg (1 mL) 0.02 mg to 1 mg (0.1 mL to 5 mL)
Subcutaneous Use Solution 1:5000 undiluted 0.2 mg (1 mL) 0.15 mg to 0.2 mg (0.75 mL to 1 mL)
Intracardiac Use Solution 1:5000 undiluted 0.02 mg (0.1 mL)  

*Subsequent dosage and method of administration depend on the ventricular rate and the rapidity with which the cardiac pacemaker can take over when the drug is gradually withdrawn.

There are no well-controlled studies in children to establish appropriate dosing; however, the American Heart Association recommends an initial infusion rate of 0.1 mcg/kg/min, with the usual range being 0.1 mcg/kg/min to 1 mcg/kg/min.

Recommended dosage for adults with shock and hypoperfusion states:

Route of Administration Preparation of Dilution† Infusion Rate††
Intravenous infusion Dilute 5 mL (1 mg) in 500 mL of 5% Dextrose Injection, USP 0.5 mcg to 5 mcg per minute (0.25 mL to 2.5 mL of diluted solution)
†Concentrations up to 10 times greater have been used when limitation of volume is essential.
††Rates over 30 mcg per minute have been used in advanced stages of shock. The rate of infusion should be adjusted on the basis of heart rate, central venous pressure, systemic blood pressure, and urine flow. If the heart rate exceeds 110 beats per minute, it may be advisable to decrease or temporarily discontinue the infusion.

Recommended dosage for adults with bronchospasm occurring during anesthesia:

Route of Administration Preparation of Dilution Initial Dose Subsequent Dose
Bolus intravenous injection Dilute 1 mL (0.2 mg) to 10 mL with Sodium Chloride Injection, USP, or 5% Dextrose Injection, USP 0.01 mg to 0.02 mg (0.5 mL to 1 mL of diluted solution) The initial dose may be repeated when necessary

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Such solution should not be used.

HOW SUPPLIED

List Container Concentration Fill Quantity
1410 Ampul 0.2 mg (0.2 mg/mL) 1 mL UNI-AMP® pak of 25
1410 Ampul 1 mg (0.2 mg/mL) 5 mL 10 ampuls per carton

Protect from light. Keep in opaque container until used.

Store at controlled room temperature 20° to 25°C (68° to 77°F). [See USP.]

Do not use if the injection is pinkish or darker than slightly yellow or contains a precipitate.

Hospira, Inc., Lake Forest, IL 60045 USA

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

SIDE EFFECTS

The following reactions to isoproterenol hydrochloride injection have been reported:

CNS: Nervousness, headache, dizziness, nausea, visual blurring.

Cardiovascular: Tachycardia, palpitations, angina, Adams-Stokes attacks, pulmonary edema, hypertension, hypotension, ventricular arrhythmias, tachyarrhythmias.

In a few patients, presumably with organic disease of the AV node and its branches, isoproterenol hydrochloride injection has been reported to precipitate Adams-Stokes seizures during normal sinus rhythm or transient heart block.

Respiratory: Dyspnea.

Other: Flushing of the skin, sweating, mild tremors, weakness, pallor.

Read the Isuprel (isoproterenol) Side Effects Center for a complete guide to possible side effects »

DRUG INTERACTIONS

Isoproterenol hydrochloride injection and epinephrine should not be administered simultaneously because both drugs are direct cardiac stimulants and their combined effects may induce serious arrhythmias. The drugs may, however, be administered alternately provided a proper interval has elapsed between doses.

ISUPREL should be used with caution, if at all, when potent inhalational anesthetics such as halothane are employed because of potential to sensitize the myocardium to effects of sympathomimetic amines.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

WARNINGS

Isoproterenol hydrochloride injection, by increasing myocardial oxygen requirements while decreasing effective coronary perfusion, may have a deleterious effect on the injured or failing heart. Most experts discourage its use as the initial agent in treating cardiogenic shock following myocardial infarction. However, when a low arterial pressure has been elevated by other means, isoproterenol hydrochloride injection may produce beneficial hemodynamic and metabolic effects.

In a few patients, presumably with organic disease of the AV node and its branches, isoproterenol hydrochloride injection has paradoxically been reported to worsen heart block or to precipitate Adams-Stokes attacks during normal sinus rhythm or transient heart block.

Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.

PRECAUTIONS

General

Isoproterenol hydrochloride injection should generally be started at the lowest recommended dose. This may be gradually increased if necessary while carefully monitoring the patient. Doses sufficient to increase the heart rate to more than 130 beats per minute may increase the likelihood of inducing ventricular arrhythmias. Such increases in heart rate will also tend to increase cardiac work and oxygen requirements which may adversely affect the failing heart or the heart with a significant degree of arteriosclerosis. Particular caution is necessary in administering isoproterenol hydrochloride injection to patients with coronary artery disease, coronary insufficiency, diabetes, hyperthyroidism, and sensitivity to sympathomimetic amines.

Adequate filling of the intravascular compartment by suitable volume expanders is of primary importance in most cases of shock and should precede the administration of vasoactive drugs. In patients with normal cardiac function, determination of central venous pressure is a reliable guide during volume replacement. If evidence of hypoperfusion persists after adequate volume replacement, isoproterenol hydrochloride injection may be given.

In addition to the routine monitoring of systemic blood pressure, heart rate, urine flow, and the electrocardiograph, the response to therapy should also be monitored by frequent determination of the central venous pressure and blood gases. Patients in shock should be closely observed during isoproterenol hydrochloride injection administration. If the heart rate exceeds 110 beats per minute, it may be advisable to decrease the infusion rate or temporarily discontinue the infusion. Determinations of cardiac output and circulation time may also be helpful. Appropriate measures should be taken to ensure adequate ventilation. Careful attention should be paid to acid-base balance and to the correction of electrolyte disturbances. In cases of shock associated with bacteremia, suitable antimicrobial therapy is, of course, imperative.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Long-term studies in animals to evaluate the carcinogenic potential of isoproterenol hydrochloride have not been done. Mutagenic potential and effect on fertility have not been determined. There is no evidence from human experience that isoproterenol hydrochloride injection may be carcinogenic or mutagenic or that it impairs fertility.

Pregnancy Category C

Animal reproduction studies have not been conducted with isoproterenol hydrochloride. It is also not known whether isoproterenol hydrochloride can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Isoproterenol hydrochloride should be given to a pregnant woman only if clearly needed.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when isoproterenol hydrochloride injection is administered to a nursing woman.

Pediatric Use

Safety and efficacy of isoproterenol in pediatric patients have not been established.

Intravenous infusions of isoproterenol in refractory asthmatic children at rates of 0.05-2.7 μ g/kg/min have caused clinical deterioration, myocardial necrosis, congestive heart failure and death. The risks of cardiac toxicity appear to be increased by some factors [acidosis, hypoxemia, coadministration of corticosteroids, coadministration of methylxanthines (theophylline, theobromine) or aminophylline] that are especially likely to be present in these patients. If I.V. isoproterenol is used in children with refractory asthma, patient monitoring must include continuous assessment of vital signs, frequent electrocardiography, and daily measurements of cardiac enzymes, including CPK-MB.

Geriatric Use

Clinical studies of Isuprel did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects in clinical circumstances. There are, however, some data that suggest that elderly healthy or hypertensive patients are less responsive to beta-adrenergic stimulation than are younger subjects. In general, dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function and of concomitant diseases or other drug therapy.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

OVERDOSE

The acute toxicity of isoproterenol hydrochloride in animals is much less than that of epinephrine. Excessive doses in animals or man can cause a striking drop in blood pressure, and repeated large doses in animals may result in cardiac enlargement and focal myocarditis.

In case of accidental overdosage as evidenced mainly by tachycardia or other arrhythmias, palpitations, angina, hypotension, or hypertension, reduce rate of administration or discontinue isoproterenol hydrochloride injection until patient's condition stabilizes. Blood pressure, pulse, respiration, and EKG should be monitored.

It is not known whether isoproterenol hydrochloride is dialyzable.

The oral LD50 of isoproterenol hydrochloride in mice is 3,850 mg/kg ± 1,190 mg/kg of pure drug in solution.

CONTRAINDICATIONS

Use of isoproterenol hydrochloride injection is contraindicated in patients with tachyarrhythmias; tachycardia or heart block caused by digitalis intoxication; ventricular arrhythmias which require inotropic therapy; and angina pectoris.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

CLINICAL PHARMACOLOGY

Isoproterenol is a potent nonselective beta-adrenergic agonist with very low affinity for alpha-adrenergic receptors. Intravenous infusion of isoproterenol in man lowers peripheral vascular resistance, primarily in skeletal muscle but also in renal and mesenteric vascular beds. Diastolic pressure falls. Renal blood flow is decreased in normotensive subjects but is increased markedly in shock. Systolic blood pressure may remain unchanged or rise, although mean arterial pressure typically falls. Cardiac output is increased because of the positive inotropic and chronotropic effects of the drug in the face of diminished peripheral vascular resistance. The cardiac effects of isoproterenol may lead to palpitations, sinus tachycardia, and more serious arrhythmias; large doses of isoproterenol may cause myocardial necrosis in animals.

Isoproterenol relaxes almost all varieties of smooth muscle when the tone is high, but this action is most pronounced on bronchial and gastrointestinal smooth muscle. It prevents or relieves bronchoconstriction, but tolerance to this effect develops with overuse of the drug.

In man, isoproterenol causes less hyperglycemia than does epinephrine. Isoproterenol and epinephrine are equally effective in stimulating the release of free fatty acids and energy production.

Absorption, Fate, and Excretion

Isoproterenol is readily absorbed when given parenterally or as an aerosol. It is metabolized primarily in the liver and other tissues by COMT. Isoproterenol is a relatively poor substrate for MAO and is not taken up by sympathetic neurons to the same extent as are epinephrine and norepinephrine. The duration of action of isoproterenol may therefore be longer than that of epinephrine, but is still brief.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

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PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

ISUPREL
(isoproterenol hydrochloride) Injection, Solution
Sterile Injection 1:5000

DRUG DESCRIPTION

Isoproterenol hydrochloride is 3,4-Dihydroxy-a-[(isopropylamino)methyl] benzyl alcohol hydrochloride, a synthetic sympathomimetic amine that is structurally related to epinephrine but acts almost exclusively on beta receptors. The molecular formula is C11H17NO3• HCl. It has a molecular weight of 247.72 and the following structural formula:

Isuprel (isoproterenol hydrochloride) Structural Formula Illustration

Isoproterenol hydrochloride is a racemic compound.

Each milliliter of the sterile 1:5000 solution contains:

ISUPREL®, brand of isoproterenol hydrochloride injection, USP 0.2 mg

Lactic Acid 0.12 mg

Sodium Chloride 7.0 mg

Sodium Lactate 1.8 mg

Sodium Metabisulfite 1.0 mg

Water for Injection qs ad 1.0 mL

The pH is adjusted between 2.5 and 4.5 with hydrochloric acid.

The sterile 1:5000 solution is nonpyrogenic and can be administered by the intravenous, intramuscular, subcutaneous, or intracardiac routes.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

ISUPREL
(isoproterenol hydrochloride) Injection, Solution
Sterile Injection 1:5000

DRUG DESCRIPTION

Isoproterenol hydrochloride is 3,4-Dihydroxy-a-[(isopropylamino)methyl] benzyl alcohol hydrochloride, a synthetic sympathomimetic amine that is structurally related to epinephrine but acts almost exclusively on beta receptors. The molecular formula is C11H17NO3• HCl. It has a molecular weight of 247.72 and the following structural formula:

Isuprel (isoproterenol hydrochloride) Structural Formula Illustration

Isoproterenol hydrochloride is a racemic compound.

Each milliliter of the sterile 1:5000 solution contains:

ISUPREL®, brand of isoproterenol hydrochloride injection, USP 0.2 mg

Lactic Acid 0.12 mg

Sodium Chloride 7.0 mg

Sodium Lactate 1.8 mg

Sodium Metabisulfite 1.0 mg

Water for Injection qs ad 1.0 mL

The pH is adjusted between 2.5 and 4.5 with hydrochloric acid.

The sterile 1:5000 solution is nonpyrogenic and can be administered by the intravenous, intramuscular, subcutaneous, or intracardiac routes.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

ISUPREL
(isoproterenol hydrochloride) Injection, Solution
Sterile Injection 1:5000

DRUG DESCRIPTION

Isoproterenol hydrochloride is 3,4-Dihydroxy-a-[(isopropylamino)methyl] benzyl alcohol hydrochloride, a synthetic sympathomimetic amine that is structurally related to epinephrine but acts almost exclusively on beta receptors. The molecular formula is C11H17NO3• HCl. It has a molecular weight of 247.72 and the following structural formula:

Isuprel (isoproterenol hydrochloride) Structural Formula Illustration

Isoproterenol hydrochloride is a racemic compound.

Each milliliter of the sterile 1:5000 solution contains:

ISUPREL®, brand of isoproterenol hydrochloride injection, USP 0.2 mg

Lactic Acid 0.12 mg

Sodium Chloride 7.0 mg

Sodium Lactate 1.8 mg

Sodium Metabisulfite 1.0 mg

Water for Injection qs ad 1.0 mL

The pH is adjusted between 2.5 and 4.5 with hydrochloric acid.

The sterile 1:5000 solution is nonpyrogenic and can be administered by the intravenous, intramuscular, subcutaneous, or intracardiac routes.

Last reviewed on RxList: 6/11/2012
This monograph has been modified to include the generic and brand name in many instances.

Isuprel Patient Information Including Side Effects

Brand Names: Isuprel Mistometer

Generic Name: isoproterenol inhalation (Pronunciation: eye so proe TER e nole)

What is isoproterenol inhalation (Isuprel)?

Isoproterenol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Isoproterenol inhalation is used to treat conditions such as asthma, bronchitis, and emphysema.

Isoproterenol inhalation may also be used for conditions other than those listed in this medication guide.

What are the possible side effects of isoproterenol inhalation (Isuprel)?

If you experience any of the following serious side effects, stop using isoproterenol inhalation and seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
  • chest pain or an irregular heartbeat.

Other, less serious side effects may be more likely to occur. Continue to use isoproterenol 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. You may report side effects to FDA at 1-800-FDA-1088.

Read the Isuprel (isoproterenol) Side Effects Center for a complete guide to possible side effects »

What is the most important information I should know about isoproterenol inhalation (Isuprel)?

It is important to use the isoproterenol inhaler properly, so that the medicine gets into the lungs. Your doctor may want you to use a spacer with the inhaler. Talk to your doctor about proper inhaler 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.

Side Effects Centers

Isuprel Patient Information including How Should I Take

What should I discuss with my healthcare provider before using isoproterenol inhalation (Isuprel)?

Before using this medication, tell your doctor if you have

  • heart disease or high blood pressure;
  • epilepsy or a seizure disorder;
  • diabetes;
  • an overactive thyroid (hyperthyroidism); or
  • liver or kidney disease.

You may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Isoproterenol inhalation is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether isoproterenol passes into breast milk. Do not use isoproterenol inhalation without first talking to your doctor if you are breast-feeding a baby.

How should I use isoproterenol inhalation (Isuprel)?

Use isoproterenol inhalation exactly as directed by your doctor. If you do not understand these directions, 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. Put the mouthpiece of the inhaler or spacer into your mouth. Be sure the mouthpiece is above the tongue and past the teeth. Alternatively, place the inhaler mouthpiece (not with spacer attached) several inches in front of your open mouth, if directed to do so by your doctor. Take a deep, slow breath as you push down on the canister. Hold your breath for 10 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.
  • Keep the inhaler clean and dry. Keep the mouthpiece capped to avoid getting dirt inside it. Clean the inhaler once a day by removing the canister and immersing the mouthpiece in warm water. Allow the parts to dry, then reassemble the inhaler.

To use the solution for nebulization:

  • Measure the correct amount of medication with the dropper provided or select the prescribed number of ampules. Transfer the liquid into the medication chamber of the nebulizer. If the medication has a dropper, do not allow the dropper to touch any surface including the hands or the chamber of the nebulizer. Dilute the medication with normal saline if prescribed by your doctor.
  • Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright, in a comfortable position, and put the mouthpiece into the mouth or put the face mask on, covering the nose and mouth. Breathe slowly and evenly until all of the medicine has been inhaled (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.
  • Clean the nebulizer after a treatment as directed by the manufacturer.

If you also use a steroid inhaler, use the isoproterenol inhaler or nebulization solution first to open up the airways, then use the steroid inhaler as directed.

It is important to use the isoproterenol inhaler properly, so that the medicine gets into the lungs. Your doctor may want you to use a spacer with the inhaler. Talk to your doctor about proper inhaler 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.

Carry the inhaler with you at all times in case of emergencies. Store the solution for nebulization at room temperature. Get a refill before you run out of medicine and before going on vacation.

Side Effects Centers

Isuprel Patient Information including If I Miss a Dose

What happens if I miss a dose (Isuprel)?

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

What happens if I overdose (Isuprel)?

Seek emergency medical attention if an overdose is suspected.

Symptoms of an isoproterenol inhalation overdose may include angina or chest pain, irregular heartbeats or a fluttering heart, seizures, tremor, weakness, headache, nausea, and vomiting.

What should I avoid while using isoproterenol inhalation (Isuprel)?

Avoid situations that may trigger an asthma attack such as exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens such as pet fur.

What other drugs will affect isoproterenol (Isuprel)?

Before using this medication, 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
  • caffeine, diet pills, or decongestants.

You may not be able to use ipratropium inhalation, or you may require a dosage adjustment or special monitoring during treatment.

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

Where can I get more information?

Your pharmacist has additional information about isoproterenol written for health professionals that you may read.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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