Print this page
Home > Taking PERFOROMIST > How to Take

How to Take PERFOROMIST® Using a Nebulizer

Good Results There are simple steps you can take to get the most out of your treatment with PERFOROMIST. Consider these ideas.
PERFOROMIST FAQs Answers to frequently asked questions about PERFOROMIST. Get answers.
Prescribing Information and Patient Medication Guide Be sure to read the patient medication guide at the end of the full prescribing information that describes how to take PERFOROMIST. Find guidance.

"How to Neb with PERFOROMIST"

Watch the video below to see a person take PERFOROMIST with a nebulizer, step-by-step.

Download Video: MP4, WebM, Ogg

Things to Keep in Mind1

  • Take PERFOROMIST twice daily: once in the morning and once in the evening.
  • There are two ways to store PERFOROMIST:
    • Keep PERFOROMIST in a refrigerator, until the expiration date;
    • Or, keep PERFOROMIST at room temperature for up to three months (90 days), or until the expiration date, whichever comes sooner.
  • PERFOROMIST is used only in a standard jet nebulizer machine connected to an air compressor. Make sure you know how to use your nebulizer machine before you use it to breathe in PERFOROMIST or other medicines.
  • Do not mix PERFOROMIST with other medicines in your nebulizer machine.
  • PERFOROMIST comes sealed in a foil pouch. Do not open a sealed pouch until you are ready to use a dose of PERFOROMIST. Once the pouch is open, use the PERFOROMIST immediately.

Instructions1

Remove vial from the foil pouch. Twist the cap completely off the vial and squeeze all the medicine into the nebulizer medicine cup (reservoir).
image of step two

Connect the nebulizer reservoir to the mouthpiece or facemask, and connect the nebulizer to the compressor.
image of step three

Sit in a comfortable, upright position. Place the mouthpiece in your mouth or put on the facemask. Turn on the compressor. Breathe as calmly, deeply and evenly as possible through your mouth until no more mist is formed in the nebulizer reservoir.
image of step four

Throw away the PERFOROMIST container and top when you are done, and clean the nebulizer according to manufacturer's instructions.

How Long Does It Take?

The average nebulization time is about nine minutes.1 You may be able to use the time for reading, watching TV or another activity that helps you to relax.

Cleaning a Nebulizer20

Be sure to clean your nebulizer after each use.

  1. Disassemble nebulizer parts.
  2. Wash all parts in warm, soapy water—BUT DO NOT WASH THE TUBING.
  3. Rinse and shake off excess water and let the pieces dry on a clean cloth (or hand dry with a lint-free cloth).
  4. Reconnect the pieces to the nebulizer and store.

Every other day it's a good idea to soak all of the parts (except for the tubing) in one part distilled vinegar and three parts hot tap water for one hour. Rinse and air dry or dry with a clean, lint-free cloth. Parts (except tubing) may also be disinfected by boiling them in a clean pot of water for a full 10 minutes.. Read the instructions that come with your nebulizer.

Additional Important Information on Taking PERFOROMIST1

Take PERFOROMIST exactly as prescribed. One ready-to-use vial of PERFOROMIST is one dose. The usual dose of PERFOROMIST is one ready-to-use vial, twice a day (morning and evening) inhaled through your nebulizer machine. The two doses should be about 12 hours apart. Do not use more than two vials of PERFOROMIST a day.

If you miss a dose of PERFOROMIST, just skip that dose. Take your next dose at your usual time. Do not take two doses at one time.

While you are taking PERFOROMIST two times each day:

  • Do not use other medicines that contain a long-acting beta2-agonist (LABA) for any reason.
  • You should only use your short-acting beta2-agonist (SABA) "as needed" for rescue situations (sudden episodes of shortness of breath).

PERFOROMIST does not relieve sudden symptoms of COPD. Always have a rescue inhaler with you to treat sudden symptoms. If you do not have a rescue inhaler, ask your doctor if you should have one.

Do not stop taking PERFOROMIST or other medicines to control or treat your COPD unless told to do so by your health care provider because your symptoms might get worse. Your health care provider will change your medicines as needed.

Do not take PERFOROMIST:

  • more often than prescribed,
  • more than prescribed for you, or
  • with other LABA medicines

Call your health care provider or get emergency medical care right away if:

  • your breathing problems worsen with PERFOROMIST
  • you need to use your rescue inhaler more often than usual
  • your rescue inhaler does not work as well as it used to for relieving symptoms

Next topic: Good Results

References

  1. PERFOROMIST Prescribing Information. Napa, CA: Dey Pharma, L.P. 2010.
  2. Gross NJ, Nelson HS, Lapidus RJ, et al; Formoterol Study Group. Efficacy and safety of formoterol fumarate delivered by nebulization to COPD patients. Respir Med. 2008;102(2):189-197.
  3. Mannino DM et al. MMWR Surveill Summ. 2002;51:1-13.
  4. National Institutes of Health/U.S. Department of Health & Human Services. National Heart Lung and Blood Institute Diseases and Conditions Index. What is COPD? Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html. Accessed July 13, 2011.
  5. Rodriguez-Roisin R, Anzueto A, Bourbeau J, et al; GOLD Executive Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2009). Global Initiative for Chronic Obstructive Lung Disease website: http://www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html. Accessed March 8, 2010.
  6. National Heart Lung and Blood Institute: National Institutes of Health. When you are diagnosed with COPD. Available at: http://www.nhlbi.nih.gov/health/public/lung/copd/breathing-better/taking-action.htm. Accessed July 13, 2011.
  7. American Lung Association. Living with COPD: a life change. Available at: http://www.lungusa.org/lung-disease/copd/living-with-copd/life-change.html. Accessed July 13, 2011.
  8. CDC FastStats: Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema. Available at: http://www.cdc.gov/nchs/fastats/copd.htm. Accessed April 11, 2011.
  9. CDC Vital and Health Statistics. Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009. Hyattsville, Maryland. 8/2010.
  10. U.S. Department of Health and Human Services. Caregiver tip sheet. Available at: http://www.strokecamp.com/content/resourcesCAR/CaregiverTipSheet.pdf. Accessed on July 13, 2011.
  11. Data on file. Evaluation of concepts for Perforomist. Dey #0257 Final research report (market research). LinguiSearch. March 23, 2011.
  12. Nelson HS, Gross NJ, Levine B, et al. Formoterol Study Group. Cardiac safety profile of nebulized formoterol in adults with COPD: a 12-week, multicenter, ranodmized, double-blind, double-dummy, placebo- and active-controlled trial [published correction appears in Clin Ther. 2009;31(4):920].
  13. Proventil HFA Prescribing Information. Kenilworth, NJ: Schering-Plough. 1998.
  14. Atrovent HFA Prescribing Information. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc. 2010.
  15. Combivent Prescribing Information. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc. September 2010.
  16. Spiriva HandiHaler Prescribing Information. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc. and New York, NY: Pfizer Inc. 2010.
  17. Dolovich MB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol treatment: evidence-based guidelines. Chest. 2005;127(1):335-371.
  18. Theophylline extended-release tablets prescribing information. Kansas City, MO: Nostrum Laboratories, Inc. May 2009.
  19. Pari Trek S Compact Compressor Nebulizer System. Instructions for use. Revised 2006.
  20. Geller DE. Comparing clinical features of the nebulizer, metered-dose inhaler, and dry powder inhaler. Respir Care. 2005;50:1313-1321.
  21. Advair HFA Prescribing Information. Research Triangle Park, NC: GlaxoSmithKline. 2011.
  22. Press VG, Arora VM, Shah LM, et al. Misuse of respiratory inhalers in hospitalized patients with asthma or COPD. J Gen Intern Med. In press.
  23. Van der Palen J, Klein JJ, Kerkhoff AH, van Herwaarden CL, Seydel ER. Evaluation of the long-term effectiveness of three instruction modes for inhaling medicines. Pt Ed Couns. 1997;32:S87-S95.
  24. Data on file. Survey conducted by KRC Research: COPD Patient and Caregiver Studies, March 2009. Dey Pharma, LP.
  25. Advair Diskus Prescribing Information. Research Triangle Park, NC: GlaxoSmithKline. 2011.
  26. Pulmicort Flexhaler Prescribing Information. Södertälje, Sweden: AstraZeneca. 2010.
  27. Mayo Clinic. Asthma inhalers: which one’s right for you? Available at: http://www.mayoclinic.com/health/asthma-inhalers/HQ01081/METHOD=print. Accessed August 22, 2011.
  28. American Lung Association of Minnesota/Minnesota COPD Coalition/NCQA Certified Disease Management. Understanding & managing your chronic obstructive pulmonary disease (COPD) brochure. 09/07.
  29. Ventolin HFA Prescribing Information. Research Triangle Park, NC: GlaxoSmithKline. 2009.
  30. American Lung Association. My COPD Action Plan. Available at: http://www.lungusa.org/lung-disease/copd/living-with-copd/copd-management-tools.html. Accessed August 22, 2011.
  31. American Thoracic Society. Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine. 1995;152:S77-S120
  32. National Heart, Lung, and Blood Institute: National Institutes of Health. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Full Report 2007.
  33. Symbicort Prescribing Information. Dunkerque, France: AstraZeneca. 2010.
  34. Centers for Medicare & Medicaid Services. Department of Health and Human Services, USA. Medicare and Home Health Care. Available at: www.medicare.gov.
  35. Centers for Medicare & Medicaid Services. Medicaid Program—General Information: Overview. Available at: www.cms.gov/MedicaidGenInfo/. Accessed June 23, 2011.

Please see full Prescribing Information and Medication Guide, including Boxed Warning.

Indication

PERFOROMIST (formoterol fumarate) Inhalation Solution is used for the long-term treatment of chronic obstructive pulmonary disease (COPD) including chronic inflammation of the lungs (bronchitis) and emphysema. It is only to be used with a nebulizer and is taken twice daily (morning and evening).

WARNING: ASTHMA-RELATED DEATH

PERFOROMIST Inhalation Solution belongs to a class of drugs called long-acting beta2-agonists (LABA). People with asthma who take LABA such as PERFOROMIST Inhalation Solution have an increased risk of death from asthma problems. Do not use PERFOROMIST Inhalation Solution if you have asthma without using a long-term asthma control medicine.

IMPORTANT SAFETY INFORMATION

Warnings and Precautions
PERFOROMIST Inhalation Solution should not be used instead of rescue inhaler or nebulized medicine for the treatment of acute symptoms. Extra doses of PERFOROMIST Inhalation Solution should not be used for that purpose since overuse can cause serious heart problems, including death. Acute or sudden symptoms should be treated with an inhaled short-acting beta2-agonist. Seek immediate medical attention if:

  • your symptoms quickly worsen despite recommended doses of PERFOROMIST Inhalation Solution
  • PERFOROMIST Inhalation Solution treatment becomes less effective
  • you need more inhalations of a short-acting beta2-agonist (rescue inhaler or nebulized medicine) than usual.

Do not use PERFOROMIST Inhalation Solution with other LABA medicines for any reason.

How to Use PERFOROMIST Inhalation Solution
Use PERFOROMIST Inhalation Solution exactly as directed by your health care professional. Do not stop using PERFOROMIST Inhalation Solution or other medicines to control or treat your COPD unless told to do so by your health care professional because your symptoms might get worse. Your health care professional will change your medicines as needed.

Co-existing Conditions
The use of PERFOROMIST Inhalation Solution with certain health conditions or with certain medications can cause serious side effects. Tell your health care professional about all of your health conditions, including if you:

  • have heart problems
  • have high blood pressure
  • have diabetes
  • have seizures
  • have thyroid problems
  • have liver problems
  • are pregnant or planning to become pregnant. It is not known if PERFOROMIST Inhalation Solution can harm an unborn baby.
  • are breastfeeding. It is not known if PERFOROMIST Inhalation Solution passes into breast milk and if it can harm your baby.

Drug Interactions
Tell your health care professional about all the medicines you take including prescription and over-the-counter medicines, vitamins and herbal supplements. PERFOROMIST Inhalation Solution and certain other medicines may interact with each other and cause serious side effects.

Side Effects
The most common side effects reported in patients taking PERFOROMIST Inhalation Solution were diarrhea, nausea, nasopharyngitis, dry mouth, dizziness, and insomnia. Serious side effects may include sudden shortness of breath, serious allergic reactions, chest pain, increased or decreased blood pressure, a fast and irregular heartbeat, low blood potassium, high blood sugar, and high blood acid.

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.