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How to Take PERFOROMIST® Using
a Nebulizer

Results There are steps you can take to get the most out of your treatment with PERFOROMIST. Consider these ideas.
Frequently Asked Questions Answers to frequently asked questions. PERFOROMIST FAQs.
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.

Things to Keep in Mind11

  • 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.


  1. Remove vial from the foil pouch.
  2. Twist the cap completely off the vial and squeeze all the medicine into the nebulizer medicine cup (reservoir).
  3. Connect the nebulizer reservoir to the mouthpiece or facemask.
  4. Connect the nebulizer to the compressor.
  5. Sit in a comfortable, upright position. Place the mouthpiece in your mouth or put on the facemask; and turn on the compressor.
  6. Breathe as calmly, deeply and evenly as possible through your mouth until no more mist is formed in the nebulizer reservoir. The average nebulization time is 9 minutes. At this point, the treatment is finished.
  7. Discard the PERFOROMIST Inhalation Solution container and top after use.
  8. Clean the nebulizer (see manufacturer’s instructions).

How Long Does It Take?

The average nebulization time is about nine minutes.11 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. Disconnect the tubing from the nebulizer cup.
  2. Dry out any moisture in the tubing by air drying or running the compressor for 2-3 minutes.
  3. Disassemble nebulizer parts.
  4. Wash all parts in warm, soapy water—BUT DO NOT WASH THE TUBING.
  5. Rinse and shake off excess water and let the pieces dry on a clean cloth (or hand dry with a lint-free cloth).
  6. 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 PERFOROMIST11

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: Results

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


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 jet nebulizer and is taken twice daily (morning and evening).

Important Limitations for Use:

  • PERFOROMIST should not be used as a rescue medication
  • PERFOROMIST is not indicated to treat asthma. The safety and effectiveness of PERFOROMIST Inhalation Solution in asthma has not been established.


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.


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.

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
It is important to inform your healthcare professional of all prescription or over the counter medications you are taking including: beta-blockers, some antidepressants (tricyclic and MAO inhibitors), steroids, diuretics, xanthine derivatives (e.g. theophylline), as well as vitamins and herbal supplements. PERFOROMIST Inhalation Solution and certain medicines may interact with each other and cause serious side effects.

Immediate allergic reactions may occur after taking PERFOROMIST Inhalation Solution, including anaphylactic reactions, hives, generalized swelling including the airway, rash, and bronchospasm.

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.

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.

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