Provocholine (Inhalation)

Methacholine (Inhalation) is used to assist your doctor in diagnosing bronchial airway hyperreactivity or asthma. This medicine causes your bronchial airways to narrow. The amount of narrowing will be measured with a device called a spirometer. This test is also known as the methacholine challenge test.

This medicine should only be given while under the supervision of your doctor.

It is very important that your doctor checks you or your child's progress closely during treatment with this medicine to see if it is working properly and to check for any unwanted effects.

This medicine may cause severe bronchoconstriction and should not be used in patients with asthma or with breathing difficulties. Check with your doctor right away if you are having severe cough, difficulty breathing, noisy breathing, or tightness in the chest.

This medicine may cause mild cough, chest tightness, or trouble with breathing. This is normal and nothing to worry about.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a diagnostic test, you and your doctor need to consider the risks of the test compared to the benefits it may provide. Other factors can also influence test results. For this test, keep the following in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare provider know about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

There have not been appropriate studies conducted on how methacholine inhalation affects children younger than 5 years old. Its safety and effectiveness have not been established for this age group.

Geriatric

There is no information available regarding how methacholine inhalation affects older adults.

Breast Feeding

There are not enough studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if there could be an interaction. In these situations, your doctor may adjust the dose, or other precautions may be needed. It is especially important for your healthcare provider to know if you are taking any of the medicines listed below while receiving this diagnostic test. The following interactions have been highlighted based on their potential significance and are not necessarily a complete list.

Using this diagnostic test with any of the following medicines is usually not recommended, but may be necessary in some instances. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both of the medicines.

• Aclidinium
• Albuterol
• Amantadine
• Amitriptyline
• Amoxapine
• Arformoterol
• Atropine
• Bambuterol
• Belladonna
• Benztropine
• Biperiden
• Brompheniramine
• Carbinoxamine
• Carisoprodol
• Chlorpheniramine
• Chlorpromazine
• Clemastine
• Clenbuterol
• Clidinium
• Clomipramine
• Clozapine
• Colterol
• Cyclobenzaprine
• Cyclopentolate
• Cyproheptadine
• Darifenacin
• Desipramine
• Dicyclomine
• Dimenhydrinate
• Diphenhydramine
• Doxepin
• Fenoterol
• Fesoterodine
• Flavoxate
• Fluphenazine
• Formoterol
• Glycopyrrolate
• Glycopyrronium Tosylate
• Hexoprenaline
• Homatropine
• Hydroxyzine
• Hyoscyamine
• Imipramine
• Indacaterol
• Ipratropium
• Isoetharine
• Levalbuterol
• Loxapine
• Meclizine
• Mepenzolate
• Metaproterenol
• Nortriptyline
• Olanzapine
• Olodaterol
• Orphenadrine
• Oxitropium Bromide
• Oxybutynin
• Paroxetine
• Perphenazine
• Pimozide
• Pipenzolate Bromide
• Pirbuterol
• Pirenzepine
• Procaterol
• Prochlorperazine
• Procyclidine
• Promethazine
• Propantheline
• Propiverine
• Protriptyline
• Reproterol
• Ritodrine
• Salmeterol
• Scopolamine
• Solifenacin
• Stramonium
• Terbutaline
• Terodiline
• Theophylline
• Thioridazine
• Thiothixene
• Tiotropium
• Tizanidine
• Tolterodine
• Tretoquinol
• Trifluoperazine
• Trihexyphenidyl
• Trimipramine
• Tropicamide
• Trospium
• Tulobuterol
• Umeclidinium
• Vilanterol

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around meal times or with certain types of food, as interactions may occur. Using alcohol or tobacco with certain medicines can also lead to interactions. Discuss with your healthcare provider about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may impact the use of this diagnostic test. Make sure to inform your doctor of any other medical problems you have, especially:

• Allergic rhinitis without asthma symptoms or
• Infection (e.g., upper respiratory infection, influenza) or
• Chronic lung disease (e.g., COPD, tuberculosis, sarcoidosis, or cystic fibrosis)—Using this in patients with these conditions may sometimes lead to a false-positive result.

• Aortic aneurysm (bulge in the wall of the main artery of the heart) or
• History of heart attack or
• Uncontrolled hypertension (high blood pressure) or
• History of stroke—Use with caution. It is not recommended for patients with these conditions.

• Epilepsy or
• Peptic ulcer disease or
• Thyroid disease or
• Urinary tract blockage or
• Vagotonia (excessive activity of the vagus nerve)—Use with caution. There may be an increased risk for more side effects. Your doctor should only test this medicine in patients with these conditions if the benefits outweigh the risks.

Along with its needed effects, a medicine may cause some unwanted effects. Not all of these side effects may occur, but if they do, they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

• Cough
• Difficulty breathing
• Noisy breathing
• Tightness in the chest

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Headache
• Itching
• Lightheadedness
• Throat irritation

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Provocholine

Available Dosage Forms:

• Solution
• Powder for Solution

Therapeutic Class: Diagnostic Agent, Bronchial

Pharmacologic Class: Cholinergic System

A doctor or other health professional will give you this medicine in the hospital. It is given through oral inhalation using a dosimeter. Your doctor will also use a device, called a spirometer, to check for your lung function.