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Table 1 Medications and other factors that may decrease bronchial hyperresponsiveness and their required withholding periods

From: Comparison of mannitol and methacholine to predict exercise-induced bronchoconstriction and a clinical diagnosis of asthma

  FACTOR Withholding Period
Inhaled agents Short acting bronchodilators (isoproterenol, isoetharine, metaproterenol, albuterol, levalbuterol, terbutaline) (e.g. Proventil® or Ventolin®) 8 hr
  Inhaled anticholinergics or combination products (e.g. Atrovent® or Combivent®) 1 week
  Medium acting bronchodilators (ipratropium) 1 week
  Long acting inhaled bronchodilators (salmeterol, formoterol) (e.g. Serevent® or Foradil®) 2 weeks
  Inhaled corticosteroid/long acting inhaled bronchodilator combination (e.g. Advair®) 4 weeks
Oral bronchodilators Theophylline 24 hr
  Intermediate theophylline 48 hr
  Long acting theophylline 48 hr
  Standard β-agonist tablets 24 hr
  Long acting β-agonist tablets 48 hr
Corticosteroids There is no washout for topical steroids applied to skin unless they are high potency steroids 4 weeks
Other medications Hydroxyzine, cetirizine (and other antihistamines) 72 hr
  Tiotropium bromide 72 hr
  Nasals steroids 1 week
  β-blockers 1 week
  Cromolyn sodium 2 weeks
  Nedocromil 2 weeks
  Leukotriene modifiers 6 weeks
Foods Coffee, tea, cola drinks, chocolate (caffeinated foods) 12 hr
Strenuous exercise or exposure to cold air to a level that would be expected to interfere with challenges 12 hr
Tobacco   6 hr