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