Indications for PERFOROMIST:

Long-term maintenance treatment of bronchoconstriction in COPD, including chronic bronchitis and emphysema.

Limitations of Use:

Not indicated to treat acute deteriorations of COPD or for treatment of asthma.


20micrograms (1 vial) by nebulizer twice daily (AM & PM). Use standard jet nebulizer (eg, PARI-LC Plus [with face-mask or mouthpiece]) and air compressor (eg, Proneb Ultra compressor). Does not need to be diluted before nebulization. Do not mix with other drugs.


Not established.


Use of LABA without inhaled corticosteroid (ICS) in asthma.


LABA as monotherapy (without ICS) for asthma can increase risk of asthma-related events. Do not initiate in acute deteriorating COPD. Not for relief of acute symptoms. Prescribe a short-acting, inhaled β2-agonist for acute symptoms; monitor for increased need. Do not exceed recommended dose. Cardiovascular disease (esp. hypertension, coronary insufficiency, arrhythmias). Convulsive disorders. Thyrotoxicosis. Hyperresponsiveness to sympathomimetics. Diabetes. Ketoacidosis. Hypokalemia. Pregnancy. Labor & delivery. Nursing mothers.

Pharmacologic Class:

Long-acting beta-2 agonist (LABA).


Caution with concomitant other adrenergic drugs; may potentiate sympathetic effects. Extreme caution with MAOIs, tricyclics, or others that prolong QTc interval (may cause ventricular arrhythmias). Antagonized by β-blockers. K+-depleting diuretics, xanthines, steroids may potentiate hypokalemia.

Adverse Reactions:

GI upset, nasopharyngitis, dry mouth, dizziness, insomnia; ECG changes or cardiovascular effects (eg, increased BP, tachycardia; consider discontinuing if occur); hypokalemia, hyperglycemia, metabolic acidosis; hypersensitivity reactions; rarely: paradoxical bronchospasm.

Generic Availability:


How Supplied:

Single-use vials (2mL)—30, 60


2ml of 20mcg/2ml vial (Qty: 60)
Appx. price $1093