Medication	Medication delivery	Dosage	Serious adverse effects
Short-acting muscarinic antagonist
Ipratropium (Atrovent)	Multidose inhaler	2 puffs four times per day	Anaphylaxis, angle-closure glaucoma, hypersensitivity reaction, paradoxical bronchospasm
Long-acting muscarinic antagonists
Aclidinium (Tudorza)	Dry powder inhaler	1 puff two times per day	Anaphylaxis, angle-closure glaucoma, hypersensitivity reaction, paradoxical bronchospasm
Glycopyrrolate (Seebri)	Dry powder inhaler	1 puff two times per day
Tiotropium (Spiriva)	Dry powder inhaler; soft mist inhaler	2 puffs per day
Umeclidinium (Incruse Ellipta)	Dry powder inhaler	1 puff per day
Short-acting beta2agonists
Albuterol	Multidose inhaler	2 puffs every four to six hours as needed	Anaphylaxis, angina, arrhythmia, cardiac arrest, hyperglycemia, hypersensitivity reaction, hypertension, hypokalemia, hypotension, paradoxical bronchospasm
Levalbuterol (Xopenex)	Multidose inhaler	2 puffs every four to six hours as needed
Long-acting beta2agonists
Arformoterol (Brovana)	Nebulizer	12 mcg every 12 hours	Angina, arrhythmia, asthma exacerbation, asthma-related death (treatment without concurrent inhaled corticosteroid), cardiac arrest, hyperglycemia, hypersensitivity reaction, hypertension, hypokalemia, hypotension, paradoxical bronchospasm U.S. Food and Drug Administration boxed warnings (salmeterol only): increased risk of asthma-related death when used as monotherapy; increased risk of asthma-related hospitalizations in children and adolescents when used as monotherapy
Formoterol	Nebulizer	20 mcg every 12 hours
Olodaterol (Striverdi Respimat)	Multidose inhaler	2 puffs per day
Salmeterol	Dry powder inhaler	1 puff every 12 hours
Short-acting beta2agonist/short-acting muscarinic antagonist combination
Albuterol/ipratropium	Nebulizer; soft mist inhaler	Nebulizer: 3 mL four times per day Inhaler: 1 puff four times per day	Anaphylaxis, angina, angle-closure glaucoma, arrhythmia, asthma-related death (treatment without concurrent inhaled corticosteroid), cardiac arrest, hyperglycemia, hypersensitivity reaction, hypertension, hypokalemia, hypotension, paradoxical bronchospasm
Long-acting beta2agonist/long-acting muscarinic antagonist combinations
Formoterol/aclidinium (Duaklir Pressair)	Dry powder inhaler	1 puff every 12 hours	Same adverse effects as individual classes listed above
Formoterol/glycopyrrolate (Bevespi Aerosphere)	Multidose inhaler	2 puffs two times per day
Olodaterol/tiotropium (Stiolto Respimat)	Multidose inhaler	2 puffs per day
Vilanterol/umeclidinium (Anoro Ellipta)	Dry powder inhaler	1 puff per day
Long-acting beta2agonist/inhaled corticosteroid combinations
Formoterol/budesonide (Symbicort)	Multidose inhaler	2 puffs two times per day	Adrenal suppression (long-term use), anaphylaxis, arrhythmia, asthma exacerbation, asthma-related death (treatment without concurrent inhaled corticosteroid), cardiac arrest, cataracts (long-term use), Churg-Strauss syndrome, eosinophilia, growth suppression (long-term use in children), hypercorticism (long-term use), hyperglycemia, hypersensitivity reaction, hypertension, hypokalemia, hypotension, immunosuppression (long-term use), open-angle glaucoma (long-term use), osteoporosis (long-term use), paradoxical bronchospasm
Formoterol/mometasone (Dulera)	Multidose inhaler	2 puffs two times per day
Salmeterol/fluticasone	Dry powder inhaler	1 puff every 12 hours
Vilanterol/fluticasone (Breo Ellipta)	Dry powder inhaler	1 puff per day
Triple combination therapy (inhaled corticosteroid/long-acting muscarinic antagonist/long-acting beta2agonist)
Budesonide/glycopyrrolate/formoterol (Breztri Aerosphere)	Multidose inhaler	2 puffs two times per day	Same adverse effects as individual classes listed above
Vilanterol/umeclidinium/fluticasone (Trelegy Ellipta)	Dry powder inhaler	1 puff per day
Macrolide antibiotics
Azithromycin	Oral tablet	250 mg per day or 500 mg three times per week	Arrhythmia (not shown in studies for chronic obstructive pulmonary disease, although only 12-month length), diarrhea, pancreatitis, tinnitus, vertigo U.S. Food and Drug Administration boxed warning (both medications): may cause fatal arrhythmias
Erythromycin	Oral tablet	500 mg two times per day
Phosphodiesterase-4 inhibitor
Roflumilast (Daliresp)	Oral tablet	500 mcg per day	Atrial fibrillation, hypersensitivity reaction, pancreatitis, renal failure, severe diarrhea, suicidality