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