Methacholine Challenge Test

Pretest instructions

Please allow about one and a half hours to complete the test.

Please be on time for your test.

Get adequate rest the night before your test.

Do not participate in significant exercise or have exposure to extreme heat or cold for 2 hours prior to testing.

If you are having respiratory symptoms on the day of the test, tell the respiratory therapist before starting the test.

Do not eat or drink anything with caffeine (coffee, cola, chocolate) for at least 16 hours prior to testing.


Do not take any breathing medication before the test as directed below:

Slo-bid, Theodur, Theo-24, Uniphyl, Dilor, Dilex, or other theophylline containing products should be held for 24 hours.

Tornalate, Serevent, Foradil, Advair, Proventil Repetabs and Volmax should be held for 12 hours.

Albuterol, Ventolin, Proventil, Maxair, Alupent, Vanceril, Azmacort, Flovent, Pulmicort, Aerobid, Q-Var, Atrovent or other inhalers should be held for 8 hours.

For any questions about your medications, contact your physician’s office.


Do not smoke for at least 6 hours prior to testing.

Please bring your insurance cards and driver’s license for billing purposes.

If for some reason you cannot be present for testing, please notify us 24 hours ahead. Methacholine has a very short shelf life and has to be discarded if not used. It is prepared on the testing day by our staff. If you do not cancel and miss your test, you may be billed for the cost of the medication.

Test Information

A methacholine challenge test is designed to demonstrate the presence of hyper-reactive airways in individuals suspected of having asthma. In this test, the patient performs a series of spirometry tests. Each spirometry is preceded by a dose of inhaled methacholine. This chemical is known for inducing asthma symptoms in patients prone to have asthma. Very small doses are used in the study. These small doses will not cause an asthma reaction in patients who do not have asthma. The test is safe as long as the patient is not having significant asthma symptoms before starting the test. We will always check a baseline spirometry before the test to assure this.

If you have an asthma reaction from the methacholine, we will reverse this with asthma medication. The discomfort from the asthma attack will only be for a brief time.

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