Not recommended in patients w/ asthma. Not to be used for acute symptom relief ie, rescue therapy for bronchospasm acute episodes. Discontinue immediately if paradoxical bronchospasm occurs. Patients w/ unstable or life-threatening CV disease; pulmonary TB or w/ chronic or untreated infections; narrow-angle glaucoma or urinary retention. Systemic effects may occur particularly at high doses for long periods. Possible pneumonia development in COPD patients; risk factors include current smokers, patients w/ prior pneumonia history, low BMI, severe COPD; re-evaluate treatment if pneumonia occurs. Blurred vision or other visual disturbances. Increased blood glucose levels in patients w/ DM history or risk factors. May affect ability to drive & use machines. Moderate to severe hepatic impairment. Pregnancy & lactation. Childn <18 yr.