albuterol: Adult Dosing

Dosage forms: 2,4; 4,8 ER; 2/5 mL

bronchospasm

2-4 mg PO tid-qid

Max: 32 mg/day; Alt: 4-8 mg ER PO q12h; Info: start 4 mg ER PO q12h if low body wt; do not cut/crush/chew ER form

renal dosing

adjust dose amount

CrCl 10-50: decr. dose 25%; CrCl <10: decr. dose 50%; HD/CAPD: not defined

hepatic dosing

not defined

albuterol: Peds Dosing

Dosage forms: 2,4; 4,8 ER; 2/5 mL

bronchospasm

2-6 yo

Dose: 0.1-0.2 mg/kg PO tid: Start: 0.1 mg/kg PO tid; Max: 12 mg/day

6-12 yo

Dose: 2 mg PO tid-qid; Max: 24 mg/day; Alt: 4 mg ER PO q12h; Info: do not cut/crush/chew ER form

>12 yo

Dose: 2-4 mg PO tid-qid; Max: 32 mg/day; Alt: 4-8 mg ER PO q12h; Info: start 4 mg ER PO q12h if low body wt; do not cut/crush/chew ER form

renal dosing

see Adult Dosing

renal impairment: dose adjustment may be required although specific pediatric dosing adjustments not defined; see adult renal dosing for guidance

hepatic dosing

not defined

albuterol: Contraindications/Cautions

• hypersens. to drug/class/compon.
• caution if ischemic heart dz
• caution if HTN
• caution if cardiac arrhythmia
• caution if hypokalemia
• caution if diabetes mellitus
• caution if seizure disorder
• caution if hyperthyroidism
• caution if pheochromocytoma
• caution in pregnancy
• caution in elderly pts

albuterol: Drug Interactions

Alpha-blockers: May diminish the therapeutic effects of albuterol.

Atomoxetine: May enhance tachycardic effects of albuterol; monitor heart rate.

Beta-blockers (nonselective): May diminish the bronchodilatory effects of albuterol; avoid concurrent use.

Betahistine: May diminish the therapeutic effect of albuterol due to bronchoconstrictive or other smooth muscle effects.

Diuretics (nonpotassium-sparing): ECG changes and/or hypokalemia may result from concomitant use; use caution with high doses.

MAO inhibitors: Cardiac effects of albuterol may be potentiated; use with extreme caution with use or within 2 weeks of discontinuing MAO inhibitor.

Tricyclic antidepressants (TCAs): Cardiac effects of albuterol may be potentiated; use with extreme caution or within 2 weeks of discontinuing TCAs.

Sympathomimetics: May increase side effects of other sympathomimetics; monitor heart rate and blood pressure.

Ethanol/Nutrition/Herb Interactions

Food: Avoid or limit caffeine (may cause CNS stimulation).

Herb/Nutraceutical: Avoid ephedra, yohimbe (may cause CNS stimulation). Avoid St John's wort (may decrease the levels/effects of albuterol).

This list is not complete and there may be other drugs that can interact with albuterol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Contraindicated

• phenothiazines

Avoid/Use Alternative

• sotalol

Monitor/Modify Tx

• A2R blocker/HCTZ combos

• ACE inhibitor/HCTZ combos

• amiodarone

• amphotericins

• antiarrhythmics, class Ia

• beta blocker/thiazide combos

• budesonide

• carbonic anhydrase inhibitors, systemic

• carboplatin

• chloroquine phosphate

• cisapride

• cisplatin

• clarithromycins

• corticosteroids, systemic

• dasatinib

• digoxin

• diuretics, loop

• diuretics, potassium-sparing/HCTZ

• diuretics, thiazide

• dofetilide

• dolasetron

• droperidol

• erythromycins

• flecainide

• foscarnet

• haloperidol

• ibutilide

• lapatinib

• meperidine/promethazine

• methadone

• paliperidone

• pentamidine

• pimozide

• polyethylene glycol/electrolytes

• quetiapine

• ranolazine

• sodium phosphate

• telithromycin

• vorinostat

Caution Advised

• atomoxetine

• beta blockers, systemic

• linezolid

• MAOIs, all

• propafenone

• quinolones, QT prolongers

• tricyclic antidepressants

• ziprasidone

albuterol: Adverse Reactions

Serious Reactions

• urticaria
• angioedema
• bronchospasm, paradoxical
• angina
• arrhythmias
• QT prolongation
• HTN
• hypokalemia
• seizures

Common Reactions

• tremor
• nervousness
• headache
• nausea
• tachycardia
• muscle cramps
• palpitations
• insomnia
• dizziness

albuterol: Safety Monitoring

Pregnancy: C

Lactation: Probably Safe

Monitoring Parameters: no routine tests recommended

albuterol: Pharmacology

Metabolism: liver extensively; CYP450: unknown

Excretion: urine primarily, feces; Half-life: 2.7-6h

Class: Bronchodilators

Mechanism Of Action
stimulates beta2-adrenergic receptors, relaxing airway smooth muscle (selective beta agonist)

albuterol: Manufacturer/Pricing

Manufacturer: generic DEA/FDA: Rx Approximate Retail Price tablet: 2 mg (60 ea): $15.99 4 mg (60 ea): $14.99

albuterol: Patient Education

• Generic Name: albuterol

• Pronounced: al BYOO teh rall

• Brand Names:
  • Proventil
  • Proventil Repetabs
  • Ventolin
  • Volmax

What is the most important information I should know about albuterol?

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

What is albuterol?

Albuterol works by relaxing muscles in the airways to improve breathing.

Albuterol is used to treat bronchospasm (wheezing, shortness of breath) associated with reversible obstructive airway disease such as asthma.

Albuterol may also be used for conditions other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking albuterol?

Before taking albuterol, tell your doctor if you have

• heart disease or high blood pressure;
• epilepsy or another seizure disorder;
• diabetes;
• an overactive thyroid (hyperthyroidism);
• difficulty swallowing;
• liver disease; or
• kidney disease.

You may not be able to take albuterol or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Albuterol is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby. Do not take albuterol without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether albuterol passes into breast milk. Do not take albuterol without first talking to your doctor if you are breast-feeding a baby.

How should I take albuterol?

Take albuterol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

To ensure that you get a correct dose, measure the liquid forms of albuterol with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Do not break, crush, or chew the Volmax or Proventil Repetabs tablets. These are specially formulated to release the medication slowly in the body. The Volmax tablets have an outer shell that is not absorbed by the body. Occasionally, this shell may be seen in the stool. This is not a problem as the medication has been absorbed by the body.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

Store the Volmax brand of albuterol tablets in the refrigerator between 36 and 46 degrees Fahrenheit (2 and 8 degrees Celsius).

Store all other forms of albuterol at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an albuterol overdose may include angina or chest pain, irregular heartbeats or a fluttering heart, seizures, tremor, weakness, headache, nausea, and vomiting.

What should I avoid while taking albuterol?

Avoid situations that may worsen your respiratory condition such as exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens such as pet fur.

What are the possible side effects of albuterol?

Stop taking albuterol and seek emergency medical attention if you experience any of the following serious side effects:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); or
• chest pain or irregular heartbeats.

Other, less serious side effects may be more likely to occur. Continue to take albuterol and talk to your doctor if you experience

• headache;
• dizziness or lightheadedness;
• insomnia;
• tremor or nervousness;
• sweating;
• nausea, vomiting, or diarrhea; or
• dry mouth.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect albuterol?

Before taking albuterol, tell your doctor if you are taking any of the following medicines:

• a beta-blocker such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), propranolol (Inderal), acebutolol (Sectral), bisoprolol (Zebeta), carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), or pindolol (Visken);
• a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or protriptyline (Vivactil);
• a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);
• another oral or inhaled bronchodilator; or
• caffeine, diet pills, or decongestants.

You may not be able to take albuterol, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medications listed above.

Drugs other than those listed here may also interact with albuterol or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist has additional information about albuterol written for health professionals that you may read.

What does my medication look like?

Albuterol is available with a prescription under the brand names Ventolin, Proventil, and Volmax. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Ventolin 2 mg-white, round, scored tablets
• Ventolin 4 mg-white, round, scored tablets
• Ventolin Syrup 2 mg/5 mL-clear orange-yellow strawberry-flavored liquid
• Proventil 2 mg-white, round, scored tablets
• Proventil 4 mg-white, round, scored tablets
• Proventil Repetabs 4 mg-white, round tablets
• Volmax 4 mg-light blue, hexagonal-shaped tablets
• Volmax 8 mg-white, hexagonal-shaped tablets

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

albuterol: Pill Pictures

U.S. Brand Names

• AccuNeb®
• ProAir™ HFA
• Proventil® HFA
• Proventil®
• Ventolin® HFA
• VoSpire ER®

Index Terms

• Albuterol Sulfate
• Salbutamol Sulphate
• Salbutamol

Canadian Brand Names

• Airomir
• Alti-Salbutamol
• Apo-Salvent® CFC Free
• Apo-Salvent® Respirator Solution
• Apo-Salvent® Sterules
• Apo-Salvent®
• Gen-Salbutamol
• PMS-Salbutamol
• ratio-Inspra-Sal
• ratio-Salbutamol
• Rhoxal-salbutamol
• Salbu-2
• Salbu-4
• Ventolin® Diskus
• Ventolin® HFA
• Ventolin® I.V. Infusion
• Ventolin®
• Ventrodisk

International Brand Names

• Aero-Vent (PH)
• Aerolin (BR, CN, GR)
• Aeromol (TH)
• Airomir (AU, FR, HK, LU, MY, PL, SE, TH, UY)
• Almotex (PH)
• Asmacaire (PH)
• Asmadil (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZA, ZM, ZW)
• Asmalin Pulmoneb (PH)
• Asmatol (AR)
• Asmidon (JP)
• Asmol CFC-Free (AU)
• Asmovent (MY)
• Assal (MX)
• Asthalin (IN)
• Asthalin HFA (HK)
• Asthavent (ZA)
• Asvimol (PH)
• Avedox-FC (MX)
• Azmacon (ID)
• Azmasol (SG)
• Bronchosol (TH)
• Broncovaleas (IT)
• Bronter (CO)
• Brusal (MX)
• Brytolin (PH)
• Butahale (SG)
• Butamol (AU)
• Buto-Asma (ES, SG, TH)
• Butotal (CN)
• Buventol (NO, SG, TW)
• Buventol Easyhaler (FR, ID, TH)
• Cybutol (HK, ID)
• Easyhaler Salbutamol (GB, IE)
• Emplusal (PH)
• Epaq Inhaler (AU)
• Farcolin (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE)
• Glisend (ID)
• Hivent DS (PH)
• Huma-Salmol (HU)
• Inbumed (MX)
• Libretin (PH)
• Medolin (SG)
• Mozal (TW)
• Provexel NS (PH)
• Pulmol-S (PE)
• Respax (NZ)
• Salamol (PL)
• Salbetol (IN)
• Salbron (ID)
• Salbulin (LU)
• Salbumed (PH)
• Salbutalan (MX)
• Salbutamol (HU, PL)
• Salbutamol-GW (HU)
• Salbutan (VE)
• Salbutin (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE)
• Salbutol (KP, PE)
• Salbutron SR (KP)
• Salbuven (ID)
• Salbuvent (PL)
• Salda (TH)
• Salden (EC)
• Salmaplon (IN)
• Salmundin Retard (DE)
• Salomol (TW)
• Sedalin (PH)
• Solia (TH)
• Steri-Neb Salamol (PL)
• Sultanol (AT, DE, JP)
• Suprasma (ID)
• Teoden (BR)
• Tobybron (ID)
• Unibron (MX)
• Venalax (PH)
• Venderol (SG)
• Venetlin (JP)
• Venteze (ZA)
• Ventilan (CO, PT)
• Ventilastin Novolizer (DE, FR)
• Ventodisk (LU, PL)
• Ventol (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE)
• Ventolin (AE, AR, AU, BB, BE, BF, BG, BH, BJ, BM, BS, BZ, CH, CI, CL, CR, CY, CZ, EC, EE, EG, ET, GH, GM, GN, GT, GY, HK, HN, HR, HU, ID, IE, IL, IQ, IR, IT, JM, JO, KE, KW, LB, LR, LU, LY, MA, ML, MR, MU, MW, MX, MY, NE, NG, NI, NL, OM, PA, PE, PH, PK, PL, PY, QA, SA, SC, SD, SL, SN, SR, SV, SY, TH, TN, TT, TW, TZ, UG, UY, VE, YE, ZA, ZM, ZW)
• Ventolin CFC-Free (AU)
• Ventolin [tabs./sol./sir.] (PL)
• Ventoline (DK, FI, FR, NO, SE)
• Volmax (AE, BH, CY, EC, EG, HK, HU, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE)
• Zenmolin (AE, BH, CY, EG, HK, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE)
• Zibil (MX)