SABAs (Short-Acting Beta Agonists) for Asthma

If you have asthma, it is likely that you use a rescue inhaler. Rescue inhalers contain a drug that is in a class of medicine called SABAs, or short-acting beta agonists.

What are SABAs?

A SABA drug stands for short-acting beta agonist. SABAs are also known as bronchodilators.¹

Bronchodilators can help people who have asthma or COPD (chronic obstructive pulmonary disease). These drugs can help improve symptoms, making it easier to breathe.¹

SABAs commonly prescribed for asthma are usually in the form of an inhaler or an inhalation solution used in the nebulizer machine. SABAs may also come in tablet or syrup form, or an injection form that is used in the hospital setting. The most common SABAs are available as:²

Albuterol, which is found in:

• ProAir HFA, Ventolin HFA, and Proventil HFA inhalers, and in generic form as albuterol HFA
• ProAir RespiClick and ProAir Digihaler
• Albuterol or AccuNeb nebulizer solution

Levalbuterol, which is found in:

• Xopenex HFA inhaler and in generic form as levalbuterol HFA
• Levalbuterol or Xopenex nebulizer solution

How do SABAs work?

SABAs work on the smooth muscles of the lungs. SABAs target a receptor called the beta-2 receptor in the airways. The drug activates the beta-2 receptor, and this helps relax the muscles in the airway. As a result, breathing improves.¹

When are SABAs used?

New updates to asthma guidelines were published in 2020, known as the “2020 Asthma Guideline Update From the National Asthma Education and Prevention Program.” Although changes were made from the previous (2007) guidelines, SABAs are still recommended as first-line treatment for people with intermittent asthma.³

People with intermittent asthma have symptoms like wheezing, shortness of breath, and cough that occur fewer than 2 days a week and do not interfere with daily activities. People with intermittent asthma may also experience symptoms at night fewer than 2 days per month.⁴

The new guidelines kept the previous recommendation of using the SABA albuterol as the first step if needed as a rescue treatment in people ages 12 years or older with intermittent asthma.³

People with mild, moderate, or severe persistent asthma often use a SABA as needed, along with another inhaled drug(s), such as an inhaled steroid and/or other drugs.³

What are the side effects of SABAs?

The most common side effects of SABAs include:^1,5

• Trembling
• Nervousness
• Headache
• Dizziness
• Sore throat
• Heart palpitations
• Muscle cramps
• Chest pain

More severe side effects include:^1,5

• Paradoxical bronchospasm (sudden airway constriction)
• Low potassium levels

If you experience paradoxical bronchospasm, stop using your SABA medicine and contact your doctor as soon as possible.⁵

If you have ever had an allergic reaction to a medicine that contains albuterol or levalbuterol, notify your doctor. Immediate hypersensitivity reactions have occurred. Symptoms may include itching, rash, swelling around the mouth/face/tongue, and/or trouble breathing. If you experience any of these serious symptoms, seek emergency medical care.⁵

These are not all the possible side effects of SABAs. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with SABAs

Things to consider

Ask your doctor or pharmacist if you need help using your SABA. For example, if you have a SABA asthma inhaler, they can show you how to prime, use, and clean your inhaler.

Use your SABA as prescribed. If you find that you need to use your SABA more often than prescribed, talk to your doctor. You may need additional medicine to help control your asthma. Do not change the dose or frequency of your SABA unless your doctor tells you to do so. In rare cases, excessive use can lead to death.⁵

SABA drugs can cause effects on the heart including increased pulse and/or blood pressure. SABAs should be used with caution in people with heart or blood pressure problems. SABAs should be used with caution in people with a convulsive disorder, hyperthyroidism, or diabetes. Ask your doctor if a SABA is safe with any medical conditions you have.⁵

SABAs may interact with certain medicines, including:⁵

• Other SABAs
• Beta-blockers
• Diuretics
• Digoxin
• MAOI antidepressants
• Tricyclic antidepressants

Before beginning treatment for asthma, tell your doctor about any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.