Albuterol

RATE

Albuterol is a short-acting beta agonist (abbreviated: SABA). It is used as a rescue medication to treat an asthma attack for people ages four years and older.1-3 It is also approved to prevent exercise-induced asthma.1-3 Albuterol is taken via metered dose inhaler. Currently, albuterol is marketed as three brand name products:

  • ProAir, made by Teva Respiratory, LLC1
  • Proventil, made by Merck & Co, Inc2
  • Ventolin, made by GlaxoSmithKline3

Albuterol also comes as a nebulizing solution, tablet, and syrup.4 Inhaled albuterol works more quickly and more effectively than albuterol taken by mouth.5 It also has fewer side effects.

How does albuterol work?

Albuterol relaxes the smooth muscle that surround the airways. This helps the airways to open up. Albuterol affects the whole airway, from the large trachea to the very small bronchioles. It works in five to eight minutes.1,3  The effects last three to six hours.1

How should I use the albuterol inhaler?

Each inhaler is a little different. Be sure to read the instructions that come with your medication. Ask your health care provider or respiratory therapist to show you how to use your inhaler properly. General steps for using a metered dose inhaler are in the Table.6-8

Before using any of the albuterol products, you have to prime the inhalers.6-8 To do this, shake the inhaler for a few seconds. Press the canister down and release one puff into the air. Repeat this two or three more times, depending on the specific instructions for your inhaler. You have to prime it again if you have not used the inhaler for two weeks.6-8

Table. Using your metered dose inhaler

The steps for using your metered dose inhaler are:

  1. Shake the inhaler before using it.
  2. Breathe out until your lungs are empty.
  3. Put the mouthpiece in your mouth and close your lips around it.
  4. Begin to breathe in deeply and slowly through your mouth. Press the canister down to release a “puff” as you breathe in. Press down until the canister stops moving.
  5. Hold your breath for 10 seconds. Exhale slowly. (For some inhalers, you should remove the inhaler from your mouth before starting to hold your breath.)
  6. If your provider has told you to take more than 1 puff, wait 1 minute. Shake the inhaler again and repeat.

Tips

  • Read the Patient Information that comes with your specific inhaler for complete instructions.
  • The inhaler is best used at room temperature.
  • You can use a spacer or valved holding chamber with a metered dose inhaler. These devices help the medications to get into your lungs.

ProAir® HFA [patient information]. Horsham, PA: Teva Respiratory, LLC; 2012; Proventil® HFA [patient information]. Whitehouse Station, NJ: Merck & Co, Inc; 2012; Ventolin® [patient information]. Research Triangle Park, NC; GlaxoSmithKline; 2014.

What should I do if I miss a dose of albuterol?

Albuterol is taken as needed to treat an asthma attack or prevent exercise-induced asthma.5 Plan ahead to make sure that you do not run out of albuterol. When the counter on your inhaler shows that you have 20 doses left, it is time to refill your prescription.1,3

Albuterol should not be taken on a regularly scheduled basis.5 Studies show that taking albuterol on a regularly scheduled basis can actually lead to worse lung function and asthma control. Using albuterol more than two days per week for quick relief of symptoms is a sign of poor asthma control.5 Speak with your health care provider about changing your control medications.

What are the recommendations for storing, cleaning, and discarding my albuterol inhaler?

Albuterol comes in a metal canister with a separate plastic inhaler.1-3 Only use the inhaler that comes with your medication.

Wash the inhaler at least once a week.6-8 Before washing the inhaler, take the cap off the mouthpiece and remove the canister. You should not let the canister get wet. Take the cap off of the mouthpiece. Hold the inhaler upright and run warm water through it for 30 seconds. Then turn the inhaler over and run warm water through the mouthpiece for 30 seconds. Shake the inhaler to remove the water, and allow it to air dry overnight.

Your inhaler will be labeled with the number of doses it contains. Some inhalers have built-in counters. Throw away your inhaler when the counter gets to 0 or you have used all the doses in the canister. You have used all the medication.

Most albuterol inhalers can be safely stored between 68˚F and 77˚F.1-3 Avoid high heat or flames.

What are the possible side effects of taking albuterol?

Taking albuterol could cause your airways to tighten suddenly (“bronchospasm”).1-3 This side effect can happen right after using the inhaler. Frequently, it occurs the first time you use a new canister. Start alternate therapy and call your health care provider.

You might feel shaky or nervous after taking albuterol.6-8 Albuterol can cause chest pain, palpitations, and increased heart rate. It can also cause headache, dizziness, muscle pain, colds, sore throat, or runny nose.

Are there people who should not take albuterol?

People with heart problems should be cautious about taking albuterol.1-3 Albuterol can cause changes in blood pressure, heart rate, and other heart disease symptoms. These effects are rare if the recommended doses of albuterol are taken.1,2 Tell your health care provider if you have heart disease or high blood pressure.6,8

Talk to your provider if you have had thyroid problems, seizures, diabetes, or low potassium levels.6,8 Taking albuterol may make these conditions worse.

Tell your health care provider about any prescription or over-the-counter medications or supplement that you take. Certain medications affect the way that albuterol works, including: other asthma medications, other inhaled medications, beta-blockers, diuretics, digoxin, MAOIs (monoamine oxidase inhibitors), TCAs (tricyclic antidepressants).6,8

There are no high-quality studies of albuterol in pregnant or breastfeeding women.6-8 The National Heart, Lung, and Blood Institute states that albuterol is the preferred SABA during pregnancy.9 They cite available studies with reassuring data about the safety of beta agonists in general and albuterol in particular. These guidelines also state that women can breastfeed while taking a beta agonist.9 The prescribing information for albuterol products suggests talking to your health care provider about using albuterol during pregnancy or while breastfeeding.6-8

If you are allergic to albuterol or any other ingredient, you should not take this medication.6,8

What evidence do we have that albuterol works?

Multiple high-quality randomized controlled trials have shown that SABAs are the most effective medications for opening airways.5 The National Heart, Lung, and Blood Institute recommends the use of SABAs for all patients who are having an asthma attack. Three doses of a SABA is enough to treat 60% to 70% of patients who come to the emergency department for asthma.5

Is there a generic alternative to the branded albuterol inhalers?

There is currently no generic albuterol inhaler.

view references
  1. ProAir® HFA [prescribing information]. Horsham, PA: Teva Respiratory, LLC; 2012.
  2. Proventil® HFA [prescribing information]. Whitehouse Station, NJ: Merck & Co, Inc; 2012.
  3. Ventolin® [prescribing information]. Research Triangle Park, NC; GlaxoSmithKline; 2014.
  4. National Library of Health. Daily Med. Available at: http://dailymed.nlm.nih.gov/dailymed/index.cfm.
  5. National Heart, Lung, and Blood Institute. Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma - Full Report 2007. Accessed 11/12/14 at: http://www.nhlbi.nih.gov/files/docs/guidelines/asthgdln.pdf
  6. ProAir® HFA [patient information]. Horsham, PA: Teva Respiratory, LLC; 2012.
  7. Proventil® HFA [patient information]. Whitehouse Station, NJ: Merck & Co, Inc; 2012.
  8. Ventolin® [patient information]. Research Triangle Park, NC; GlaxoSmithKline; 2014.
  9. National Heart Lung and Blood Institute. Working group report on managing asthma during pregnancy: Recommendations for pharmacologic treatment. Update 2004. Accessed 1/20/15 at: http://www.nhlbi.nih.gov/files/docs/resources/lung/astpreg_full.pdf
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