What is Albuterol?

Albuterol is a commonly prescribed medication used to alleviate breathing difficulties in individuals with respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). As a bronchodilator, it works by relaxing the muscles in the airways, allowing increased airflow to the lungs. It is typically administered through inhalation, providing quick relief from symptoms like wheezing, coughing, and shortness of breath. It is available in various forms, including metered-dose inhalers, nebulizer solutions, and tablets. Albuterol’s rapid action and effectiveness make it a vital tool in managing acute episodes of respiratory distress. However, it is essential to follow prescribed dosages and consult a healthcare professional to optimize its usage and minimize potential side effects such as tremors, increased heart rate, and nervousness.

Albuterol
Albuterol (Salbutamol Sulfate) (Generic)
Albuterol (Salbutamol Sulfate)
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What is Albuterol?

Albuterol is an inhaled medication that is indicated for:

  • Treating bronchospasm
  • Preventing bronchospasm
  • Preventing exercise-induced bronchospasm
  • Treating wheezing and chest tightness in those with chronic obstructive pulmonary disease (COPD)

Albuterol is normally taken as one to two inhalations every four to six hours each day. If a patient is to take two puffs, they should wait one full minute in between puffs. Additionally, if they are using another inhaler, they should wait one minute before using the other inhaler.

How does Albuterol Work?

Albuterol has an effect on beta2-adrenergic receptors. Albuterol’s effect on these adrenoreceptors contributes to increased cyclic AMP levels, causing the bronchial smooth muscle to relax and the inhibition of mediator release. This relaxes the muscles in the walls of the lung, opening the airways. This mechanism, therefore, alleviates wheezing, cough, and chest tightness allowing the individual to breathe easier.

Side Effects

Side effects of Albuterol include:

  • Hypertension
  • Nausea and vomiting
  • Headache
  • Anxiety or irritability
  • Fatigue
  • Weakness
  • Shakiness
  • Insomnia
  • Dizziness
  • Hyperactivity in children
  • Myalgia
  • Irritated or dry throat
  • Fever

Warnings & Precautions

Paradoxical Bronchospasm

Albuterol can cause paradoxical bronchospasm like other inhaled medications. This event can be life-threatening. If this occurs, stop Albuterol right away and start a different therapy.

Deterioration of Asthma

A patient’s asthma may deteriorate for hours or days after administration. If an individual requires more Albuterol doses, this may indicate that their asthma is becoming destabilized. The patient may need to be reevaluated and require a different treatment regimen. Specifically, providers should consider anti-inflammatory treatment with something like corticosteroids.

Anti-inflammatory Agents

Beta-adrenergic agonist bronchodilators, such as Albuterol, alone may not provide enough asthma relief. If this is the case, providers should consider using adjunct anti-inflammatory agents such as corticosteroids.

Cardiovascular Effects

Beta2-adrenergic agonists can cause certain cardiovascular effects. These effects can include changes to blood pressure or pulse rate. If this happens, providers should stop therapy with Albuterol. Beta-agonists have also demonstrated electrocardiogram (ECG) alterations. Therefore, Albuterol and other sympathomimetic agents should be used with caution in those that have cardiovascular disorders. In particular, those with cardiac arrhythmias, hypertension, and coronary insufficiency should use caution.

Hypokalemia

Beta-agonists, such as Albuterol, can cause hypokalemia. These changes can lead to cardiovascular events. However, decreases in potassium levels are usually transient and do not necessitate supplementation.

Hypersensitivity Reactions

Albuterol has been shown to cause hypersensitivity events such as rash, angioedema, hypotension, and bronchospasm.

Coexisting Conditions

Therapy with sympathomimetic amines such as Albuterol should be monitored in those with certain conditions. These conditions include those with diabetes mellitus, convulsive disorders, and hyperthyroidism. Additionally, large doses of albuterol have been shown to exacerbate diabetes mellitus and ketoacidosis.

Excessive Doses

Inhaled sympathomimetic drugs have been shown to cause death when used at doses that exceed what is recommended. The mechanism causing this is unknown. However, cardiac arrest and hypoxia are potential sources.

Drug Interactions

Beta-adrenergic Receptor Blocking Agents

Beta-blockers stop beta-agonist effects on the pulmonary system. Additionally, they may cause serious bronchospasm in those with asthma. Any patient with asthma should avoid beta-blockers. If necessary, providers can consider cardio-selective beta-blockers but should still use caution.

Non-Potassium-Sparing Diuretics

Beta-agonists, such as salmeterol, can worsen hypokalemia and/or ECG changes caused by non-potassium-sparing diuretics like thiazide or loop diuretics. Providers should use caution when prescribing Albuterol in patients on these types of diuretics.

Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs)

Providers should use caution when prescribing Albuterol with MAOIs or TCAs. Salbutamol’s effect on the vascular system can be increased by these types of medications.

Digoxin

In one study, serum digoxin levels decreased after oral and intravenous administration with salbutamol. Providers, therefore, should carefully monitor serum digoxin levels in those that are taking digoxin concomitantly with albuterol.

Frequently Asked Questions

Albuterol is an inhalation aerosol. It contains 108 mcg of albuterol sulfate for each dose. It is supplied as a blue plastic container with a blue cap. The container has a meter that provides either 60 or 200 metered inhalations. The meter is displayed as a counter on the device.

Before starting Albuterol, let your provider know if:

  • You ever needed to discontinue another medication due to allergy or illness
  • You have an allergy to lactose (milk sugar) or milk protein
  • You are taking medication for a heart problem
  • You are taking medication for high blood pressure
  • You are taking medication for a thyroid problem
  • You have diabetes
  • You have low potassium levels in your blood, known as hypokalemia. This is especially important if you are taking medications such as water pills (diuretics), steroids for asthma, drugs from the xanthine derivative class (e.g., theophylline).
  • You have a medical history that involves seizures
  • You are pregnant or may become pregnant. It is not known what Albuterol’s effect on pregnancy is. Therefore, your physician will need to weigh the benefits and risks of taking Albuterol during pregnancy.
  • You are breastfeeding or may begin breastfeeding. It is unknown if Albuterol can pass into breast milk.

  • If you are not experiencing the same level of relief of chest tightness or wheezing with Albuterol
  • If the effects of Albuterol are lasting less than three hours
  • If you have immediate worsening of wheezing and shortness of breath symptoms. This may mean that your condition is getting worse, and you may require another type of medication to manage your disease.

Children taking Albuterol may see:

  • Alterations to sleep patterns
  • Alterations to behavior, such as hyperactivity, excitability, and restlessness

  • Allergy medications
  • Antidepressants
  • Diuretics (“water pills”)
  • Epinephrine
  • Bronchodilators that open the airway (like other asthma medications)
  • Digoxin (a medication for the heart)
  • Blood pressure medications (e.g., propranolol)

If you are also taking an inhaled corticosteroid, make sure that you:

  • Always take Albuterol first
  • Wait a few minutes after administering Albuterol before taking your inhaled corticosteroid

Albuterol should be kept at room temperature away from moisture and light. Therefore, do not keep Albuterol in the bathroom. You should store your Albuterol with the mouthpiece down. Always keep your inhaler and other medications out of reach from children. Never puncture the canister.

If you take too large of a dose, you may experience side effects. These effects include headaches, shakiness, restlessness, or a fast heartbeat. These side effects should stop within a couple of hours; however, you should still contact your doctor as soon as possible. You could also go to your nearest emergency department or contact the Poison Control Center.

If you forget to take a dose, take a dose whenever you are scheduled to take your next dose or if you start to become wheezy. This will depend on how your doctor directed you to take your inhaler. Sometimes Albuterol is taken at scheduled times and sometimes it is taken as needed for shortness of breath or wheezing.

This will depend on what you are using Albuterol for. Follow the instructions that your doctor gave you on how to take Albuterol. Typically, you should inhale Albuterol every four to six hours as needed. However, your dose will be based on your medical conditions and how well you respond to treatment. For example, if you are taking Albuterol to help with exercise-induced asthma, patients will normally take two puffs 15 to 30 minutes prior to exercising. Do not alter your dose yourself. Taking too much Albuterol can increase your risk for severe side effects.

Certain medications may affect how your Albuterol works. You should maintain a list of all the medications you take, including over the counter and herbal medications. Share this list with your doctor and pharmacist. Never start, stope, or alter your dose without first consulting your doctor.

You should always keep Albuterol on you, as it is a quick-relief inhaler. Keep track of how many inhalations you take. Once you have used all the inhalations on the product package, you should throw away the inhaler. Test sprays should be counted.

It is also important to understand which of your inhalers you should use at which time. Some inhalers are “controller drugs” which may be used every day. Other inhalers are “quick-relief drugs” that should be used only if you suddenly start having trouble breathing.

Learn which of your inhalers you should use every day (controller drugs) and which you should use if your breathing suddenly worsens (quick-relief drugs).