Salbutamol

Generic name: Salbutamol
Dosage form: metered-dose aerosol inhalation (inhaler), inhalation powder (dry powder inhaler), solution for inhalation, oral syrup, oral tablet, intravenous (infusion) injection, intravenous (bolus) injection, subcutaneous injection, intramuscular injection

Usage of Salbutamol

SalbUTAmol (albuterol) is a medication used to relax and open up your airways. It is used to relieve wheezing, coughing, chest tightness and breathlessness in people with asthma and chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

Salbutamol is a fast-acting bronchodilator and reliever medication. It belongs to a class of medications known as short-acting beta-2 adrenergic agonist. Salbutamol works by stimulating the beta-2 adrenoceptors in your bronChial muscles, which are the smooth muscles lining the two large tubes (bronchi) that carry air from your windpipe (trachea) to your lungs. This causes your bronchi to relax and dilate, widening your airway for a short period of about 4 to 6 hours and making it easier for you to breathe. It can also act on beta-2 adrenoceptors in your uterus (womb).

Branded and generic formulations of salbutamol are available worldwide. In many countries this medication is known by the generic name salbutamol, which is the generic name assigned using the International Nonproprietary Name (INN) system. In the US, however, salbutamol is known by the name albuterol (ProAir, Ventolin), which is the generic name assigned using the United States Adopted Names (USAN) system. Usually the INN and USAN names for a drug are the SAMe.

Salbutamol became available in the UK in the late 1960s and in the US in the 1980s. Salbutamol and albuterol are both marketed under the brand name Ventolin.

Salbutamol side effects

Serious side effects of salbutamol include:

  • Allergic Reactions. If you have an allergic reaction, stop taking this medication and see a doctor straight away. Signs of an allergic reaction include swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, itchy rash, feeling faint and light headed (due to low blood pressure), and collapse. Talk to your doctor as soon as possible if:
  • you feel your heart is beating faster or stronger than usual (palpitations). This is usually harmless, and usually stops after you have used the medicine for a while
  • you may feel your heartbeat is uneven or it gives an extra beat Do not stop using this medicine unless told to do so.
  • Tell your doctor if you have any of the following side effects which may also happen with this medicine:

  • Common side effects of salbutamol include:
  • feeling shaky
  • headache
  • muscle cramps
  • Rare and very rare side effects of salbutamol include:
  • Your heart beats too fast, too slow or irregularly (cardiac arrhythmia)
  • A low level of potassium in your blood (hypokalemia)
  • Increased blood flow to your extremities (peripheral dilatation)
  • Changes in sleep patterns and changes in behavior, such as restlessness and excitability
  • Muscle tension
  • The following side effects can also happen but the frequency of these are not known:
  • Chest pain, due to heart problems such as angina. Tell your doctor, nurse or pharmacist if this occurs. Do not stop using this medicine unless told to do so.
  • Lactic acidosis has also been reported very rarely in patients receiving intravenous and nebulized salbutamol therapy for the treatment of acute asthma exacerbation.

    Salbutamol injections and infusions have also uncommonly been associated with pulmonary edema.

    These are not all of the possible side effects of salbutamol.

    Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

    Before taking Salbutamol

    Tell your doctor if you are pregnant or are planning to get pregnant. Your doctor will tell you whether or not you should take salbutamol during pregnancy. Tell your doctor if you are breastfeeding of planning to breastfeed. Salbutamol's use in people who are breastfeeding is not recommended unless the expected benefits outweigh any potential risk. It is not known whether salbutamol in breast milk has a harmful effect on the neonate.

    How to use Salbutamol

    The recommended dose of salbutamol Depends on the age of the patient, condition being treated and the formulation being used.

    A general guide to the recommended doSage is given below.

    Asthma symptoms and bronchospasm

  • Salbutamol inhaler 100 micrograms (mcg) per dose:
  • Adults: 1-2 puffs every 4 hours up to 4 times (8 puffs) in 24 hours to relieve symptoms. To prevent symptoms caused by exercise or other triggers, the recommended dose is 2 puffs 15 minutes before exposure.
  • Children: 1 puff (increased to 2 puffs if required) every 4 hours up to 4 times (8 puffs) in 24 hours to relieve symptoms. To prevent symptoms caused by exercise or other triggers, the recommended dose is 1 puff (increased to 2 puffs if required) 15 minutes before exposure.
  • Salbutamol dry powder inhaler 200 mcg per dose:
  • Adults, adolescents aged 12 years and over and children 4 to 11 years of age: 1 inhalation up to 4 times per day to relieve symptoms. To prevent symptoms caused by exercise or other triggers, the recommended dose is 1 inhalation 10 to 15 minutes before exposure.
  • Salbutamol oral syrup 2 mg/5 ml:
  • Adults (over 18 years old): The usual dose is 5 ml to 20 ml, up to 4 times a day.
  • Children over 12 years old: The usual dose is 5 ml to 10 ml, 3 or 4 times a day.
  • Children aged between 6 and 12 years: The usual dose is 5 ml, 3 or 4 times a day.
  • Children aged between 2 and 6 years: The usual dose is 2.5 ml to 5 ml, 3 or 4 times a day.
  • Elderly (over 65 years old): The usual dose is 5 ml, up to 3 times a day.
  • Salbutamol tablets 2mg and 4mg:
  • Adults: The recommended dose is 4mg 3 or 4 times a day. Your doctor may increase this gradually up to a maximum of 8mg three or four times a day. Some patients may be treated successfully with 2mg three or four times a day.
  • Children over 12 years old: The recommended dose is 2 mg to 4 mg 3 or 4 times a day.
  • Children aged between 6 and 12 years: The recommended dose is 2 mg 3 or 4 times a day
  • Children aged between 2 and 6 years: The recommended dose is 1 to 2 mg 3 or 4 times a day.
  • Elderly or patients known to be sensitive to this product or other similar drugs: The recommended dose is initially 2 mg 3 or 4 times a day.
  • Salbutamol respirator solution 5 mg/ml - for use with nebulizer:
  • Intermittent treatment - Adults and adolescents aged 12 years and over: The usual dose is 0.5 ml to 1 ml of respirator solution (2.5 to 5 mg salbutamol). Some patients may require up to 2 ml (10 mg salbutamol).
  • Intermittent treatment - Children aged 18 months to 12 years: The usual dose is 0.5 ml to 1 ml (2.5 to 5 mg salbutamol) of Ventolin Respirator Solution.
  • Intermittent treatment may be given up to 4 times per day.
  • Continuous treatment: The usual dose is 1 to 2 mg of salbutamol per hour. This dose can be obtained by diluting 1 or 2 ml of respirator solution to 100 ml with sterile normal saline solution to produce a solution containing 50 or 100 micrograms/ml of salbutamol, and inhaling the mist from a suitable nebulizer.
  • Severe bronchospasm and status asthmaticus

  • Salbutamol injection 500 micrograms/ml:
  • Adults: The recommended dose for suBCutaneous or intramuscular injection is 500 micrograms (8 micrograms/kg bodyweight) and repeated every 4 hours as required.
  • Salbutamol solution for infusion 5mg/5ml:
  • Adults: The recommended dose is 250 micrograms (4 micrograms/kg bodyweight) injected slowly. If necessary the dose may be repeated. 250 micrograms in 5 mL (50 micrograms/mL) is a suitably dilute preparation for slow intravenous injection. In status asthmaticus, infusion rates of 3 to 20 micrograms per minute are generally adequate but in patients with respiratory failure, higher dosage has been used with success. A starting dose of 5 micrograms per minute is recommended with appropriate adjustment in dosage according to patient response.
  • Preterm labor

  • Salbutamol solution for infusion 5mg/5ml:
  • Infusion rates of 10-45 micrograms per minute are generally adequate to control uterine contractions but greater or lesser infusion rates may be required according to the strength and frequency of contractions.
  • See the full prescribing details for more information about salbutamol dosing.

    Warnings

    If your breathing suddenly becomes more difficult after using salbutamol, contact your healthcare provider immediately.

    If you need to use this medication more frequently than usual, this can be a sign that your breathing condition is getting worse. Follow your treatment action plan or contact your healthcare provider for advice.

    What other drugs will affect Salbutamol

    Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your doctor if you are taking any of the medicines listed below:

  • Corticosteroids, such as beclometasone dipropionate for your asthma
  • Diuretics or water tablets, such as furosemide
  • Medicine to reduce blood pressure, such as atenolol or propranolol
  • Medicines to control an irregular heart beat/rhythm (digoxin), or very fast pulse
  • Tablets prescribed for your asthma to help your breathing, including xanthine derivatives (theophylline, aminophylline)
  • Certain medications for depression including moclobemide, phenelzine, amitriptyline, clomipramide or Imipramine
  • Some general anaesthetics may interact with salbutamol to cause heart problems and decrease blood pressure. If you are having an operation, advise hospital staff that you are taking salbutamol.

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