Albuterol: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on July 4, 2023.

1. How it works

• Albuterol is a bronchodilator - this means it relaxes muscles in the airways, widening them and allowing more air to flow into the lungs.
• Albuterol works preferentially on beta2 receptors, which are the predominant receptors in the smooth muscle of the bronchi (the breathing tubes). Activation of these receptors leads to the relaxation of the smooth muscle from the trachea to the end of the bronchial tree. Albuterol stimulates the production of an important cellular messenger called cyclic AMP, which relaxes smooth muscle and prevents the release of histamine and other mediators from mast cells within the airways.
• Albuterol belongs to the class of medicines known as bronchodilators. It is also called a short-acting beta-agonist (SABA).

2. Upsides

• Used to treat or prevent bronchospasm in adults and children over the age of 6 with asthma (reversible obstructive airway disease). This allows patients to breathe easier (relieves bronchospasm).
• Also useful for treating exercise-induced bronchospasm.
• May be used to relieve symptoms of chronic obstructive pulmonary disease (COPD). May be given in combination with ipratropium bromide.
• Regular use of albuterol in people with COPD (in contrast to people with asthma) does not appear to be detrimental.
• Available as an inhaler, a nebulizing solution, an oral solution, and as conventional tablets and extended-release tablets.
• Generic albuterol inhalers, nebulizing solutions, and tablets are available.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Tremor, headaches, and nervousness.
• May sometimes affect heart rate and blood pressure, possibly causing chest pain and palpitations. This is because beta2 receptors are also present in the heart, at concentrations of approximately 10-50%. Seek medical advice if these side effects occur. ECG changes have also been reported.
• Albuterol may not be suitable for some people with cardiovascular disease, arrhythmia, high blood pressure, seizures, or an overactive thyroid.
• May aggravate diabetes and cause low potassium levels.
• Very rarely, may cause paradoxical bronchospasm (instead of opening the airways it closes them). Discontinue immediately and contact emergency services.
• May interact with other drugs including antidepressants, beta-blockers, diuretics, and digoxin.
• Nebulizers should be properly cleaned as per the manufacturer's instructions to avoid microbial contamination.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Albuterol helps people with asthma and certain other breathing disorders to breathe easier. While it is effective at relieving symptoms of asthma, it does not prevent asthma from getting worse.

5. Tips

• If you use an albuterol inhaler, ask your pharmacist or doctor to check that you are using it correctly. You will need to prime your inhaler before you first use it, or if you haven't used it for a long time, by test spraying (three for ProAir HFA: four times for Ventolin HFA or Proventil HFA) into the air. Always test spray Ventolin HFA if you have dropped it. Follow the instructions provided with the inhaler.
• To use the inhaler, exhale slowly and place the mouthpiece of the inhaler well into the mouth with the lips closed around it. As you push down on the inhaler, inhale slowly and deeply through the mouth. Hold your breath for as long as possible, withdraw the mouthpiece, and exhale slowly. Allow 1 minute between doses if you are prescribed two doses at once.
• Most inhalation devices require regular cleaning or else they will clog. Follow the instructions provided on how to clean your device and mouthpiece. Discard the canister when the number of actuations left reads zero.
• Store your device at room temperature away from heat, cold, open flames, and moisture. Do not puncture or burn an empty canister.
• Before using your inhaler, shake it well. Avoid spraying into the eyes. Rinse your eyes with water if this happens by accident.
• Albuterol extended-release tablets should be swallowed whole and not chewed or crushed.
• Albuterol relieves breathlessness but does not reduce inflammation. Needing to use albuterol more frequently than usual may be a sign that your asthma is destabilizing and you should seek immediate medical advice for a re-evaluation of your treatment regimen and the possible need for anti-inflammatory treatment (such as corticosteroids) to heal the airways. Deterioration of asthma can occur quite quickly over several hours, or it may take days or weeks.
• Albuterol alone is usually not enough to achieve good asthma control in most adults and children with asthma. Corticosteroids (such as budesonide [Pulmicort] or fluticasone [Flovent]) are often also needed.
• Always keep albuterol on hand at all times, and refill your prescription before you run out completely. Keep using all other medications as prescribed by your doctor.
• Seek emergency help if you have signs of an allergic reaction (breathing difficulties, facial swelling, hives), chest pain or fast heart rate, pain or burning when you urinate, signs of high blood sugar (increased thirst, increased urination, hunger, dry mouth), or signs of low potassium (such as leg cramps, irregular heartbeat).

6. Response and effectiveness

• Effects of albuterol usually last four to six hours, sometimes eight hours or longer. Unless your doctor has told you to, resist the temptation to increase the dose of albuterol or to take it more frequently if the effects appear to be wearing off sooner. Instead, seek medical attention immediately, as this can be a sign of deteriorating asthma control that can be masked by albuterol overuse.
• Albuterol can also be fatal if too much is taken. If you think somebody has taken too much albuterol, seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

7. Interactions

Medicines that interact with albuterol may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with albuterol. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with albuterol include:

• antibiotics, such as azithromycin
• antidepressants, such as amitriptyline, imipramine, or nortriptyline
• astemizole
• atomoxetine
• beta-blockers, such as atenolol or carvedilol
• digoxin
• diuretics, such as furosemide or HCTZ
• epinephrine
• linezolid
• medicines that increase the QT-interval, such as haloperidol
• monoamine oxidase inhibitors, such as selegiline, isocarboxazid, or phenelzine
• ondansetron
• other inhaled bronchodilators.

Note that this list is not all-inclusive and includes only common medications that may interact with albuterol. You should refer to the prescribing information for albuterol for a complete list of interactions.

References

• Albuterol. Revised 06/2023. Chartwell RX, LLC https://www.drugs.com/pro/albuterol.html

Further information

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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