Albuterol

BRAND NAMES: Ventolin; Proventil

Albuterol is a bronchodilator used in treating asthma and other conditions with reversible airway obstruction. Asthma is a breathing problem involving widespread narrowing of the airways (bronchial tubes). Airways are breathing passages that allow air to move in and out of the lungs. These airways can be narrowed due to the accumulation of mucus, spasm of the muscles that surround these airways, or swelling of the lining of the airways. Airway narrowing leads to shortness of breath, wheezing, cough, and congestion. Albuterol dilates bronchial airways by relaxing the surrounding bronchial muscles. Albuterol can also be helpful in patients with emphysema and chronic bronchitis when their symptoms are partially related to reversible airway obstruction....

Why is this medication prescribed?

Albuterol is used to prevent and treat wheezing, shortness of breath, and troubled breathing caused by asthma, chronic bronchitis, emphysema, and other lung diseases. Albuterol inhalation also is used to prevent breathing difficulties (bronchospasm) during exercise. Albuterol is in a class of medications called beta-agonists. It works by relaxing and opening air passages in the lungs, making it easier to breathe.

How should this medicine be used?

Albuterol comes as a tablet, extended-release (long-acting) tablet, and a syrup to take by mouth and as an aerosol, a solution (liquid), and a powder-filled capsule to inhale by mouth. The solution is inhaled using a nebulizer, and the powder-filled capsules are inhaled using a special dry powder inhaler. Albuterol tablets and syrup are usually taken three or four times a day, and extended-release tablets are usually taken twice a day. For the treatment or prevention of asthma symptoms, the oral inhalation is usually used every 4 to 6 hours as needed. For the prevention of bronchospasm during exercise, the oral inhalation is used 15 minutes before exercise. The nebulized solution is used three or four times a day.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take albuterol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release tablets whole; do not split, chew, or crush them.

Albuterol controls symptoms of asthma and other lung diseases but does not cure them. Do not stop taking albuterol without talking to your doctor.

Before you use the albuterol inhaler for the first time, read the written instructions that come with it. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler while he or she watches.

Before using the aerosol inhaler for the first time and any time it has not been used in more than 4 weeks, ''test spray'' the inhaler. Do this by spraying 4 times into the air.

To use the aerosol inhaler, follow these steps:

• Shake the inhaler well.
• Remove the protective cap.
• Exhale (breathe out) as completely as possible through your nose while keeping your mouth shut.
• Open Mouth Technique: Open your mouth wide, and place the open end of the mouthpiece about 1-2 inches from your mouth.Closed Mouth Technique: Place the open end of the mouthpiece well into your mouth, past your front teeth. Close your lips tightly around the mouthpiece.
• Take a slow, deep breath through the mouthpiece and, at the same time, press down on the container to spray the medication into your mouth. Be sure that the mist goes into your throat and is not blocked by your teeth or tongue. Adults giving the treatment to young children may hold the child's nose closed to be sure that the medication goes into the child's throat.
• Hold your breath for 5-10 seconds, remove the inhaler, and exhale slowly through your nose or mouth. If you take two puffs, wait 2 minutes and shake the inhaler well before taking the second puff.
• Replace the protective cap on the inhaler.
• After each treatment, rinse your mouth with water or mouthwash.

If you have difficulty getting the medication into your lungs, a spacer (a special device that attaches to the inhaler) may help; ask your doctor, pharmacist, or respiratory therapist for more information.

Use only the adapter that comes with your canister. Do not use the adapter with any other product canister.

To use the dry powder inhaler, follow these steps:

• Remove the inhaler from its container and check to make sure it is clean and dry. Make sure that there are no objects in the mouthpiece.
• Keep the inhaler upright and hold the darker-colored end in one hand. Turn the lighter-colored end as far as it can go in either direction.
• Take a powder-filled capsule from its pack and place the clear (thinner) end of the capsule in the raised hole in the lighter-colored end of the inhaler. If there is a used capsule shell in the inhaler, it will be pushed into the chamber.
• Push the new capsule in until it is even with the top of the hole in the inhaler.
• Hold the inhaler level (horizontally) with the white dot uppermost, and turn the lighter-colored end (where the capsule was put in) as far as it will go in the opposite direction. This will open the capsule.
• Keep the inhaler level. Breathe out as far as you comfortably can. Raise the inhaler to your mouth and gently put the mouthpiece (darker-colored end) between your teeth and lips. Do not push the inhaler further inside your mouth than your teeth.
• Hold the dark blue part of the inhaler so you won't accidentally inhale the device.
• Breathe in through your mouth as quickly and as deeply as you comfortably can.
• Hold your breath for a short time, then remove the inhaler from your mouth and breathe out.
• If your doctor has told you to inhale 2 capsules, repeat steps 2-9.

Other uses for this medicine

Inhaled albuterol also is used sometimes to treat or improve muscle paralysis in patients with a condition that causes occasional paralysis and to treat high potassium levels in patients with kidney failure. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking albuterol,

• tell your doctor and pharmacist if you are allergic to albuterol or any other medications.
• tell your doctor and pharmacist what prescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); digoxin (Lanoxin); diuretics ('water pills'); and other inhaled medications used to relax the air passages. Also tell your doctor or pharmacist if you are taking the following medications or who have stopped taking them within the past two weeks: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); and monoamine oxidase (MAO) inhibitors, including phenelzine (Nardil) and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor and pharmacist what nonprescription medications you are taking, including ephedrine, phenylephrine, phenylpropanolamine, and pseudoephedrine. Many nonprescription products contain these medications (e.g., diet pills and medications for colds and asthma), so check labels carefully. Do not take any of these medications without talking to your doctor (even if you never had a problem taking them before).
• tell your doctor if you have or have ever had an irregular heartbeat, heart disease, high blood pressure, narrowing of the digestive tract (for the extended-release product only), an overactive thyroid gland (hyperthyroidism), diabetes, or seizures.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking albuterol, call your doctor.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Albuterol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• tremor
• nervousness
• shakiness
• dizziness
• excitement
• headache
• difficulty falling asleep or staying asleep
• nosebleed
• increased appetite
• upset stomach
• vomiting
• stomach pain
• muscle cramps
• cough
• dry mouth (inhalation only)
• throat irritation (inhalation only)

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• rapid, pounding, or irregular heartbeat
• chest pain or discomfort
• severe rash
• hives
• itching
• increased difficulty breathing
• difficulty swallowing
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness

Albuterol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. Avoid puncturing the aerosol container, and do not discard it in an incinerator or fire.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• seizures
• chest pain
• rapid heartbeat
• irregular heartbeat
• nervousness
• headache
• tremor
• dry mouth
• upset stomach
• dizziness
• excessive tiredness
• lack of energy
• difficulty falling asleep or staying asleep

What other information should I know?

Call your doctor if you find that albuterol becomes less effective at relieving your symptoms, your symptoms become worse, or you need to take albuterol more often. These may be signs that your asthma is getting worse.

Keep all appointments with your doctor.

To relieve dry mouth or throat irritation caused by albuterol inhalation, rinse your mouth with water, chew gum, or suck sugarless hard candy after using albuterol.

Inhalation devices require regular cleaning. Once a week, remove the medication container from the plastic mouthpiece, wash the mouthpiece with warm tap water, and dry it thoroughly.

The extended-release tablet does not dissolve in the stomach after swallowing. It slowly releases the medicine as it passes through your digestive system. You may notice the tablet coating in your stool.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

Brand names of combination products

Other names

• Salbutamol