How does this medication work? What will it do for me?

Salbutamol belongs to a class of medications called bronchodilators, and more specifically, β2-adrenergic agonists. This medication is used to treat asthma, chronic bronchitis, and other breathing disorders.

Inhaled salbutamol is also used to prevent asthma attacks caused by exercise. It works by relaxing the muscles in the walls of the small airways in the lungs. This helps to open up the airways and make breathing easier.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

Each mL of solution for inhalation contains: salbutamol sulfate equivalent to salbutamol 5 mg. Nonmedicinal ingredients: benzalkonium chloride, sulfuric acid, and water for injection.

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How should I use this medication?

Aerosol inhaler: The usual dose to relieve asthma symptoms is 1 to 2 inhalations (also called "puffs") for people 12 years of age and older, and 1 puff for children 6 to 11 years of age. More puffs may be needed to relieve symptoms during a more severe attack.

The usual dose for long-term treatment of asthma is 1 to 2 puffs (or 1 puff in children 4 years and older) 4 times per day. The maximum daily dose is 8 puffs for adults and 4 puffs for children.

For preventing exercise-induced asthma, the usual dose is 2 puffs before exercise for adults and 1 puff before exercise for children.

Nebulizer solution: For people over 12 years of age, the usual dose is 2.5 mg to 5.0 mg up to 4 times per day. For children 5 to 12 years of age, the usual dose is 2.5 mg up to 4 times a day.

Diskus: The usual dose to relieve asthma symptoms for adults and children 4 years and older is 1 inhalation as needed. The usual dose for long-term treatment of asthma is 1 inhalation 3 to 4 times per day. The maximum daily dose is 4 puffs per day. For preventing exercise-induced asthma, the usual dose is 1 inhalation 15 minutes before exercise.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

To ensure administration of the proper dose of this medication, make sure you are instructed by your doctor, pharmacist, or other health care professional in the proper use of the inhaler, Diskus, or nebulizer systems.

The use of these inhalation systems by children depends on the ability of the individual child to learn the proper use of the devices. During inhalation, children should be assisted or supervised by an adult who knows how to use these devices properly. For inhalers, your doctor may recommend a spacer device to help ensure the medication is used properly.

It is very important not to exceed the prescribed dose. If the effects of this medication last for less than 3 hours or if you notice a sudden worsening of your breathing, contact your doctor immediately. If you need to use this medication more than usual, contact your doctor.

Always keep your salbutamol inhaler with you to use immediately for an asthma attack.

It is important to use this medication exactly as prescribed by your doctor. If you are using inhaled salbutamol on a schedule and you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children. The contents of the canister of the inhaler are under pressure and may explode if heated. Do not place it in hot water, near radiators, stoves, or other sources of heat. The Diskus should be stored in a dry place at a temperature not more than 30°C. The respirator solution and nebules should be protected from light. Respirator solution that has not been used within 1 month of opening the container should be discarded appropriately.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use inhaled salbutamol if you:

  • are allergic to salbutamol or any ingredients of the medication
  • are allergic to lactose, milk protein or milk (for Diskus only)
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What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • coughing
  • difficulty sleeping
  • dizziness
  • drowsiness
  • dry or irritated throat
  • faster heartbeat (usually temporary)
  • fatigue
  • flushing
  • headache
  • irritability
  • nausea
  • nervousness
  • restlessness
  • tremor (shakiness)
  • viral infections of the nose and throat (fever, sore throat, runny nose)
  • weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • difficulty urinating
  • increased blood pressure
  • muscle cramps
  • sensation of spinning
  • signs of decreased levels of potassium in the blood (e.g., irregular or pounding heartbeat, persistent muscle cramps, muscle pain or weakness)
  • vomiting

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain or discomfort
  • severe dizziness
  • symptoms of a severe allergic reaction (e.g., hives; swelling of lips, face, tongue, or throat; difficulty breathing; fainting; increased wheezing or chest tightness)
  • worsening breathing problems

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

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Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Asthma control: If your usual dose of this medication no longer seems to work as well or if you are using more than usual, your asthma could be worsening. Contact your doctor if this happens.

Diabetes: Salbutamol given by a nebulizer can increase blood sugar levels. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Difficulty breathing: For some people, this medication and other inhaled medications can cause difficulty breathing and increased wheezing. If this happens, stop using this medication and get immediate medical attention.

Heart conditions: Salbutamol can cause heart complications when used by people with heart conditions such as heart disease, abnormal heart rhythms, and high blood pressure.

If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Low blood potassium: Salbutamol can cause low potassium levels in the blood. If you experience weakness, tiredness, muscle cramps, nausea, or vomiting while receiving this medication, let your doctor know. Your doctor will monitor your potassium levels with blood tests if needed.

Seizures: Salbutamol can increase the risk of seizures, especially for people with a history of seizure disorders. If you have a seizure disorder, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Thyroid disease: Salbutamol can increase the activity of the thyroid gland. This can become a problem for people who have an overactive thyroid gland.

If you have hyperthyroidism (a condition where the thyroid is overactive), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Use of anti-inflammatory agents: According to current practice guidelines for treating asthma, anti-inflammatory medications (e.g., corticosteroids such as inhaled beclomethasone, budesonide, or fluticasone) should also be used if you are using more than 3 doses of salbutamol a week (not including its use before exercise). If your asthma becomes worse (you need to use salbutamol more often or it stops working), contact your doctor.

Pregnancy: Although salbutamol is often used during pregnancy, there are no well-controlled studies to show its safety. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor.

Breast-feeding: It is not known if salbutamol passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using the inhaler form of salbutamol have not been established for children less than 4 years of age. The safety and effectiveness of using the nebulizer solution have not been established for children less than 5 years of age. All children should be supervised by an adult when using this medication.

Very rarely, this medication may cause hyperactivity, sleeping problems, and behavioural changes in children. If this occurs, contact the child's doctor.

Seniors: Seniors may be more likely to experience low blood potassium or heart problems with salbutamol. Your doctor may suggest a lower dose to reduce the risk of these problems.

What other drugs could interact with this medication?

There may be an interaction between salbutamol and any of the following:

  • aminophylline
  • atomoxetine
  • beta-blockers (e.g., propranolol, labetolol, nadolol, sotalol)
  • betahistine
  • caffeine
  • carvedilol
  • certain diuretics (e.g., hydrochlorothiazide, furosemide)
  • dextroamphetamine
  • digoxin
  • dipivefrine
  • dobutamine
  • dopamine
  • epinephrine
  • methylphenidate
  • monoamine oxidase inhibitors (e.g., phenelzine, tranylcypromine, moclobemide, selegiline)
  • nabilone
  • naphazoline
  • norepinephrine
  • other bronchodilators (e.g., salmeterol, terbutaline)
  • oxymetazoline
  • phenylephrine
  • pseudoephedrine
  • theophylline
  • tricyclic antidepressants (e.g., amitriptyline, desipramine, nortriptyline)
  • xylometazoline

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.