Albuterol

• Type of Drug: Bronchodilator.
• Prescribed for: Asthma and bronchial spasms.

General Information

Albuterol is similar to other bronchodilator drugs, such as Metaproterenol and Isoetharine, but it has a weaker effect on nerve receptors in the heart and blood vessels; therefore, it is somewhat safer for people with heart conditions.

Albuterol tablets and syrup begin to work within 30 minutes and continue working for up to 8 hours. There is also a long-acting tablet preparation JRepetabs) that continues to work for up to 12 hours. Albuterol inhalation begins working within 5 minutes and continues for 3 to 8 hours.

Cautions and Warnings

Albuterol should be used with caution by people with a history of angina (chest tightness/pain), heart disease, high blood pressure, stroke or seizure, diabetes, thyroid disease, prostate disease, or glaucoma. Excessive use of Albuterol inhalants can lead to worsening of asthmatic or other respiratory conditions, and can lead to increased breathing difficulty, instead of providing breathing relief. In the most extreme cases, people have had heart attacks after using excessive amounts of inhalant.

Animal studies with Albuterol have revealed a significant increase in certain kinds of tumors.

Possible Side Effects

Albuterol’s side effects are similar to those of other bronchodilators, except that its effects on the heart and blood vessels are not as pronounced.

• Most common: restlessness, weakness, anxiety, fear, tension, sleeplessness, tremors, convulsions, dizziness, headache, flushing, appetite changes, pallor, sweating, nausea, vomiting, and muscle cramps.
• Less common: angina, abnormal heart rhythms, rapid heartbeat and heart palpitations, high blood pressure, feelings of ill health, irritability and emotional instability, nightmares, aggressive behavior, bronchitis, stuffed nose, nosebleeds, increased sputum, conjunctivitis (“pink-eye”), tooth discoloration, voice changes, hoarseness, and urinary difficulty.

Drug Interactions

• • Albuterol’s effects may be increased by monoamine oxidase (MAO) inhibitor drugs, tricyclic antidepressants, thyroid drugs, other bronchodilator drugs, and some antihistamines.
  • The chance of cardiotoxicity may be increased in people taking Albuterol and Theophylline. Albuterol is antagonized by beta-blocking drugs (Propranolol and others). Albuterol may antagonize the effects of blood-pressure-lowering drugs, especially Reserpine, Methyldopa, and Guanethidine.
  • Albuterol may reduce the amount of Digoxin in the blood of people taking both drugs. This could result in the need to adjust the Digoxin dose.

Food Interactions

Albuterol tablets are more effective when taken on an empty stomach; or 1 hour before or 2 hours after meals, but can be taken with food if they, upset your stomach. Do not inhale Albuterol if you have food or anything else in your mouth.

Usual Dose

Inhalation Aerosol
Adult and Adolescent (age 12 and older) (for Ventolin, Adult and Child age 4 and older): 1 or 2 puffs every 4 to 6 hours (each puff delivers 90 micrograms of Albuterol). Asthma brought on by exercise may be prevented by taking 2 puffs 15 minutes before exercising.

Inhalation Solution
Adult and Adolescent (age 12 and older): 2.5 mg 3 or 4 times per day. (Dilute 0.5 milliliters of the 0.5% solution with 2.5 milliliters of sterile saline.) Deliver over 5 to 15 minutes by nebulizer.

Inhalation Capsules
Adult and Child (age 4 and older): 200 to 400 micrograms inhaled every 4 to 6 hours using a special Rotahaler device. Adults and adolescents (age 12 and over) may prevent asthma brought “on by exercise by inhaling, a single 200- microgram dose 15 minutes before exercising.

Tablets

• Adult and Adolescent (age 12 and older): 6 to 16 mg per day in divided doses to start; the dosage may be slowly increased until the asthma is controlled to a maximum of 32 mg per day.
• Senior: 6 to 8 mg per day in divided doses to start, but increase to the maximum daily adult dosage, if tolerated.
• Child (age 6 to 14 years): 6 to 8 mg a day in divided doses to start, up to a maximum daily dose of 24 mg.
• Child (age 2 to 5 years): up to 4 mg, 3 times per day.

Extended-Release Tablets
Adult and Adolescent (age 12 and older): 4 to 8 mg every 12 hours. Dosage may be cautiously increased to a maximum of 32 mg a day. People being switched from regular to extended- release tablets generally take the same amount per day, but in fewer tablets, i.e., one 4-mg tablet every 12 hours (1 dose) instead of a 2-mg tablet every 6 hours (2 doses).

Overdosage

Overdose of Albuterol inhalation usually results in exaggerated side effects, including heart pains and high blood pressure, although the pressure may drop to a low level after a short period of elevation. People who inhale too much Albuterol should see a doctor, who may prescribe a beta- blocking drug (such as Metoprolol or Atenolol) to counteract the overdose effect.

Overdose of Albuterol tablets is more likely to lead to side effects: changes in heart rate, palpitations, unusual heart rhythms, heart pains, high blood pressure, fever, chills, cold sweats, nausea, vomiting, and dilation of the pupils. Convulsions, sleeplessness, anxiety, and tremors may also develop, and the victim may collapse.

If the overdose was taken within the past half hour, give the victim Syrup of Ipecac to induce vomiting. DO NOT GIVE SYRUP OF IPECAC IF THE VICTIM IS UNCONSCIOUS OR CONVULSING. If symptoms have begun to develop, the victim may need to be taken to a hospital emergency room (call for instructions). ALWAYS bring the prescription bottle.

Special Information

If you are inhaling Albuterol, be sure to follow the inhalation instructions that come with the product. The drug should be inhaled during the second half of your breath, allowing it to reach deeper into your lungs. Wait about 5 minutes between puffs, if you use more than 1 puff per dose.

Do not take more Albuterol than prescribed by your doctor. Taking more than you need could actually worsen your symptoms. If your condition worsens rather than improves after taking your dose, stop taking it and call your doctor at once.

Call your doctor immediately if you develop chest, pains, palpitations, rapid heartbeat, muscle tremors, dizziness, headache, facial flushing, or urinary difficulty, or if you continue having breathing difficulty after taking the medicine.

If a dose of Albuterol is forgotten, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten one. Do not take a double dose.

Special Populations

Pregnancy/Breast-feeding
When used during labor and delivery, Albuterol can slow or delay natural labor. It can Cause rapid heartbeat and high blood sugar in the mother and rapid heartbeat and low blood sugar in the baby.
It is not known if Albuterol causes birth defects in humans, but it has caused birth defects in animal studies. When it is deemed essential, the potential risks of taking Albuterol must be carefully weighed against any potential benefits.
It is not known if Albuterol passes into breast milk. Nursing mothers must look for any possible drug effect on their infants if taking this>medication. You may want to consider bottle-feeding your infant.

Seniors
Older adults are more sensitive to the effects of Albuterol. Closely follow your doctor’s directions and report any side effects at once.