Ventolin HFA Inh W/dos Ctr 200puffs
It is used to open the airways in lung diseases where spasm may cause breathing problems. It is used to prevent breathing problems that happen with exercise.
Drug Class
Bronchodilator
Pharmacologic Class
Selective Beta2-Adrenergic Agonist
Pregnancy Category
Category C
FDA Approved
Aug 1982
DEA Schedule
Not Controlled
Overview
What is this medicine?
Albuterol is a 'rescue inhaler' that helps open up your airways quickly when you have trouble breathing due to asthma or COPD. It works by relaxing the muscles around your airways, making it easier to breathe. It's used for quick relief of symptoms like wheezing, shortness of breath, and coughing, or before exercise to prevent breathing problems.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication effectively, follow your doctor's instructions and read all the information provided. For inhalation into the lungs, use the medication as directed. If you are using multiple inhaled medications, consult your doctor about which one to use first.
Using the Inhaler
If you are using this medication to prevent exercise-induced breathing problems, use it 15 to 30 minutes before exercising.
Always follow the cleaning instructions carefully.
Replace the cap after each use.
Shake the inhaler well before use.
Before using the inhaler for the first time, or if it has not been used for a while, you will need to prime it. Be sure to understand when and how to prime the inhaler. If you have questions, consult your doctor or pharmacist.
If you drop the inhaler, it may need to be primed again. Check with your doctor or pharmacist if you are unsure.
A spacer can be used with the inhaler to make it easier to use.
Some inhalers have a dose counter to track the number of doses remaining. If your inhaler has a dose counter, discard it when the counter reaches "0".
Storing and Disposing of Your Medication
Store the medication at room temperature, protected from light and moisture. Do not store it in a bathroom.
Keep the medication away from cold temperatures.
If the inhaler comes in a foil pouch, store it in the pouch until you are ready to use it.
Protect the medication from heat and sunlight. Do not puncture or burn the inhaler, even if it seems empty.
Missing a Dose
If you use this medication regularly, take a missed dose as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not take two doses at the same time or extra doses.
If you use this medication on an as-needed basis, do not use it more frequently than directed by your doctor.
To use this medication effectively, follow your doctor's instructions and read all the information provided. For inhalation into the lungs, use the medication as directed. If you are using multiple inhaled medications, consult your doctor about which one to use first.
Using the Inhaler
If you are using this medication to prevent exercise-induced breathing problems, use it 15 to 30 minutes before exercising.
Always follow the cleaning instructions carefully.
Replace the cap after each use.
Shake the inhaler well before use.
Before using the inhaler for the first time, or if it has not been used for a while, you will need to prime it. Be sure to understand when and how to prime the inhaler. If you have questions, consult your doctor or pharmacist.
If you drop the inhaler, it may need to be primed again. Check with your doctor or pharmacist if you are unsure.
A spacer can be used with the inhaler to make it easier to use.
Some inhalers have a dose counter to track the number of doses remaining. If your inhaler has a dose counter, discard it when the counter reaches "0".
Storing and Disposing of Your Medication
Store the medication at room temperature, protected from light and moisture. Do not store it in a bathroom.
Keep the medication away from cold temperatures.
If the inhaler comes in a foil pouch, store it in the pouch until you are ready to use it.
Protect the medication from heat and sunlight. Do not puncture or burn the inhaler, even if it seems empty.
Missing a Dose
If you use this medication regularly, take a missed dose as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not take two doses at the same time or extra doses.
If you use this medication on an as-needed basis, do not use it more frequently than directed by your doctor.
Lifestyle & Tips
- Always carry your rescue inhaler with you.
- Use a spacer device as instructed by your doctor to improve drug delivery to the lungs, especially for children or those with difficulty coordinating breathing and actuation.
- Shake the inhaler well before each use.
- Prime the inhaler before first use or if not used for more than 2 weeks by releasing 4 test sprays into the air.
- Clean the mouthpiece regularly as instructed in the package insert.
- Do not exceed the prescribed dose or frequency. If you need to use it more often than prescribed, contact your doctor immediately as it may indicate worsening asthma control.
- Avoid triggers that worsen your breathing problems (e.g., allergens, smoke, cold air).
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
2 inhalations (180 mcg) every 4 to 6 hours as needed for bronchospasm. For exercise-induced bronchospasm, 2 inhalations 15 to 30 minutes before exercise.
Dose Range:
90 - 180 mg
Condition-Specific Dosing:
exercise_induced_bronchospasm:
2 inhalations 15-30 minutes before exercise.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (generally not recommended for routine use under 4 years old without specific guidance)
Child:
4 years and older: 2 inhalations (180 mcg) every 4 to 6 hours as needed for bronchospasm. For exercise-induced bronchospasm, 2 inhalations 15 to 30 minutes before exercise.
Adolescent:
2 inhalations (180 mcg) every 4 to 6 hours as needed for bronchospasm. For exercise-induced bronchospasm, 2 inhalations 15 to 30 minutes before exercise.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended.
Moderate:
No specific adjustment recommended.
Severe:
No specific adjustment recommended; use with caution due to potential for increased systemic exposure.
Dialysis:
Considerations: Albuterol is primarily eliminated renally. Monitor for increased side effects.
Hepatic Impairment:
Mild:
No specific adjustment recommended.
Moderate:
No specific adjustment recommended.
Severe:
No specific adjustment recommended; use with caution due to potential for altered metabolism and increased systemic exposure.
Confidence:
Medium
Pharmacology
Mechanism of Action
Albuterol is a selective beta2-adrenergic agonist. It acts on beta2-adrenergic receptors in the smooth muscle of the bronchi, leading to activation of adenyl cyclase and an increase in intracellular cyclic-3',5'-adenosine monophosphate (cAMP). Increased cAMP levels cause relaxation of bronchial smooth muscle, inhibition of mediator release from mast cells, and some inhibition of microvascular leakage.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 20% (oral bioavailability of swallowed dose); rapid absorption from lungs.
Tmax:
0.5 to 2 hours (systemic absorption after inhalation)
FoodEffect:
Not applicable for inhaled formulation.
Distribution:
Vd:
Not readily available for inhaled form, but widely distributed.
ProteinBinding:
10%
CnssPenetration:
Limited
Elimination:
HalfLife:
3.8 to 5 hours (inhaled)
Clearance:
Not readily available (primarily renal excretion)
ExcretionRoute:
Renal (urine)
Unchanged:
Approximately 69% of a single dose is excreted in urine as unchanged drug and metabolites within 24 hours.
Pharmacodynamics
OnsetOfAction:
5 to 15 minutes
PeakEffect:
30 to 60 minutes
DurationOfAction:
4 to 6 hours
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood pressure, including:
+ Severe headache
+ Dizziness
+ Fainting
+ Changes in eyesight
Signs of low potassium levels, such as:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Chest pain or pressure
Rapid or irregular heartbeat
Severe breathing problems, which can be life-threatening, especially when using an inhaler or liquid for breathing in. This may occur shortly after taking a dose or when using a new canister or vial of this medication. If you experience trouble breathing, worsening breathing, wheezing, or coughing, seek medical help immediately.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or if they persist or bother you, contact your doctor:
Feeling nervous or excitable
Dizziness or headache
Upset stomach or vomiting
Shakiness
Throat irritation
Runny nose
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood pressure, including:
+ Severe headache
+ Dizziness
+ Fainting
+ Changes in eyesight
Signs of low potassium levels, such as:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Chest pain or pressure
Rapid or irregular heartbeat
Severe breathing problems, which can be life-threatening, especially when using an inhaler or liquid for breathing in. This may occur shortly after taking a dose or when using a new canister or vial of this medication. If you experience trouble breathing, worsening breathing, wheezing, or coughing, seek medical help immediately.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or if they persist or bother you, contact your doctor:
Feeling nervous or excitable
Dizziness or headache
Upset stomach or vomiting
Shakiness
Throat irritation
Runny nose
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Increased heart rate or palpitations
- Tremor or shakiness
- Nervousness or anxiety
- Headache
- Dizziness
- Muscle cramps
- Worsening shortness of breath or wheezing after using the inhaler (paradoxical bronchospasm - seek immediate medical attention)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you are currently taking another medication similar to this one. If you are unsure, consult your doctor or pharmacist to determine if the medications are similar.
This list is not exhaustive, and it is crucial to discuss all your medications and health conditions with your doctor. Provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your health problems, including any pre-existing conditions
Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to ensure your safety. It is vital to verify that it is safe to take this medication with all your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you are currently taking another medication similar to this one. If you are unsure, consult your doctor or pharmacist to determine if the medications are similar.
This list is not exhaustive, and it is crucial to discuss all your medications and health conditions with your doctor. Provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your health problems, including any pre-existing conditions
Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to ensure your safety. It is vital to verify that it is safe to take this medication with all your other medications and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. To ensure safe use, do not exceed the prescribed dose or frequency, as overdoses have been fatal. If you experience any concerns, consult your doctor immediately.
If you find that your usual dose is not providing adequate relief, your symptoms are worsening, or you need to use this medication more frequently than prescribed, notify your doctor right away.
If you have diabetes (high blood sugar), it is crucial to closely monitor your blood sugar levels while taking this medication.
Before taking this medication, inform your doctor if you are pregnant, planning to become pregnant, or are breast-feeding. Your doctor will discuss the potential benefits and risks of this medication to both you and your baby, allowing you to make an informed decision.
If you find that your usual dose is not providing adequate relief, your symptoms are worsening, or you need to use this medication more frequently than prescribed, notify your doctor right away.
If you have diabetes (high blood sugar), it is crucial to closely monitor your blood sugar levels while taking this medication.
Before taking this medication, inform your doctor if you are pregnant, planning to become pregnant, or are breast-feeding. Your doctor will discuss the potential benefits and risks of this medication to both you and your baby, allowing you to make an informed decision.
Overdose Information
Overdose Symptoms:
- Exaggerated beta-adrenergic effects: tachycardia, palpitations, chest pain, arrhythmias, tremor, nervousness, headache, dizziness, nausea, vomiting, hypokalemia, hyperglycemia, metabolic acidosis.
What to Do:
Seek immediate medical attention or call a poison control center (1-800-222-1222). Treatment is supportive and symptomatic. Consider a cardioselective beta-blocker if severe, but use with extreme caution in patients with a history of bronchospasm.
Drug Interactions
Major Interactions
- Beta-blockers (e.g., propranolol, carvedilol): May block the bronchodilatory effect of albuterol and produce severe bronchospasm in asthmatic patients. Avoid concomitant use.
- Diuretics (e.g., furosemide, hydrochlorothiazide): May exacerbate ECG changes and/or hypokalemia associated with albuterol, especially at higher doses.
Moderate Interactions
- Monoamine Oxidase Inhibitors (MAOIs) (e.g., phenelzine, selegiline) and Tricyclic Antidepressants (TCAs) (e.g., amitriptyline, imipramine): May potentiate the vascular effects of albuterol, increasing risk of cardiovascular adverse effects. Use with extreme caution or avoid within 14 days of discontinuing MAOIs/TCAs.
- Digoxin: Albuterol may decrease serum digoxin levels. Monitor digoxin levels.
- Other sympathomimetics: Concomitant use may potentiate cardiovascular effects. Use with caution.
Confidence Interactions
Monitoring
Baseline Monitoring
Pulmonary Function Tests (e.g., FEV1, PEF)
Rationale: To assess baseline lung function and severity of asthma/COPD.
Timing: Prior to initiation and periodically.
Heart Rate/Rhythm
Rationale: Albuterol can cause tachycardia and palpitations.
Timing: Prior to initiation, especially in patients with pre-existing cardiovascular conditions.
Routine Monitoring
Frequency of Albuterol Use
Frequency: Daily/Weekly
Target: <2 days/week (excluding exercise-induced bronchospasm)
Action Threshold: If use increases to >2 days/week, it may indicate worsening asthma control and need for reassessment of maintenance therapy.
Symptoms of Bronchospasm (e.g., wheezing, shortness of breath, cough)
Frequency: Daily (patient self-monitoring)
Target: Improvement or resolution of symptoms
Action Threshold: Persistent or worsening symptoms, or increased need for rescue inhaler, requires medical evaluation.
Peak Expiratory Flow (PEF)
Frequency: Daily (patient self-monitoring, if applicable)
Target: Patient's personal best or within green zone
Action Threshold: Significant drop in PEF (e.g., into yellow or red zone) requires action per asthma action plan.
Serum Potassium (K+)
Frequency: Periodically, especially with high doses, concomitant diuretics, or severe asthma exacerbations.
Target: 3.5-5.0 mEq/L
Action Threshold: Hypokalemia (<3.5 mEq/L) may require supplementation or dose adjustment.
Symptom Monitoring
- Wheezing
- Shortness of breath
- Cough
- Chest tightness
- Palpitations
- Tremor
- Nervousness
- Headache
Special Patient Groups
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Category C. Untreated asthma poses a greater risk to the mother and fetus than albuterol.
Trimester-Specific Risks:
First Trimester:
Limited data, but generally considered low risk for congenital malformations.
Second Trimester:
Generally considered safe for use if needed for asthma control.
Third Trimester:
May inhibit uterine contractions (tocolytic effect) at high doses, but this is generally not clinically significant at therapeutic inhaled doses. Monitor for maternal tachycardia.
Lactation
Albuterol is excreted into human milk. Use with caution. The amount transferred is likely small and adverse effects on the infant are not expected at therapeutic doses. Monitor infant for irritability, tremor, or poor feeding.
Infant Risk:
Low risk (L3)
Pediatric Use
Approved for children 4 years and older. Younger children may require a nebulizer or a valved holding chamber with a mask. Close monitoring for side effects (e.g., hyperactivity, tremor) is important.
Geriatric Use
No specific dose adjustment is generally needed. However, elderly patients may be more sensitive to the cardiovascular effects of albuterol (e.g., tachycardia, tremor). Use with caution in patients with underlying cardiovascular disease.
Clinical Information
Clinical Pearls
- Albuterol is a rescue medication, not a controller. Increased use indicates worsening asthma control and necessitates re-evaluation of maintenance therapy.
- Proper inhaler technique is crucial for effective drug delivery. Educate patients on shaking the inhaler, priming, slow deep inhalation, breath-holding, and cleaning.
- Paradoxical bronchospasm (worsening wheezing immediately after use) is rare but serious; discontinue use and seek immediate medical attention.
- Patients should be advised to seek medical attention if their symptoms do not improve or worsen after using albuterol, or if they need to use it more frequently than usual.
- Hypokalemia can occur, especially with high doses or in patients on diuretics; monitor potassium levels in at-risk patients.
Alternative Therapies
- Other short-acting beta2-agonists (SABAs) like levalbuterol (Xopenex HFA)
- Long-acting beta2-agonists (LABAs) for maintenance (e.g., salmeterol, formoterol) - *not for acute relief*
- Inhaled corticosteroids (ICS) for maintenance (e.g., fluticasone, budesonide) - *not for acute relief*
- Combination ICS/LABA inhalers for maintenance (e.g., fluticasone/salmeterol, budesonide/formoterol) - *not for acute relief*
- Systemic corticosteroids for severe exacerbations
- Anticholinergics (e.g., ipratropium) for COPD or severe asthma exacerbations
Cost & Coverage
Average Cost:
$30 - $70 per 200-puff inhaler
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (often preferred generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.