Albuterol
VENTOLIN
Pronunciation: al-BYOO-ter-ol (VENT-oe-lin)
“Albert, all Ventilated”
Bananas dispersing → ↓ serum potassium
What it isShort-acting beta-2 agonist; rescue bronchodilation in asthma and COPD.
Why this oneIt is the inexpensive racemic rescue standard; levalbuterol rarely offers a meaningful clinical advantage.
What limits itFrequent need signals inadequate asthma control. Tremor and tachycardia are common; repeated high use can lower potassium.
FDA-approved for
- asthma/bronchospasm (1981)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Bronchospasm (treatment or prevention; reversible obstructive airway disease) | Adults & children ≥4 yr | 2 inhalations q4–6h PRN (1 inhalation q4h may suffice) | 2 inhalations q4–6h (more frequent dosing or more inhalations not recommended) | |
| Prevention of exercise-induced bronchospasm | Adults & children ≥4 yr | 2 inhalations 15–30 min before exercise | Undefined |
Renal Undefined
Hepatic Undefined
Instructions
- Oral inhalation only
- Prime (4 sprays into air, shaking before each) before first use, if unused >2 weeks, or if dropped
- Wash actuator with warm water and air-dry at least once a week
- Discard when counter reads 000
Available strengths
- inhaler 90 mcg/actuation (HFA)
Cautions
- Paradoxical bronchospasm (may be life-threatening; often with new canister)
- Deterioration of asthma (increasing use = reevaluate)
- Not a substitute for corticosteroids
- Cardiovascular effects (pulse/BP changes, QTc prolongation, ST depression)
- Do not exceed recommended dose (fatalities with excessive use)
- Hypersensitivity reactions incl. anaphylaxis
- Coexisting conditions: convulsive disorders, hyperthyroidism, diabetes
- Hypokalemia
Adverse reactions
- Throat irritation (10%)
- Viral respiratory infections (7%)
- Upper respiratory inflammation (5%)
- Cough (5%)
- Musculoskeletal pain (5%)
Pregnancy Human data do not consistently show risk of major birth defects or miscarriage; animal cleft palate/delayed ossification below MRHDID; restrict use during labor (may interfere with uterine contractility).
Lactation No data on presence in milk; plasma levels after inhalation are low, so milk levels likely low.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 90 mcg/actuation | inhaler | per unit | $1.83/g | offered |
Other forms: Albuterol nebulizer
Available combined with: albuterol / ipratropium · albuterol / ipratropium / inhaler
Generic entry1989
NO BOXED WARNINGS
Principal riskTachycardia and hypokalemia at high doses
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityTremor, tachycardia or anticholinergic effects; excessive beta-agonist exposure can cause hypokalemia and arrhythmia.
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