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Salbutamol information from DrugsUpdate  

See Available Brands of Salbutamol in India

P - Caution when used during pregnancy

Salbutamol or albuterol is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It is marketed by GlaxoSmithKline as Ventolin, Aerolin or Ventorlin depending on the market; by Cipla as Asthalin; by Schering-Plough as Proventil and by Teva as ProAir.

Salbutamol was the first selective Β2-receptor agonist to be marketed, in 1968. It was first sold by Allen & Hanburys under the brand name Ventolin. The drug was an instant success, and has been used for the treatment of asthma ever since.

Salbutamol sulfate is usually given by the inhaled route for direct effect on bronchial smooth muscle. This is usually achieved through a metered dose inhaler (MDI), nebuliser or other proprietary delivery devices (e.g. Rotahaler or Autohaler). In these forms of delivery, the maximal effect of Salbutamol can take place within five to twenty minutes of dosing, though some relief is immediately seen. Salbutamol can also be given orally as an inhalant or intravenously.

Pharmacodynamics

Pharmacokinetics

Salbutamol is a direct-acting sympathomimetic with β-adrenergic activity and selective action on β2 receptors, producing bronchodilating effects. It also decreases uterine contractility.

Onset
Inhalation: 5-15 min; oral: 30 min.

Duration
Inhalation: 3-6 hr; oral: 8 hr; modified-release preparation: 12 hr.

Absorption
Readily absorbed from the GI tract.

Metabolism
Hepatic and in the gut wall.

Excretion
Via the urine as metabolites and unchanged drug. Some excretion in the faeces.

Salbutamol Indications / Salbutamol Uses

Information Not Available

Salbutamol Adverse Reactions / Salbutamol Side Effects

Fine skeletal muscle tremor especially hands, tachycardia, palpitations, muscle cramps, headache, paradoxical bronchospasm, angioedema, urticaria, hypotension and collapse.

Potentially Fatal: Potentially serious hypokalaemia after large doses.

Precautions

Overdosage


May lead to tachycardia, tremor, CNS stimulation, hypokalaemia and hyperglycaemia. Symptomatic treatment is recommended.


 

Special Precautions

Pregnancy; mild to moderate pre-eclampsia. Arrhythmias, hyperthyroidism, hypertension, DM, myocardial insufficiency, susceptibility to QT-interval prolongation. Monitor serum potassium levels. In women treated for premature labour, monitor hydration status, cardiac and respiratory function. Minimise volume of infusion fluid. Discontinue treatment if patient develops signs of pulmonary oedema.

Other Drug Interactions

Diuretics, corticosteroids and xanthines may augment hypokalaemia. CV effects potentiated by MAOIs, TCAs, sympathomimetics. Increases absorption of sulfamethoxazole when used together. May markedly increase heart rate and BP when used with atomoxetine. Reduces serum levels of digoxin. Hypokalaemia induced by salbutamol increases the risk of digitalis toxicity. BP should be closely monitored if linezolid is used concurrently with salbutamol.

Other Interactions

Information Not Available

Dosage

Oral
Acute bronchospasm
Adult: 2-4 mg (up to 8 mg) 3-4 times daily. As modified-release tablet: 8 mg bid.
Child: 1 mth-2 yr: 100 mcg/kg (max: 2 mg), 2-6 yr: 1-2 mg, >6 yr: 2 mg. Doses to be taken 3-4 times daily.
Elderly: Initially, 2 mg 3-4 times daily.

Intravenous
Uncomplicated premature labour
Adult: For arrest of preterm labor between 24 and 33 wk of gestation: Initially, 10 mcg/min using a dilute solution of 20 mcg/ml in glucose 5% (200 mcg/ml of salbutamol if using a syringe pump), increase rate gradually at 10-min intervals until there is response; then increase slowly until contractions cease. Maintain rate for 1 hr after contractions have stopped, then gradually reduce rate by 50% at intervals of 6 hr. Usual dose: 10-45 mcg/min. Avoid prolonged therapy.

Parenteral

Severe bronchospasm
Adult: 250 mcg (as a solution of 50 mcg/ml) via IV inj, or via IV infusion of a solution containing 5 mg in 500 ml at a rate of 3-20 mcg/min adjusted according to patient's need. Higher dosages may be used in respiratory failure. IM/SC: 500 mcg, repeated every 4 hr if necessary.

Inhalation
Acute bronchospasm
Adult: As aerosol: 100 or 200 mcg (1-2 puffs) 3-4 times daily. 2 puffs may be given prior to exertion to prevent exercise-induced bronchospasm.

Inhalation

Acute severe asthma
Adult: As MDI: 4-6 inhalations may be given every 10-20 min via a large volume spacer.

Inhalation
Severe bronchospasm
Adult: Via nebuliser: 2.5-5 mg, may repeat up to 4 times daily. Alternatively, may be given continuously at a rate of 1-2 mg/hr. Patients with asthma may require supplemental oxygen.
Child: >18 mth: Via nebuliser: 2.5-5 mg, may repeat up to 4 times daily. Alternatively, may be given continuously at a rate of 1-2 mg/hr. Patients with asthma may require supplemental oxygen.

Food(before/after)

Should be taken on an empty stomach. (Take 1 hour before or 2 hours after meals.)

List of Contraindications

Salbutamol and Pregnancy

Caution when used during pregnancy.


Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Salbutamol and Lactation

Information Not Available

Salbutamol and Children

Information Not Available

Salbutamol and Geriatic

Information Not Available

Salbutamol and Other Contraindications

Eclampsia and severe pre-eclampsia; intra-uterine infection, intra-uterine foetal death, antepartum haemorrhage, placenta praevia and cord compression, threatened miscarriage, cardiac disease.

Storage

Inhalation
Store between 2-25°C (36-77°F).

Intravenous

Store below 30°C. Protect from light.

Oral
Store at 20-25°C (68-77°F).

Parenteral
Store below 30°C. Protect from light.

Lab interference

Inhalation
Store between 2-25°C (36-77°F).

Intravenous

Store below 30°C. Protect from light.

Oral
Store at 20-25°C (68-77°F).

Parenteral
Store below 30°C. Protect from light.

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