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albuterol (Rx)Brand and Other Names:Proventil HFA, Ventolin HFA, more...Proair HFA, ProAir RespiClick, Proventil, AccuNeb, Ventolin Injection, Ventolin Nebules PF, Ventolin Oral Liquid, Ventolin Respirator Solution, Vospire ER

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

aerosol metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate)

powder metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg abluterol sulfate); ProAir RespiClick

tablet

  • 2mg
  • 4mg

tablet, extended release

  • 4mg
  • 8mg

nebulizer solution

  • 0.083%
  • 0.5%
  • 1.25mg/3mL
  • 0.63mg/3mL

syrup

  • 2mg/5mL
more...

Bronchospasm

Nebulizer solution: 2.5 mg BID/TID PRN; 1.25 - 5 mg q4-8hr PRN for quick relief

Aerosol metered-dose inhaler: 180 mcg (2 puffs) inhaled PO q4-6hr; not to exceed 12 inhalations/24 hr

Powder metered-dose inhaler: 180 mcg (2 puffs) inhaled PO q4-6hr; not to exceed 12 inhalations/24 hr; in some patients 1 inhalation (90 mcg) q4hr may be sufficient

Tablet and syrup: 2-4 mg PO q6-8hr; not to exceed 32 mg/day

Extended release: 8 mg PO q12hr; in some patients 4 mg PO q12hr sufficient; not to exceed 32 mg/day

Acute or Severe Bronchospasm

Nebulizer solution: 2.5-5 mg q20min for 3 doses; follow with 2.5-10 mg q1-4hr PRN or 10-15 min by continuous nebulization

Metered-dose inhaler: 4-8 puffs inhaled q20min for up to 4 hr and then q1-4hr PRN

Exercise-Induced Bronchospasm

Aerosol or powder metered-dose inhaler: 180 mcg (2 puffs) inhaled 15-30 min before exercise

Spinal Cord Injury (Orphan)

Prevention of paralysis caused by spinal cord injury

Orphan indication sponsor

  • MotoGen, Inc, 3 Pine View Road, Mount Kisco, NY 10549

Dosage Forms & Strengths

aerosol metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate)

powder metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg abluterol sulfate); ProAir RespiClick

tablet

  • 2mg
  • 4mg

tablet, extended release

  • 4mg
  • 8mg

nebulizer solution

  • 0.083%
  • 0.5%
  • 1.25mg/3mL
  • 0.63mg/3mL

syrup

  • 2mg/5mL
more...

Bronchospasm

Treatment and prevention of bronchospasm associated with obstructive airway disease

Aerosol metered-dose inhaler

  • <4 years: Safety and efficacy not established
  • ≥4 years: 90-180 mcg (1-2 puffs) inhaled PO q4-6 hr

Powder metered-dose inhaler (ProAir RespiClick)

  • <4 years: Safety and efficacy not established
  • ≥4 years: 180 mcg (2 puffs) inhaled PO q4-6hr; not to exceed 12 inhalations/24 hr
  • In some patients 1 inhalation (90 mcg) q4hr may be sufficient

Nebulizer solution

  • <2 years (off-label): 0.2-0.6 mg/kg/day divided q4-6hr  
  • 2-12 years and <15 kg: 2.5 mg/0.5mL (0.5 % solution) q6-8hr; not to exceed 10 mg (4 vials)/24hr
  • 2-12 years and >15 kg: 1 vial (2.5 mg/3mL) q6-8hr; not to exceed 10 mg (4 vials)/24hr
  • >12 years: 2.5 mg (1 vial) q6-8hr PRN; not to exceed 10 mg/24hr
  • Flow rate of delivery adjusted over period of 5-15 minutes

AccuNeb

  • <2 years: Safety and efficacy not established
  • 2-12 years 1 vial (1.25 or 0.63 mg/vial) q6-8hr inhaled PO via nebulizer over 5-15 min; 4 vials (5 mg)/24 hr
  • >12 years: Not studied

Tablet

  • <6 years: 0.3-0.6 mg/kg/day PO divided q8hr; not to exceed 12 mg/day
  • 6-12 years: 2 mg PO q6-8hr; may be gradually increased to ≤24 mg/day in divided doses
  • >12 years: 2-4 mg PO q6-8hr; not to exceed 32 mg/day

Extended Release Tablet

  • <6 years: Safety and efficacy not established
  • 6-12 years: 4 mg PO q12hr; not to exceed 24 mg/day
  • >12 years: 8 mg PO q12hr; in some patients 4 mg q12hr sufficient

Syrup

  • 2-6 years: 0.1 mg (0.25 mL)/kg PO q8hr initially, not to exceed 2 mg (5 mL) q8hr; if necessary, may be increased to 0.2 mg/kg PO q8hr, not to exceed 4 mg (10 mL) q8hr
  • 6-14 years: 2 mg (5 mL) PO q6-8hr; may be gradually increased to ≤24 mg/day in divided doses
  • >14 years: 2-4 mg PO q6-8hr; not to exceed 32 mg/day

Exercise Induced Bronchospasm Prevention

Aerosol metered-dose inhaler

  • <4 years: Safety and efficacy not established
  • ≥4 years: 180 mcg (2 puffs) inhaled 15-30 min before exercise

Powder metered-dose inhaler (ProAir RespiClick)

  • <4 years: Safety and efficacy not established
  • ≥4 years: 180 mcg (2 puffs) inhaled 15-30 min before exercise

Dosing Considerations

Potential toxic dose for children <6 years: 1 mg/kg

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Interactions

Interaction Checker

albuterol and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
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            Adverse Effects

            >10%

            Tremor (20%)

            Nervousness in children aged 2-6 years (20%)

            Insomnia in children aged 6-12 years receiving 4-12 mg q12hr (11%)

            1-10%

            Nausea (10%)

            Fever (1.6-9%)

            Bronchospasm (8%)

            Vomiting (7%)

            Headache (4-7%)

            Dizziness (1-7%)

            Cough (5%)

            Allergic reactions (4%)

            Otitis media (3.3%)

            Epistaxis in children (3%)

            Increased appetite (3%)

            Urinary tract infection (3%)

            Dry mouth (<3%)

            Eructation or flatulence (<3%)

            Increased sweating (<3%)

            Pain (2.7%)

            Dyspepsia (1-2%)

            Hyperactivity (1-2%)

            Chills (<2%)

            Lymphadenopathy (<2%)

            Ocular pruritus (<2%)

            Sweating (<2%)

            Conjunctivitis in children aged 2-6 years (1%)

            Dysphonia (>1%)

            Flu syndrome

            Nervousness

            <1%

            Epigastric pain

            Epistaxis in adults

            Hyperactivity in children

            Frequency Not Defined

            Adverse reactions such as hypertension, angina, vertigo, central nervous system stimulation, insomnia, headache, metabolic acidosis, and drying or irritation of oropharynx

            Hypersensitivity

            Hypokalemia

            Increased blood glucose levels

            Prolonged QT interval and ST-segment depression

            Sleeplessness

            Tachycardia (incidence varies with formulation)

            Urticaria, angioedema, rash, bronchospasm, and oropharyngeal edema (rare)

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            Warnings

            Contraindications

            Tachycardia secondary to heart condition

            Cautions

            Some inhalers use hydrofluoroalkane (HFA) as propellant instead of chlorofluorocarbons (CFCs); otherwise, devices are equivalent

            Risk of hypokalemia (usually transient)

            Paradoxical bronchospasm may occur

            Use with caution in patients with cardiovascular disease, asthma, glaucoma, diabetes, hypokalemia, hyperthyroidism, or seizures

            Use face mask in children <4 years

            Serious adverse effects occur when administered dose exceeds recommended dose

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Unknown whether drug is excreted in milk; not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Beta2 receptor agonist with some beta1 activity; relaxes bronchial smooth muscle with little effect on heart rate

            Absorption

            Onset: 25 min (Ventolin HFA); 0.5-2 hr (nebulization); 2-3 hr (PO)

            Duration: 4-6 hr (PO);

            Peak plasma time: Inhalation, 2-5 hr; PO, 2-2.5 hr

            Distribution

            Protein bound: 10%

            Metabolism

            Metabolized in liver

            Elimination

            Half-life: 3-8 hr (inhalation); 3.7-5 hr (PO)

            Excretion: Urine

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            Administration

            Solution for Nebulization

            Remove one vial from the foil pouch

            Twist the cap completely off the vial and squeeze the contents into the nebulizer reservoir

            Connect the nebulizer to the mouthpiece or face mask

            Connect the nebulizer to the compressor

            Sit in a comfortable, upright position; place the mouthpiece in your mouth or put on the face mask, and turn on the compressor

            Breathe as calmly, deeply and evenly as possible through your mouth until no more mist is formed in the nebulizer chamber (about 5-15 minutes); at this point, the treatment is finished

            Clean the nebulizer according to manufacturer instructions

            Aerosol Metered-Dose Inhaler

            For oral inhalation only

            Prime the inhaler before using for the first time and in cases where the inhaler has not been used for >2 weeks by releasing 4 “test sprays” into the air, away from the face

            Patient instructions for administration

            • Shake well before each use
            • Breathe out fully through the mouth, expelling as much air from your lungs as possible; place the mouthpiece fully into the mouth, holding the inhaler in its upright position and close the lips around it
            • While breathing in deeply and slowly through the mouth, fully depress the top of the metal canister with your index finger
            • Hold your breath as long as possible, up to 10 seconds; before breathing out, remove the inhaler from your mouth and release your finger from the canister
            • If your physician has prescribed additional puffs, wait 1 minute, shake the inhaler again, and repeat steps listed above; replace the cap after use

            Cleaning

            • To maintain proper use of this product, it is important that the mouthpiece be washed and dried thoroughly at least once a week
            • Keeping the plastic mouthpiece clean is very important to prevent medication buildup and blockage
            • The inhaler may cease to deliver medication if not properly cleaned and air dried thoroughly
            • If the mouthpiece becomes blocked, washing the mouthpiece will remove the blockage

            Powder Metered-Dose Inhaler

            For oral inhalation only

            Does NOT require priming

            Do not use with a spacer or volume holding chamber

            Cleaning

            • Keep clean and dry at all times
            • Never wash or put any part of inhaler in water
            • Routine maintenance not required
            • If the mouthpiece needs cleaning, gently wipe with a dry cloth or tissue as needed

            Extended-release oral tablets

            Do not chew, crush, or mix with food

            Storage

            Solution for nebulization

            • Store between 2-25° C (36-77° F)
            • Vials should be protected from light before use, therefore, keep unused vials in the foil pouch

            Aerosol metered-dose inhaler

            • Store at room temperature (15-25°C [59-77°F])

            Powder metered-dose inhaler

            • Store at room temperature (15-25°C [59-77°F])
            • Avoid exposure to extreme heat, cold, or humidity
            • Discard 13 months after opening the foil pouch, when the dose counter displays zero, or after the expiration date on the product, whichever comes first
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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Select a class to view formulary status for similar drugs

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