Dosing & Uses
Dosage Forms & Strengths
albuterol/budesonide
inhalation aerosol
- 90mcg/80mcg per actuation
Asthma
Fixed dose inhaler indicated for as needed treatment or prevention of bronchoconstriction and for prevention of exacerbations in adults with asthma
2 actuations inhaled PO PRN for asthma symptoms
2 actuations = albuterol 180 mcg and budesonide 160 mcg
Not to exceed 6 doses (12 inhalations) per 24 hr
Dosage Modifications
Renal impairment
- Formal pharmacokinetic studies have not been conducted
Hepatic impairment
- Formal pharmacokinetic studies have not been conducted
- Budesonide is predominately cleared by hepatic metabolism and hepatic impairment may lead to plasma accumulation
- Monitor patients with hepatic impairment
Dosing Considerations
Not for use as maintenance treatment for asthma
<18 years: Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (4)
- cisapride
albuterol and cisapride both increase QTc interval. Contraindicated.
- dronedarone
albuterol and dronedarone both increase QTc interval. Contraindicated.
- saquinavir
saquinavir, albuterol. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Contraindicated. Saquinavir boosted with ritonavir increases risk of hypokalemia, QT prolongation, and cardiac arrhythmias.
- thioridazine
albuterol and thioridazine both increase QTc interval. Contraindicated.
Serious - Use Alternative (16)
- amitriptyline
amitriptyline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- amoxapine
amoxapine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- azithromycin
albuterol and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- clomipramine
clomipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- desipramine
desipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- doxepin
doxepin, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- fexinidazole
fexinidazole and albuterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels and/or prolong QT interval.
- hydroxychloroquine sulfate
albuterol and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.
- imipramine
imipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- isocarboxazid
isocarboxazid increases effects of albuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- linezolid
linezolid increases effects of albuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- lofepramine
lofepramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- lonafarnib
lonafarnib will increase the level or effect of budesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.
- lopinavir
albuterol and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
budesonide inhaled, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that directly affect the pituitary secretion of growth hormone (GH) may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH growth hormone release before administering prior to administration of macimorelin. Drugs that directly affect the pituitary secretion of growth hormone (GH) may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.
- maprotiline
maprotiline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
Monitor Closely (302)
- acebutolol
acebutolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - aceclofenac
aceclofenac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- acemetacin
acemetacin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
alfentanil increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alprazolam
alprazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- amiloride
amiloride increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- amiodarone
albuterol and amiodarone both increase QTc interval. Use Caution/Monitor.
- amisulpride
albuterol and amisulpride both increase QTc interval. Use Caution/Monitor.
amisulpride and albuterol both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered. - amitriptyline
amitriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and amitriptyline both increase QTc interval. Use Caution/Monitor. - amobarbital
amobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- amoxapine
amoxapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- anagrelide
albuterol and anagrelide both increase QTc interval. Use Caution/Monitor.
- apomorphine
albuterol and apomorphine both increase QTc interval. Use Caution/Monitor.
- arformoterol
albuterol and arformoterol both decrease serum potassium. Use Caution/Monitor.
albuterol and arformoterol both decrease sedation. Use Caution/Monitor.
albuterol and arformoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - aripiprazole
aripiprazole increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- armodafinil
albuterol and armodafinil both decrease sedation. Use Caution/Monitor.
- arsenic trioxide
albuterol and arsenic trioxide both increase QTc interval. Use Caution/Monitor.
- artemether/lumefantrine
albuterol and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.
- asenapine
albuterol and asenapine both increase QTc interval. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and albuterol both increase QTc interval. Use Caution/Monitor.
- aspirin
aspirin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aspirin rectal
aspirin rectal increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atenolol
atenolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
atenolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - atomoxetine
atomoxetine, albuterol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of tachycardia, increased blood pressure.
- azelastine
azelastine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bedaquiline
albuterol and bedaquiline both increase QTc interval. Use Caution/Monitor.
- belladonna and opium
belladonna and opium increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bendroflumethiazide
albuterol and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.
- benperidol
benperidol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benzphetamine
albuterol and benzphetamine both decrease sedation. Use Caution/Monitor.
albuterol and benzphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - betaxolol
betaxolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
betaxolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - bisoprolol
bisoprolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
bisoprolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - brompheniramine
brompheniramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bumetanide
albuterol and bumetanide both decrease serum potassium. Use Caution/Monitor.
- buprenorphine
buprenorphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and buprenorphine both increase QTc interval. Use Caution/Monitor. - buprenorphine buccal
buprenorphine buccal increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
buprenorphine buccal and albuterol both increase QTc interval. Use Caution/Monitor. - buprenorphine subdermal implant
buprenorphine subdermal implant and albuterol both increase QTc interval. Use Caution/Monitor.
- buprenorphine transdermal
buprenorphine transdermal and albuterol both increase QTc interval. Use Caution/Monitor.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and albuterol both increase QTc interval. Use Caution/Monitor.
- butabarbital
butabarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- butalbital
butalbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- butorphanol
butorphanol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- caffeine
albuterol and caffeine both decrease sedation. Use Caution/Monitor.
- carbenoxolone
albuterol and carbenoxolone both decrease serum potassium. Use Caution/Monitor.
- carbinoxamine
carbinoxamine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carvedilol
carvedilol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
carvedilol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - celecoxib
celecoxib increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celiprolol
celiprolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
celiprolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - chloral hydrate
chloral hydrate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chloroquine
albuterol and chloroquine both increase QTc interval. Use Caution/Monitor.
- chlorothiazide
albuterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpromazine
chlorpromazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and chlorpromazine both increase QTc interval. Use Caution/Monitor. - chlorthalidone
albuterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- cinnarizine
cinnarizine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ciprofloxacin
albuterol and ciprofloxacin both increase QTc interval. Use Caution/Monitor.
- citalopram
albuterol and citalopram both increase QTc interval. Use Caution/Monitor.
- clarithromycin
albuterol and clarithromycin both increase QTc interval. Use Caution/Monitor.
- clemastine
clemastine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clomipramine
clomipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clonazepam
clonazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clorazepate
clorazepate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clozapine
clozapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and clozapine both increase QTc interval. Use Caution/Monitor. - cobicistat
cobicistat increases levels of budesonide inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- codeine
codeine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- crizotinib
albuterol and crizotinib both increase QTc interval. Use Caution/Monitor.
- cyclizine
cyclizine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclopenthiazide
albuterol and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.
- cyproheptadine
cyproheptadine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dasatinib
albuterol and dasatinib both increase QTc interval. Use Caution/Monitor.
- deflazacort
albuterol and deflazacort both decrease serum potassium. Use Caution/Monitor.
- degarelix
albuterol and degarelix both increase QTc interval. Use Caution/Monitor.
- desipramine
desipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and desipramine both increase QTc interval. Use Caution/Monitor. - deutetrabenazine
albuterol and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dexchlorpheniramine
dexchlorpheniramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexfenfluramine
albuterol and dexfenfluramine both decrease sedation. Use Caution/Monitor.
albuterol and dexfenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dexmedetomidine
dexmedetomidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmethylphenidate
albuterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.
albuterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dextroamphetamine
albuterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.
albuterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dextromoramide
dextromoramide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diamorphine
diamorphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and albuterol both decrease serum potassium. Use Caution/Monitor.
dichlorphenamide, albuterol. Either increases levels of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis. - diclofenac
diclofenac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diethylpropion
albuterol and diethylpropion both decrease sedation. Use Caution/Monitor.
albuterol and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - difenoxin hcl
difenoxin hcl increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diflunisal
diflunisal increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- digoxin
digoxin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dimenhydrinate
dimenhydrinate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diphenhydramine
diphenhydramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diphenoxylate hcl
diphenoxylate hcl increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dipipanone
dipipanone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- disopyramide
albuterol and disopyramide both increase QTc interval. Use Caution/Monitor.
- dobutamine
albuterol and dobutamine both decrease serum potassium. Use Caution/Monitor.
albuterol and dobutamine both decrease sedation. Use Caution/Monitor.
albuterol and dobutamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dolasetron
albuterol and dolasetron both increase QTc interval. Use Caution/Monitor.
- donepezil
donepezil and albuterol both increase QTc interval. Use Caution/Monitor.
- dopamine
albuterol and dopamine both decrease sedation. Use Caution/Monitor.
albuterol and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - dopexamine
albuterol and dopexamine both decrease serum potassium. Use Caution/Monitor.
albuterol and dopexamine both decrease sedation. Use Caution/Monitor.
albuterol and dopexamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
dopexamine, albuterol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. - doxepin
doxepin increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
doxepin and albuterol both increase QTc interval. Use Caution/Monitor. - droperidol
droperidol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and droperidol both increase QTc interval. Use Caution/Monitor. - drospirenone
drospirenone increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- efavirenz
efavirenz and albuterol both increase QTc interval. Use Caution/Monitor.
- encorafenib
albuterol and encorafenib both increase QTc interval. Use Caution/Monitor.
- entrectinib
albuterol and entrectinib both increase QTc interval. Use Caution/Monitor.
- ephedrine
albuterol and ephedrine both decrease serum potassium. Use Caution/Monitor.
albuterol and ephedrine both decrease sedation. Use Caution/Monitor.
albuterol and ephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - epinephrine
albuterol and epinephrine both decrease serum potassium. Use Caution/Monitor.
albuterol and epinephrine both decrease sedation. Use Caution/Monitor.
albuterol and epinephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - epinephrine racemic
albuterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.
albuterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.
albuterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - eribulin
albuterol and eribulin both increase QTc interval. Use Caution/Monitor.
- erythromycin base
albuterol and erythromycin base both increase QTc interval. Use Caution/Monitor.
- erythromycin ethylsuccinate
albuterol and erythromycin ethylsuccinate both increase QTc interval. Use Caution/Monitor.
- erythromycin lactobionate
albuterol and erythromycin lactobionate both increase QTc interval. Use Caution/Monitor.
- erythromycin stearate
albuterol and erythromycin stearate both increase QTc interval. Use Caution/Monitor.
- escitalopram
albuterol and escitalopram both increase QTc interval. Use Caution/Monitor.
- esmolol
esmolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
esmolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - estazolam
estazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ethacrynic acid
albuterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.
- ethanol
ethanol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- etodolac
etodolac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fenfluramine
albuterol and fenfluramine both decrease sedation. Use Caution/Monitor.
albuterol and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - fenoprofen
fenoprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fexinidazole
albuterol and fexinidazole both increase QTc interval. Use Caution/Monitor.
- fingolimod
fingolimod and albuterol both increase QTc interval. Use Caution/Monitor.
- flecainide
albuterol and flecainide both increase QTc interval. Use Caution/Monitor.
- fluconazole
albuterol and fluconazole both increase QTc interval. Use Caution/Monitor.
- fluoxetine
albuterol and fluoxetine both increase QTc interval. Use Caution/Monitor.
- fluphenazine
fluphenazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and fluphenazine both increase QTc interval. Use Caution/Monitor. - flurazepam
flurazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- flurbiprofen
flurbiprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- formoterol
albuterol and formoterol both decrease serum potassium. Use Caution/Monitor.
albuterol and formoterol both decrease sedation. Use Caution/Monitor.
albuterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - foscarnet
albuterol and foscarnet both increase QTc interval. Use Caution/Monitor.
- fostemsavir
albuterol and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- furosemide
albuterol and furosemide both decrease serum potassium. Use Caution/Monitor.
- gemifloxacin
albuterol and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
albuterol and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gentamicin
albuterol and gentamicin both decrease serum potassium. Use Caution/Monitor.
- gilteritinib
albuterol and gilteritinib both increase QTc interval. Use Caution/Monitor.
- glasdegib
albuterol and glasdegib both increase QTc interval. Use Caution/Monitor.
- goserelin
albuterol and goserelin both increase QTc interval. Use Caution/Monitor.
- granisetron
albuterol and granisetron both increase QTc interval. Use Caution/Monitor.
- green tea
green tea increases effects of albuterol by pharmacodynamic synergism. Use Caution/Monitor. Due to caffeine content. Combination may increase CNS stimulatory effects due to caffeine in green tea.
- haloperidol
haloperidol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and haloperidol both increase QTc interval. Use Caution/Monitor. - histrelin
albuterol and histrelin both increase QTc interval. Use Caution/Monitor.
- hydrochlorothiazide
albuterol and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.
- hydromorphone
hydromorphone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydroxyzine
hydroxyzine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and hydroxyzine both increase QTc interval. Use Caution/Monitor. - ibuprofen
ibuprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen IV
ibuprofen IV increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibutilide
albuterol and ibutilide both increase QTc interval. Use Caution/Monitor.
- iloperidone
iloperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and iloperidone both increase QTc interval. Use Caution/Monitor. - imipramine
imipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indapamide
albuterol and indapamide both decrease serum potassium. Use Caution/Monitor.
- indomethacin
indomethacin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- inotuzumab
albuterol and inotuzumab both increase QTc interval. Use Caution/Monitor.
- irbesartan
irbesartan increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- isoflurane
albuterol and isoflurane both increase QTc interval. Use Caution/Monitor.
- isoproterenol
albuterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.
albuterol and isoproterenol both decrease sedation. Use Caution/Monitor.
albuterol and isoproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - itraconazole
albuterol and itraconazole both increase QTc interval. Use Caution/Monitor.
- ivosidenib
albuterol and ivosidenib both increase QTc interval. Use Caution/Monitor.
- ketoprofen
ketoprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac
ketorolac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac intranasal
ketorolac intranasal increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- ketotifen, ophthalmic
ketotifen, ophthalmic increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- labetalol
labetalol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
labetalol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - lapatinib
albuterol and lapatinib both increase QTc interval. Use Caution/Monitor.
- lefamulin
albuterol and lefamulin both increase QTc interval. Use Caution/Monitor.
- lenvatinib
albuterol and lenvatinib both increase QTc interval. Use Caution/Monitor.
- leuprolide
albuterol and leuprolide both increase QTc interval. Use Caution/Monitor.
- levalbuterol
albuterol and levalbuterol both decrease serum potassium. Use Caution/Monitor.
albuterol and levalbuterol both decrease sedation. Use Caution/Monitor.
albuterol and levalbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - levofloxacin
albuterol and levofloxacin both increase QTc interval. Use Caution/Monitor.
- levorphanol
levorphanol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lisdexamfetamine
albuterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.
albuterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - lithium
albuterol and lithium both increase QTc interval. Use Caution/Monitor.
- lofepramine
lofepramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lofexidine
lofexidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and lofexidine both increase QTc interval. Use Caution/Monitor. - loperamide
albuterol and loperamide both increase QTc interval. Use Caution/Monitor.
- loprazolam
loprazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lorazepam
lorazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lormetazepam
lormetazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lornoxicam
lornoxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- loxapine
loxapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- maprotiline
maprotiline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and maprotiline both increase QTc interval. Use Caution/Monitor. - marijuana
marijuana increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meclofenamate
meclofenamate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mefenamic acid
mefenamic acid increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mefloquine
albuterol and mefloquine both increase QTc interval. Use Caution/Monitor.
- melatonin
melatonin increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meloxicam
meloxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meperidine
meperidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meprobamate
meprobamate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaproterenol
albuterol and metaproterenol both decrease serum potassium. Use Caution/Monitor.
albuterol and metaproterenol both decrease sedation. Use Caution/Monitor.
albuterol and metaproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - methadone
methadone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and methadone both increase QTc interval. Use Caution/Monitor. - methamphetamine
albuterol and methamphetamine both decrease sedation. Use Caution/Monitor.
albuterol and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - methyclothiazide
albuterol and methyclothiazide both decrease serum potassium. Use Caution/Monitor.
- methylenedioxymethamphetamine
albuterol and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.
albuterol and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - methylphenidate
albuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- metolazone
albuterol and metolazone both decrease serum potassium. Use Caution/Monitor.
- metoprolol
metoprolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
metoprolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - midazolam
midazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midodrine
albuterol and midodrine both decrease sedation. Use Caution/Monitor.
albuterol and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - mifepristone
albuterol and mifepristone both increase QTc interval. Use Caution/Monitor.
- mirtazapine
mirtazapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and mirtazapine both increase QTc interval. Use Caution/Monitor. - modafinil
albuterol and modafinil both decrease sedation. Use Caution/Monitor.
- morphine
morphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- motherwort
motherwort increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- moxifloxacin
albuterol and moxifloxacin both increase QTc interval. Use Caution/Monitor.
- moxonidine
moxonidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nabilone
nabilone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nabumetone
nabumetone increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nadolol
nadolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nadolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - nalbuphine
nalbuphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- naproxen
naproxen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nebivolol
nebivolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nebivolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - nilotinib
albuterol and nilotinib both increase QTc interval. Use Caution/Monitor.
- norepinephrine
albuterol and norepinephrine both decrease serum potassium. Use Caution/Monitor.
albuterol and norepinephrine both decrease sedation. Use Caution/Monitor.
albuterol and norepinephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - nortriptyline
nortriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and nortriptyline both increase QTc interval. Use Caution/Monitor. - octreotide
albuterol and octreotide both increase QTc interval. Use Caution/Monitor.
- ofloxacin
albuterol and ofloxacin both increase QTc interval. Use Caution/Monitor.
- olanzapine
olanzapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - olodaterol inhaled
albuterol and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects
albuterol and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. - ondansetron
albuterol and ondansetron both increase QTc interval. Use Caution/Monitor.
- opium tincture
opium tincture increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- osilodrostat
osilodrostat and albuterol both increase QTc interval. Use Caution/Monitor.
albuterol and osilodrostat both increase QTc interval. Use Caution/Monitor. Dose dependent QT prolongation - avoid drugs known to prolong the QT interval - osimertinib
albuterol and osimertinib both increase QTc interval. Use Caution/Monitor.
- oxaliplatin
oxaliplatin will increase the level or effect of albuterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
albuterol and oxaliplatin both increase QTc interval. Use Caution/Monitor. - oxaprozin
oxaprozin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxazepam
oxazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxycodone
oxycodone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxymorphone
oxymorphone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ozanimod
albuterol and ozanimod both increase QTc interval. Use Caution/Monitor.
- paliperidone
paliperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and paliperidone both increase QTc interval. Use Caution/Monitor. - panobinostat
albuterol and panobinostat both increase QTc interval. Use Caution/Monitor.
- papaveretum
papaveretum increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- papaverine
papaverine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
parecoxib increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pasireotide
albuterol and pasireotide both increase QTc interval. Use Caution/Monitor.
- pazopanib
albuterol and pazopanib both increase QTc interval. Use Caution/Monitor.
- penbutolol
penbutolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
penbutolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - pentamidine
albuterol and pentamidine both increase QTc interval. Use Caution/Monitor.
- pentazocine
pentazocine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pentobarbital
pentobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- perphenazine
perphenazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phendimetrazine
albuterol and phendimetrazine both decrease sedation. Use Caution/Monitor.
albuterol and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - phenobarbital
phenobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenoxybenzamine
phenoxybenzamine, albuterol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.
- phentermine
albuterol and phentermine both decrease sedation. Use Caution/Monitor.
albuterol and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - phenylephrine
albuterol and phenylephrine both decrease sedation. Use Caution/Monitor.
albuterol and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - phenylephrine PO
albuterol and phenylephrine PO both decrease sedation. Use Caution/Monitor.
albuterol and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - pholcodine
pholcodine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimavanserin
albuterol and pimavanserin both increase QTc interval. Use Caution/Monitor.
- pimozide
pimozide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pindolol
pindolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
pindolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - pirbuterol
albuterol and pirbuterol both decrease serum potassium. Use Caution/Monitor.
albuterol and pirbuterol both decrease sedation. Use Caution/Monitor.
albuterol and pirbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - piroxicam
piroxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pitolisant
albuterol and pitolisant both increase QTc interval. Use Caution/Monitor.
- ponesimod
albuterol and ponesimod both increase QTc interval. Use Caution/Monitor.
- posaconazole
albuterol and posaconazole both increase QTc interval. Use Caution/Monitor.
- potassium acid phosphate
potassium acid phosphate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium chloride
potassium chloride increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- primaquine
albuterol and primaquine both increase QTc interval. Use Caution/Monitor.
- primidone
primidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- procainamide
albuterol and procainamide both increase QTc interval. Use Caution/Monitor.
- procarbazine
procarbazine increases effects of albuterol by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.
- prochlorperazine
prochlorperazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- promethazine
promethazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- propafenone
albuterol and propafenone both increase QTc interval. Use Caution/Monitor.
- propranolol
propranolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
propranolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - propylhexedrine
albuterol and propylhexedrine both decrease sedation. Use Caution/Monitor.
albuterol and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - protriptyline
protriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and protriptyline both increase QTc interval. Use Caution/Monitor. - pseudoephedrine
albuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- quazepam
quazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quetiapine
quetiapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and quetiapine both increase QTc interval. Use Caution/Monitor. - quinidine
albuterol and quinidine both increase QTc interval. Use Caution/Monitor.
- quinine
albuterol and quinine both increase QTc interval. Use Caution/Monitor.
- ranolazine
albuterol and ranolazine both increase QTc interval. Use Caution/Monitor.
- ribociclib
albuterol and ribociclib both increase QTc interval. Use Caution/Monitor.
- rilpivirine
albuterol and rilpivirine both increase QTc interval. Use Caution/Monitor.
- risperidone
risperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and risperidone both increase QTc interval. Use Caution/Monitor. - romidepsin
albuterol and romidepsin both increase QTc interval. Use Caution/Monitor.
- sacubitril/valsartan
sacubitril/valsartan increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salicylates (non-asa)
salicylates (non-asa) increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salmeterol
albuterol and salmeterol both decrease serum potassium. Use Caution/Monitor.
albuterol and salmeterol both decrease sedation. Use Caution/Monitor.
albuterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - salsalate
salsalate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- saquinavir
albuterol and saquinavir both increase QTc interval. Use Caution/Monitor.
- scullcap
scullcap increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- secobarbital
secobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- selpercatinib
albuterol and selpercatinib both increase QTc interval. Use Caution/Monitor.
- serdexmethylphenidate/dexmethylphenidate
albuterol and serdexmethylphenidate/dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- sertraline
albuterol and sertraline both increase QTc interval. Use Caution/Monitor.
- sevoflurane
albuterol and sevoflurane both increase QTc interval. Use Caution/Monitor.
- shepherd's purse
shepherd's purse increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- siponimod
albuterol and siponimod both increase QTc interval. Use Caution/Monitor.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
albuterol and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- solifenacin
albuterol and solifenacin both increase QTc interval. Use Caution/Monitor.
- solriamfetol
albuterol and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- sorafenib
albuterol and sorafenib both increase QTc interval. Use Caution/Monitor.
- sotalol
sotalol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
sotalol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.
albuterol and sotalol both increase QTc interval. Use Caution/Monitor. - spironolactone
spironolactone increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- stiripentol
stiripentol will increase the level or effect of budesonide inhaled by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.
- succinylcholine
succinylcholine increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (15)
- bendroflumethiazide
albuterol, bendroflumethiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- bumetanide
albuterol, bumetanide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- chlorothiazide
albuterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- chlorthalidone
albuterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- cyclopenthiazide
albuterol, cyclopenthiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- ethacrynic acid
albuterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- eucalyptus
eucalyptus increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- furosemide
albuterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- hydrochlorothiazide
albuterol, hydrochlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- indapamide
albuterol, indapamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- methyclothiazide
albuterol, methyclothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- metolazone
albuterol, metolazone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- noni juice
noni juice increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- sage
sage increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- torsemide
albuterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
Adverse Effects
1-10%
Headache (4.3%)
Oral candidiasis (1.3%)
Cough (1%)
Postmarketing Reports
Cardiovascular disorders: Myocardial ischemia, tremor, tachycardia, palpitations, extrasystoles, arrhythmias (eg, atrial fibrillation, supraventricular tachycardia), syncope, hypertension, peripheral vasodilatation
Endocrine disorders: Signs or symptoms of systemic glucocorticoid effect (eg, hypofunction of the adrenal gland and reduction of growth rate)
Eye disorders: Cataracts, glaucoma, increased intraocular pressure
Immune system disorders: Immediate and delayed hypersensitivity reactions (eg, anaphylactic reaction, angioedema, bronchospasm, rash, contact dermatitis and urticaria)
General disorders: Fever, weight gain, taste perversion, flu syndrome
Gastrointestinal disorders: Nausea, vomiting, dyspepsia, diarrhea
Infections: Sinusitis, pharyngitis, respiratory tract infection, nasopharyngitis, gastroenteritis, otitis media, laryngitis
Metabolic disorders: Hypokalemia, metabolic acidosis
Musculoskeletal disorders: Hypertonia, musculoskeletal pain, myalgia, asthenia, arthralgia, muscle cramps, fracture
Neurological or psychiatric system disorders: Migraine, dizziness, central nervous system stimulation, insomnia, hyperactivity, psychiatric symptoms (eg, psychosis, depression, aggressive reactions, irritability, nervousness, restlessness, behavioral disturbances and anxiety)
Respiratory, thoracic, and mediastinal disorders: Rhinitis, nasal congestion, throat irritation, oropharyngeal edema, upper respiratory inflammation, drying or irritation of the oropharynx
Skin and subcutaneous tissue disorders: Skin bruising, ecchymosis
Warnings
Contraindications
Hypersensitivity to albuterol, budesonide, or any of the excipients
Cautions
Hypersensitivity reactions (eg, anaphylaxis, angioedema, bronchospasm, oropharyngeal edema, rash, urticaria) reported; discontinue if such reactions occur
Use sympathomimetic amines cautiously in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus and in patients who are unusually responsive to sympathomimetic amines
Beta-adrenergic agonists may cause hypokalemia in some patients, possibly through intracellular shunting, and thereby potential for adverse cardiovascular effects may occur; decreased serum potassium is usually transeint, not requiring supplementation
Orally inhaled corticosteroids may reduce growth velocity when administered to pediatric patients; safety and effectiveness of albuterol/budesonide have not been established in pediatric patients, and is not indicated for use in this population
Deterioration of asthma
- Asthma may deteriorate acutely over several hours or chronically over several days or longer
- If symptoms continue after using albuterol/budesonide or requires more doses than usual, evaluate patient and treatment regimen
Paradoxical bronchospasm
- Treatment may produce paradoxical bronchospasm, which may be life threatening
- If paradoxical bronchospasm occurs following, discontinue immediately, and initiate alternant therapy
- Paradoxical bronchospasm, when associated with inhaled formulations, frequently occurs with the first use of a new canister
Cardiovascular effects
- Beta2-adrenergic agonists can produce clinically significant cardiovascular (CV) effects (eg, increased pulse rate, blood pressure), ECG changes (flattening of T wave, QT prolongation, ST-segment depression), and/or other symptoms
- If such effects occur, albuterol/budesonide may need to be discontinued
- Caution in patients with CV disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension
Maximum daily dose
- Exceeding maximum dose may result in overdose
- Clinically significant CV effects and fatalities reported in association with excessive use of inhaled sympathomimetic drugs
Immunosuppression and risk of infections
- Unknown, how the dose, route, and duration of corticosteroid administration affect risk of developing a disseminated infection
- Patients taking immunosuppressants are more susceptible to infection; chicken pox and measles, for example, can have a more serious or even fatal course in susceptible patients using corticosteroids
- Review patient's immunization history and administer necessary vaccinations
- Immune globulins (eg, VZIG, IG) may be needed if exposure occurs and active infection occurs; consider antiviral agents if chickenpox develops
- Inhaled corticosteroids should be used with caution, if at all, in patients with active or quiescent TB infection of the respiratory tract; untreated systemic fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex
Oropharyngeal candidiasis
- Inhaled corticosteroid (ICS) may increase risk for localized infections of the mouth and pharynx with Candida albicans
- Advise patient to rinse their mouth with water, if available, without swallowing following administration to help reduce risk
- If oropharyngeal candidiasis develops, treat with appropriate local or systemic (ie, oral) antifungal therapy while treatment with albuterol/budesonide continues
- For some patients, albuterol/budesonide treatment may need to be interrupted
Hypercorticism and adrenal suppression
- Orally inhaled budesonide often helps control asthma symptoms with less suppression of hypothalamic-pituitary-adrenal (HPA) function than therapeutically equivalent oral doses of prednisone
- Since budesonide is absorbed into the circulation and can be systemically active at higher doses, the beneficial effects in minimizing HPA dysfunction may be expected only when recommended dosages are not exceeded
Reduced bone mineral density
- Decreases in bone mineral density (BMD) observed with long-term administration of ICS
- Clinical significance of small changes in BMD with regard to long-term consequences (eg, fracture) is unknown
- Patients with major risk factors for decreased bone mineral content (eg, prolonged immobilization, family history of osteoporosis, post-menopausal status, tobacco use, advanced age, poor nutrition, or chronic use of drugs that can reduce bone mass [eg, anticonvulsants, oral corticosteroids]) should be monitored and treated with established standards of care
Glaucoma and cataracts
- Glaucoma, increased intraocular pressure, and cataracts reported following the long-term administration of ICS
- Consider referral to an ophthalmologist in patients who develop ocular symptoms
Drug interaction overview
- Budesonide is a CYP3A4 substrate (major)
-
Strong CYP3A4 inhibitors
- Caution
- Strong CYP3A4 inhibitors may increase adverse effects owing to increased budesonide systemic exposure
-
Other short-acting bronchodilators
- Use judiciously to prevent beta-agonist overdose
- Additive effects of albuterol with other bronchodilators may occur
-
Beta-blockers
- Caution
- Beta-adrenergic receptor blocking agents not only block the pulmonary effect of beta-agonists (eg, albuterol, but may also produce severe bronchospasm in patients with asthma
- Therefore, patients with asthma should not normally be treated with beta-blockers
- However, under certain circumstances (eg, prophylaxis after MI), no acceptable alternatives may be available in these patients
- In this setting, consider cardioselective beta-blockers, although they should be administered with caution
-
Diuretics
- Caution; consider monitoring potassium levels
- ECG changes and/or hypokalemia resulting from nonpotassium sparing diuretics (eg, loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially if beta-agonist dose exceeded
-
Digoxin
- Monitor serum digoxin levels if coadministered
- Mean decreases in serum digoxin levels of 16% and 22% demonstrated after single-dose IV and oral albuterol, respectively, to normal volunteers who had received digoxin for 10 days
- Clinical significance of these findings for patients with obstructive airway disease who are receiving albuterol and digoxin on a chronic basis is unclear
-
MAOIs or TCAs
- Caution
- Monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs) may enhance adverse effects of beta2-agonists
- Administer albuterol/budesonide with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents
Pregnancy & Lactation
Pregnancy
Albuterol or budesonide: Available data from epidemiological studies and postmarketing case reports of pregnancy outcomes following inhaled albuterol or inhaled budesonide use do not consistently demonstrate a risk of major birth defects or miscarriage
Pregnancy Exposure Registry
- Registry monitors pregnancy outcomes in women exposed to asthma medications during pregnancy
- For more information, contact the MotherToBaby Pregnancy Studies conducted by the Organization of Teratology Information Specialists at 1-877-311-8972 or visit https://mothertobaby.org/ongoing-study/asthma/
Clinical considerations
- In females with poorly or moderately controlled asthma, risk is increased for several perinatal adverse outcomes (eg, preeclampsia in the mother; prematurity, low birth weight, and small for gestational age in the neonate)
- Closely monitor pregnant women with asthma and adjust medication as necessary to maintain optimal asthma control
Labor or delivery
- Because of the potential for beta-agonist interference with uterine contractility, use of during labor should be restricted to those patients in whom the benefits clearly outweigh the risk
- Serious adverse reactions, including pulmonary edema, reported during or following treatment of premature labor with beta2-agonists, including albuterol
Lactation
Data are unavailable on the effects of albuterol/budesonide on breastfed children or on milk production
Budesonide, like other inhaled corticosteroids, is present in human milk
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.Pharmacology
Mechanism of Action
Albuterol: Short-acting beta2-adrenergic bronchodilator; increases cyclic AMP which leads to protein kinase A activation, which inhibits myosin phosphorylation and lowers intracellular ionic calcium concentrations; these actions result in bronchial smooth muscle relaxation
Budesonide: Anti-inflammatory corticosteroid; has potent glucocorticoid activity and weak mineralocorticoid activity; inflammation is an important component in the pathogenesis of asthma
Absorption
Albuterol (healthy subjects)
- Peak plasma time: 1 hr
- Peak plasma concentration: 472.2 pg/mL
Budesonide (healthy subjects)
- Peak plasma time: 0.33 hr
- Peak plasma concentration: 272.8 pg/mL
Distribution
Albuterol (healthy subjects)
- Vd: 565.7 L
Budesonide (healthy subjects)
- Protein bound: 85-90%
- Vd: 1002 L
Metabolism
Albuterol: Primarily metabolized by SULTIA3 (sulfotransferase)
Budesonide: Rapidly and extensively metabolized by CYP3A4 to metabolites with <1% activity of that of the parent compound
Elimination
Excretion
- Albuterol: Primarily renal excretion
- Budesonide: Urine ~60% as metabolites
Administration
Inhaler Priming and Care
Write “use by date” (12 months after opening foil pouch) on actuator label using permanent ink
Rinse white actuator weekly and let dry
Priming inhaler
- Primer inhaler before first use
- Remove mouthpiece cover, shake, and spray test puff into air facing away from user; repeat for a total of 4 test puffs
Re-priming inhaler
- Re-prime if not used for >7 days, if inhaler dropped, or after rinsing white actuator
- Remove mouthpiece cover, shake and spray test puff; repeat for a total of 2 test puffs
Oral Inhalation
Shake inhaler and remove cap
Breathe out fully
Place mouthpiece into mouth and close lips around mouthpiece
Start to breathe in deeply and slowly while spraying 1 puff; continue breathing as tolerated
Remove mouthpiece and hold breath for as long as you can (up to 10 seconds)
Repeat above steps for 2nd inhalation
Rinse mouth with water (if available) after inhalation to decrease risk of oral/laryngeal fungal infection (thrush)
Canister has attached dose indicator showing how many inhalations remain
Storage
Store at room temperature at 68-77ºF (20-25ºC)
Keep in dry (nonhumid) place away from heat and sunlight
Images
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
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.
