Albuterol: Dosage & Side Effects
Albuterol is available as an aerosol to use in an inhaler.
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Albuterol is a prescription medicine prescribed for patients struggling with asthma, emphysema, bronchitis and other lung diseases. It is used to prevent and treat wheezing, coughing, shortness of breath and chest tightening. These symptoms are known as bronchospasms. Inhaled albuterol is sometimes used to treat or improve muscle paralysis in patients with attacks of paralysis.

Albuterol is in a class of medications called bronchodilalators. It works by relaxing and opening air passages to the lungs to make breathing easier. While albuterol can help lessen or prevent the symptoms of asthma or emphysema, it cannot cure the diseases.

However, people should treat it as a rescue inhaler, not as a daily drug, said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.

"It's what you reach for when you really need something," Horovitz told Live Science. "It's an I-need-it-now drug."

Albuterol can be taken by mouth either as a tablet or liquid, but its most common form is as an oral inhaler. As an oral inhaler, it can be used to prevent breathing difficulties during exercise, in addition to the other uses.

People in need of albuterol can take two puffs every four to six hours, Horovitz said. 

But "if you're using albuterol more than twice a week, there's something wrong with your regimen, and you need to consult a doctor," he said. 

Albuterol can be taken as a nebulized solution (a liquid that has been turned into an inhalable mist via a nebulizer machine) or as an aerosol that can be inhaled by mouth through an inhaler. 

Aerosol inhaler albuterol comes in canisters designed to provide about 200 inhalations (the exact number of inhalations can be found on the canister). After using the exact number of inhalations, it is important to throw the canister away, even if it still contains some liquid and continues to spray. Once the listed number of puffs has been exceeded, the inhaler may not provide the correct amount of medicine. Some inhalers come with a counter that keeps track of the number of sprays used. When the number reaches 020, it is time to call the doctor for a refill. If there is no counter, patients must keep track of inhalations on their own.

According to the National Institutes for Health (NIH), to use an inhaler, patients should follow the following steps:

  1. Remove the dust cap, or if the dust cap was not on, check the mouthpiece for dirt or other objects.
  2. If this is the first use of the inhaler, or it has not used it in more than 14 days, it needs to be primed. Shake it well and then press down on the canister four times to release four sprays into the air, away from the face.
  3. Shake the inhaler well.
  4. Breathe out fully.
  5. Place the mouthpiece into the mouth. Close lips tightly around the mouthpiece.
  6. Breathe in slowly and deeply through the mouthpiece. At the same time, press down once on the container to spray the medication into the mouth.
  7. Hold breath for 10 seconds, remove the inhaler, and breathe out slowly.
  8. Patients told to use two puffs should wait one minute before taking another puff.

Those using a nebulizer machine should follow the following steps:

  1. Remove one vial of albuterol solution from the foil pouch. Leave the rest of the vials in the pouch.
  2. Liquid in the vial should be clear and colorless. Do not use the vial if the liquid is cloudy or discolored.
  3. Twist off the top of the vial and squeeze all of the liquid into the nebulizer reservoir.
  4. Connect the nebulizer reservoir to the mouthpiece or facemask.
  5. Connect the nebulizer to the compressor.
  6. Place the mouthpiece in over the mouth or put on the facemask. Sit in an upright, comfortable position and turn on the compressor.
  7. Breathe in calmly, deeply, and evenly for about 5 to 15 minutes until mist stops forming in the nebulizer chamber.

Patients should clean the nebulizer or inhaler regularly. If it is not cleaned, the medicine may not spray effectively.

Patients taking albuterol through tablets, extended-release tablets, or liquid should follow their doctor’s instructions exactly. It is important to swallow the extended-release tablet whole and not to chew, crush, or break the tablet. Part of the extended-release tablet may appear in patients’ stools while using the medicine. This is not a problem and no cause for concern.

Brand names of oral tablet and liquid forms of albuterol are Proventil, Ventolin, and Volmax. Proventil and Ventolin should be stored at room temperature in a closed container, away from heat, moisture and direct light. Volmax should be stored in the refrigerator, and never frozen.

Albuterol may cause side effects. The NIH lists the following as less serious, though a doctor should be consulted if they do not go away:

  • uncontrollable shaking of a part of the body
  • nervousness
  • headache
  • nausea
  • vomiting
  • cough
  • throat irritation
  • muscle, bone, or back pain 

The following are more serious side effects and, if experienced, a doctor should be consulted immediately:

  • fast, pounding, or irregular heartbeat
  • chest pain
  • rash
  • hives
  • itching
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • increased difficulty breathing
  • difficulty swallowing
  • hoarseness

It is possible to overdose on albuterol. The following are symptoms of overdose:

  • seizures
  • chest pain
  • fast, irregular or pounding heartbeat
  • nervousness
  • headache
  • uncontrollable shaking of a part of the body
  • dry mouth
  • nausea
  • dizziness
  • excessive tiredness
  • lack of energy
  • difficulty falling asleep or staying asleep

Patients should tell their doctor if they suffer from any of the following symptoms:

  • heart disease, congestive heart failure, heart rhythm disorder, or high blood pressure
  • epilepsy or another seizure disorder
  • diabetes
  • overactive thyroid

Patients should tell their doctor if they are pregnant or are planning to become pregnant. However, "the most harmful thing to an embryo or fetus is lack of oxygen," and women should take it if they need it, Horovitz said. 

The FDA categorizes albuterol as a category C, meaning that it is unknown if albuterol could harm an unknown baby. It's also unknown about its effects during breastfeeding, so women should proceed with caution before taking it, according to the Mayo Clinic

Additional reporting by Live Science News Writer Laura Geggel. Follow her on Twitter @LauraGeggel. Follow Live Science @livescience, Facebook & Google+.

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