AlbuterolAlbuterol Sulfate

About Albuterol

Albuterol is a short-acting beta2-agonist that relaxes the muscle around the airways. The HFA inhalers and ProAir RespiClick are labeled for treating or preventing bronchospasm in people 4 years and older with reversible obstructive airway disease, and for preventing exercise-induced bronchospasm from age 4. The usual dose is 2 puffs every 4 to 6 hours, or 2 puffs 15 to 30 minutes before exercise. Nebulizer vials of 2.5 mg per 3 mL are labeled from age 2, the 0.63 and 1.25 mg vials for children 2 to 12 with asthma, and the 0.5 percent solution, diluted with saline, from age 12. Tablets are labeled from age 6 and syrup from age 2.

There is no boxed warning. Albuterol can cause paradoxical bronchospasm, a sudden and possibly life-threatening tightening of the airways that means stopping it at once, and deaths have been reported with excessive use of inhaled sympathomimetic drugs in asthma, so the prescribed dose is not exceeded. A bronchodilator alone may not control asthma, and needing it more often than usual is a reason to call the prescriber. It can affect heart rate and blood pressure, lower potassium and cause allergic reactions such as hives, swelling and rash, and it is used with caution with heart disease, seizure disorders, an overactive thyroid or diabetes. RespiClick must not be used with a severe milk protein allergy. Ventolin HFA lists throat irritation, viral respiratory infections, cough and muscle or bone pain as common side effects; the ProAir HFA authorized generic lists headache, fast heartbeat, dizziness and sore throat; and MedlinePlus lists nervousness, shakiness and headache with the tablets and syrup.

The devices differ. HFA inhalers are sprays that are shaken and primed, and the number of priming sprays depends on the product (4 for Ventolin HFA, 3 for the authorized generic of ProAir HFA); ProAir RespiClick is a breath-actuated powder inhaler that needs no priming, is never washed and is not used with a spacer. AccuNeb, ProAir Digihaler and every extended-release albuterol tablet, brand or generic (Volmax, VoSpire ER and Proventil among them), are listed as discontinued. Combinations with budesonide (Airsupra) or ipratropium (Combivent Respimat and nebulizer solution) are separate products.

Taking Albuterol

How to take it

Prime an HFA inhaler as its leaflet directs (Ventolin HFA: 4 sprays into the air before first use, after more than 2 weeks unused or if dropped), and wash its mouthpiece with warm water and let it air-dry at least once a week. Never wash RespiClick or use it with a spacer. A nebulizer vial is inhaled over 5 to 15 minutes.

If you miss a dose

It is usually used as needed. If you were told to use it on a schedule, take the missed dose when you remember unless it is almost time for the next one; then skip it. Do not take a double dose.

Storage

At room temperature, away from heat and moisture, out of reach of children. Do not puncture an HFA canister or put it near fire; it can burst above 120°F. Throw an inhaler away when its counter reaches zero (RespiClick also 13 months after opening its foil pouch), and keep nebulizer vials in their foil pouch, away from light, until use.

Interactions to know about

Beta-blockers can block its effect and may cause severe bronchospasm in people with asthma; non-potassium-sparing diuretics can worsen low potassium; it can lower digoxin levels; and monoamine oxidase inhibitors or tricyclic antidepressants, taken now or within 2 weeks, can strengthen its effects on the heart and blood vessels.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Albuterol differs from pharmacy to pharmacy

Albuterol inhalers are not interchangeable at the counter. Each generic HFA inhaler is rated equivalent to one brand only (Proventil HFA, ProAir HFA or Ventolin HFA), so a pharmacist substitutes only within that group, where state law allows; an authorized generic is the brand’s own inhaler sold under the generic name, and ProAir RespiClick has no rated generic. A quote therefore depends on the product the prescription names and whether it allows substitution.

Ventolin HFA comes with 60 or 200 puffs, and nebulizer vials come in four strengths, so quotes are comparable only for the same product, strength and quantity.

Ways to pay less for Albuterol without insurance

• Ask the prescriber to allow substitution, so a rated generic or authorized generic of the inhaler prescribed can be dispensed.
• If ProAir RespiClick is prescribed, ask the prescriber whether an HFA inhaler would suit you, since RespiClick has no rated generic.
• For nebulizer vials, tablets or syrup, ask whether albuterol is on the pharmacy’s flat-price generic list.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Albuterol

1. 1.Is my inhaler rated equivalent to the brand on my prescription?
2. 2.How do I prime, clean and read the counter on my inhaler?
3. 3.Should I use a spacer with my inhaler?
4. 4.How often can I use it before I should call my doctor?

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