From the Guidelines
Albuterol can be used as a "prn" (as needed) medication for asthma, with a typical dose of 2 puffs (90 mcg per puff) via metered-dose inhaler every 4-6 hours as needed for wheezing, chest tightness, or shortness of breath, as recommended by the National Asthma Education and Prevention Program expert panel report 3 guidelines for the management of asthma exacerbations 1.
Key Considerations
- For children, dosing may be 1-2 puffs depending on age and weight, and it is essential to follow the guidelines for pediatric dosing 1.
- When using Albuterol, it is crucial to shake the inhaler well before use, exhale completely, place the mouthpiece in your mouth with lips sealed around it, inhale slowly while pressing down on the canister, hold your breath for 10 seconds, then wait 1 minute before taking the second puff if needed.
- Albuterol works as a short-acting beta-2 agonist that relaxes the smooth muscles in your airways, providing quick relief of bronchospasm.
- However, if you're using Albuterol more than twice a week, it suggests your asthma is not well-controlled, and you should consult your healthcare provider about adjusting your controller medications 1.
Potential Side Effects
- Side effects may include tremor, nervousness, increased heart rate, and headache, as reported in the expert panel report 3 guidelines for the diagnosis and management of asthma-summary report 2007 1.
Important Notes
- The regular use of beta agonists in asthma has been found to be neither harmful nor beneficial compared to as-needed use, as concluded in the Beta Agonist Study (BAGS) 1.
- It is essential to monitor the frequency of Albuterol use and adjust the treatment plan accordingly to ensure optimal asthma control.
From the FDA Drug Label
The action of albuterol sulfate inhalation solution may last up to six hours, and therefore it should not be used more frequently than recommended Do not increase the dose or frequency of medication without medical consultation. If symptoms get worse, medical consultation should be sought promptly.
Albuterol can be given as needed (prn) for asthma, but it is essential to follow the recommended dosage and frequency to avoid potential side effects. The medication's action can last up to 6 hours, and patients should not increase the dose or frequency without consulting a medical professional. If symptoms worsen, patients should seek medical attention promptly 2.
From the Research
Albuterol Administration for Asthma
- Albuterol can be given as-needed for asthma, but the optimal treatment interval and dosing schedule may vary depending on the severity of asthma and individual patient response 3, 4.
- For acute asthma, albuterol metered-dose inhaler with a holding chamber can be given optimally at 60-min intervals with minimal adverse effects for the majority of patients 3.
- However, patients who initially demonstrate a low or poor bronchodilator response to albuterol should be given subsequent treatments at 30-min intervals 3.
- The 2020 Asthma Guideline Update recommends as-needed short-acting β2-agonists (SABAs) for rescue therapy in step 1 (intermittent asthma) and as-needed concomitant ICS and SABA therapy in step 2 (mild persistent asthma) 5.
Comparison of Albuterol and Other Treatments
- A cost-utility analysis compared as-needed ICS-albuterol in separate inhalers to ICS-formoterol in a single inhaler as reliever therapy in pediatric patients with mild asthma, and found that ICS-formoterol was associated with lower costs and greater gain in quality-adjusted life-years (QALYs) 6.
- Another study found that four times daily dosing of albuterol did not lead to deterioration of asthma control in patients with moderate to severe asthma 4.
- The use of as-needed ICS-formoterol in a single inhaler is recommended as the preferred therapy for moderate persistent asthma in step 3 and step 4 5.
Key Considerations
- Patient adherence to ICS-containing medications as a daily maintenance therapy is poor, and many patients overuse short-acting beta2-agonist relievers, which can increase the risk of severe exacerbations and death 7.
- Airway inflammation varies over time, influenced by exposures such as viral infections and allergen, and as-needed ICS strategies can empower patients to adjust their ICS intake in response to symptom fluctuation 7.