From the Guidelines
If you accidentally swallow inhaled salbutamol, it is unlikely to cause significant harm, but it's essential to exercise caution. Salbutamol is a bronchodilator, and when swallowed, it may be absorbed into the bloodstream, potentially causing systemic effects such as tremors, palpitations, or nausea [ 1, 1 ]. However, the amount of salbutamol absorbed through swallowing is typically minimal, and the risk of severe adverse effects is low.
Potential Systemic Effects
The potential systemic effects of ingesting inhaled salbutamol include:
- Tachycardia: an increase in heart rate, which may be less pronounced when delivered through a metered dose inhaler compared to a nebulizer 1
- Arrhythmias: including premature ventricular contractions 1
- Decrease in serum potassium concentration: although typically mild and of uncertain clinical significance 1
- Other effects: such as unilateral mydriasis, severe bronchospasm, and takotsubo cardiomyopathy, although these are rare and often associated with other factors 1
Precautionary Measures
As a precautionary measure, if you have swallowed a large dose of inhaled salbutamol (more than 2-3 puffs or the equivalent of 200-600 micrograms), you should:
- Monitor your heart rate and blood pressure for a few hours
- Seek medical attention immediately if you experience any concerning symptoms, such as severe palpitations, dizziness, or shortness of breath
- Consult your doctor or pharmacist for advice, especially if you have any underlying medical conditions or are taking other medications 1
From the FDA Drug Label
The results of clinical trials with albuterol sulfate inhalation solution in 135 patients showed the following side effects which were considered probably or possibly drug related: Central Nervous System: tremors (20%), dizziness (7%), nervousness (4%), headache (3%), insomnia (1%). Gastrointestinal: nausea (4%), dyspepsia (1%) Ear, Nose and Throat: pharyngitis (<1%), nasal congestion (1%). Cardiovascular: tachycardia (1%), hypertension (1%). Respiratory: bronchospasm (8%), cough (4%), bronchitis (4%), wheezing (1%).
The FDA drug label does not answer the question.
From the Research
Effects of Ingesting Inhaled Salbutamol
- The studies provided do not directly address the effects of ingesting inhaled salbutamol, but rather the effects of inhaled salbutamol on various physiological parameters 2, 3, 4, 5, 6.
- However, it can be inferred that ingesting inhaled salbutamol may have similar effects to those observed with inhaled administration, including increased heart rate and metabolic rate 2, 3.
- A study on the metabolic effects of inhaled salbutamol found no changes in plasma nonesterified fatty acids, triglyceride, glucose, insulin, or cortisol after administration 5.
- Another study found that inhaled salbutamol did not cause a sustained increase in resting metabolic rate, but prevented the increase in oxygen consumption that occurs after acute inhalations in normal subjects 3.
- In patients with coronary artery disease and asthma or chronic obstructive pulmonary disease, inhaled salbutamol was found to increase heart rate, but did not cause myocardial ischemia, arrhythmias, or changes in heart rate variability 4.
- In non-asthmatic athletes, inhaled salbutamol was found to have no significant effect on endurance performance, although it may have improved respiratory adaptation at the beginning of exercise 6.