What is the recommended dose for albuterol (salbutamol)?

From the Guidelines

The recommended dose for albuterol (salbutamol) is 2.5-5 mg every 20 minutes for 3 doses, then 2.5-10 mg every 1-4 hours as needed for adults using a nebulizer, and 4-8 puffs every 20 minutes for 3 doses, then every 1-4 hours as needed for adults using a metered-dose inhaler, as stated in the guidelines for the management of asthma exacerbations 1. The dose for children is 0.15 mg/kg (minimum dose 2.5 mg) every 20 minutes for 3 doses, then 0.15-0.3 mg/kg up to 10 mg every 1-4 hours as needed for nebulizer treatment, and 4-8 puffs every 20 minutes for 3 doses, then every 1-4 hours as needed for metered-dose inhaler treatment 1. Some key points to consider when administering albuterol include:

• Using a large volume nebulizer for continuous administration
• Diluting aerosols to a minimum of 3 mL at a gas flow of 6-8 L/min for optimal delivery
• Mixing with ipratropium nebulizer solution if necessary
• Ensuring proper technique for effective delivery, including exhaling fully, placing the mouthpiece between lips, inhaling slowly while activating the inhaler, holding breath for 10 seconds, and waiting 1 minute before the second puff if needed. It's also important to note that albuterol works as a short-acting beta-2 agonist to relax bronchial smooth muscle and open airways quickly, and side effects may include tremor, nervousness, increased heart rate, and headache 1. Overuse can lead to decreased effectiveness and worsening symptoms, so patients should follow prescribed dosing carefully. In terms of morbidity, mortality, and quality of life, it's crucial to follow the recommended dosing guidelines to ensure effective management of asthma symptoms and prevent potential complications. The guidelines provided in the study 1 are based on the most recent and highest quality evidence, and should be prioritized when making treatment decisions. Some other factors to consider when treating asthma exacerbations include:
• The severity of the exacerbation
• The patient's medical history and current medications
• The potential for interactions with other medications
• The need for additional treatments, such as oxygen therapy or corticosteroids. However, the primary focus should be on administering the recommended dose of albuterol, as stated in the guidelines 1, to ensure effective management of asthma symptoms and prevent potential complications.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Adults and Children 2 to 12 Years of Age: The usual dosage for adults and for children weighing at least 15 kg is 2.5 mg of albuterol (one vial) administered three to four times daily by nebulization. The recommended dose for albuterol is 2.5 mg administered three to four times daily by nebulization for adults and children weighing at least 15 kg. Key points to consider:

• Dose: 2.5 mg per administration
• Frequency: Three to four times daily
• Administration method: Nebulization
• Patient population: Adults and children weighing at least 15 kg 2

From the Research

Albuterol Dosing

• The recommended dose for albuterol (salbutamol) is not explicitly stated in the provided studies, but the studies discuss the use of albuterol in various treatment regimens for asthma.
• A study from 2005 3 compared the use of regular, scheduled administration of albuterol with ad-lib administration in patients hospitalized with acute asthma, and found that ad-lib administration resulted in a significant reduction in the total number of albuterol treatments administered.
• Another study from 2024 4 discussed the use of budesonide/formoterol or budesonide/albuterol as anti-inflammatory reliever therapy for asthma, but did not provide specific dosing information for albuterol.
• A cost-utility analysis from 2025 5 compared the use of as-needed inhaled corticosteroid-formoterol in a single inhaler with inhaled corticosteroid-albuterol in separate inhalers as reliever therapy in mild pediatric asthma, but did not provide specific dosing information for albuterol.
• A study from 2001 6 discussed the use of combination treatment with inhaled corticosteroid/long-acting beta 2-adrenergic bronchodilator in the treatment of asthma, but did not provide specific dosing information for albuterol.
• A study from 2024 7 discussed the use of albuterol/budesonide as reliever therapy to reduce asthma exacerbations, but did not provide specific dosing information for albuterol.

Key Findings

• The use of albuterol in combination with other medications, such as inhaled corticosteroids, may be effective in reducing asthma exacerbations and improving symptoms 4, 7.
• The use of ad-lib administration of albuterol may result in a significant reduction in the total number of albuterol treatments administered 3.
• The choice of albuterol dosing regimen may depend on individual patient needs and circumstances, and should be determined in consultation with a healthcare professional.