From the FDA Drug Label
The expected symptoms with overdosage are those of excessive beta-adrenergic stimulation and/or occurrence or exaggeration of any of the symptoms listed under ADVERSE REACTIONS, e.g., seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats per minute, arrhythmias, nervousness, headache, tremor, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, and insomnia. The cut-off for heart rate for Salbutamol (albuterol) is up to 200 beats per minute in the context of overdosage symptoms 1.
- Tachycardia is listed as a symptom with rates up to 200 beats per minute.
- This information does not provide a specific cut-off for normal use, but rather in the context of overdosage.
From the Research
Salbutamol administration should be approached with caution if a patient's heart rate exceeds 120-130 beats per minute, as it can cause tachycardia as a side effect, as evidenced by a study published in 2021 2. When administering salbutamol (also known as albuterol), healthcare providers should monitor vital signs before and after administration, especially in patients with pre-existing cardiovascular conditions.
- Salbutamol is a short-acting beta-2 agonist that works by relaxing airway smooth muscles to improve breathing,
- but it can also stimulate beta-1 receptors in the heart, particularly at higher doses, leading to increased heart rate and potential palpitations. For patients with significant tachycardia, consider using the lowest effective dose of salbutamol, ensuring adequate hydration, and potentially consulting with a specialist before administration. In emergency situations where respiratory distress outweighs cardiovascular concerns, clinical judgment should guide the decision to administer salbutamol despite elevated heart rate, as supported by a study published in 1998 3.
The most recent and highest quality study, published in 2021 2, found that salbutamol nebulization can lead to a significant increase in heart rate when compared to nebulization with normal saline in healthy individuals.
- This study highlights the importance of monitoring heart rate in patients receiving salbutamol, especially in those with pre-existing cardiovascular conditions.
- The study's findings are consistent with the known pharmacological effects of salbutamol, which can stimulate beta-1 receptors in the heart, leading to increased heart rate and potential palpitations. Overall, while there is no specific heart rate cutoff for salbutamol administration, healthcare providers should exercise caution when administering the medication to patients with elevated heart rates, and consider alternative treatments or consult with a specialist if necessary, as suggested by a study published in 1988 4.