Is Albuterol (Ventolin) as needed?

From the Guidelines

Airsupra (albuterol/budesonide) can be used as needed for quick relief of asthma symptoms, with a recommended dosage of 2 inhalations as needed when experiencing symptoms like wheezing, chest tightness, or shortness of breath, as supported by the most recent guidelines 1.

Key Considerations

• The medication combines a rescue bronchodilator (albuterol) with an anti-inflammatory steroid (budesonide) to provide immediate symptom relief while also addressing underlying inflammation.
• If Airsupra is used more than twice per week, it may indicate that the asthma is not well-controlled, and the patient should consult their healthcare provider about adjusting their maintenance therapy.
• The Expert Panel suggests that individuals aged 12 years and older with mild persistent asthma who are not taking asthma treatment may benefit from as-needed ICS therapy, but those with low or high perception of symptoms may not be good candidates for this approach 1.

Dosage and Administration

• The typical dosage of Airsupra is 2 inhalations as needed, with a maximum dosage not specified in the provided guidelines.
• Patients should be instructed to use the medication only as needed for quick relief of symptoms, and to consult their healthcare provider if they experience increasing frequency of use or worsening symptoms.

Monitoring and Follow-up

• Patients using Airsupra as needed should receive regular follow-up to ensure that the intermittent regimen is still appropriate and to monitor for any signs of worsening asthma control.
• Clinicians should discuss the benefits and risks of as-needed ICS therapy with patients and families, and involve them in shared decision-making to determine the best treatment approach 1.

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.

The medication airsupra (albuterol) should be used as needed, but not more frequently than recommended, and only under medical consultation if symptoms get worse or if the dose or frequency needs to be increased 2.

From the Research

Asthma Management and Airsupra

• The use of as-needed inhaled corticosteroids (ICS) for patients with asthma is a topic of interest in recent studies 3.
• Recommendation 17 from the Guidelines for the prevention and management of bronchial asthma suggests that as-needed low-dose ICS-formoterol is recommended for patients with limited to occasional transient daytime symptoms, no nocturnal symptoms, no risk of exacerbations, and FEV1 > 80% predicted 4.
• The addition of long-acting beta2-agonists (LABAs) to ICS versus same dose ICS for chronic asthma in adults and children has been studied, and the results show that the addition of LABAs reduces the risk of exacerbations requiring oral steroids, improves lung function and symptoms, and modestly decreases use of rescue short-acting beta2-agonists 5.

As-Needed Medication Use

• A multidisciplinary intervention to improve albuterol inhaler utilization among patients with asthma was found to be effective in reducing the count of albuterol inhalers purchased per patient per month 6.
• The study also found that the proportion of patients with at least one systemic corticosteroid purchase decreased, and the proportion of patients who purchased more than one albuterol inhaler on the same day increased 6.
• Albuterol is a long-acting beta 2-adrenergic receptor-selective drug that relaxes airway smooth muscle, and its use as a reliever medication is common in asthma management 7.

Treatment Principles

• The treatment principles for cough variant asthma (CVA) are the same as those of typical asthma, and most patients respond to ICS or ICS-LABA 4.
• Recommendation 13 from the Guidelines for the prevention and management of bronchial asthma suggests that ICS-LABA demonstrates synergistic anti-inflammatory and anti-asthmatic effects, achieving efficacy equivalent to or better than doubling the ICS dose 4.
• The use of as-needed ICS strategies can improve asthma morbidity outcomes, particularly by reducing severe exacerbations and reducing the risk of adverse effects of oral corticosteroids 3.