What is the effect of Albuterol (Salbutamol) and Budesonide 90-80 micrograms?

From the Guidelines

Albuterol-budesonide 90-80 should be used as needed for relief of acute asthma symptoms, with a typical dosage of 2 inhalations, and the maximum recommended use is 6 inhalations in 24 hours, as supported by the most recent guidelines 1.

Key Points

• This medication is used for the treatment of asthma in adults and children 4 years and older.
• The combination of albuterol and budesonide provides both immediate bronchodilation and anti-inflammatory effects in a single rescue inhaler.
• Patients should rinse their mouth after use to prevent oral thrush, a potential side effect of the budesonide component.
• If symptoms persist or worsen despite using this medication, medical attention should be sought immediately.

Dosage and Administration

• The typical dosage is 2 inhalations when experiencing shortness of breath, wheezing, or asthma symptoms.
• The maximum recommended use is 6 inhalations in 24 hours, and patients should not exceed 12 inhalations in any 24-hour period.
• The medication should be used as needed for relief of acute symptoms, and patients should receive regular follow-up to ensure that the intermittent regimen is still appropriate 1.

Benefits and Considerations

• The combination of albuterol and budesonide helps address the underlying inflammation during asthma symptoms rather than just treating the bronchospasm.
• Clinicians should inform individuals that the two treatment options do not have different effects on asthma control, asthma quality of life, or the frequency of asthma exacerbations when studied in large groups of people 1.
• Shared decision-making will allow the best choice to be made for a particular individual.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Albuterol-Budesonide 90-80 Overview

• The albuterol-budesonide 90-80 combination refers to a fixed-dose combination of 180 μg of albuterol and 160 μg of budesonide, with each dose consisting of two actuations of 90 μg and 80 μg, respectively 2.
• This combination is used as a rescue medication for patients with uncontrolled moderate-to-severe asthma who are receiving inhaled glucocorticoid-containing maintenance therapies 2, 3.

Efficacy and Safety

• The use of albuterol-budesonide 90-80 as a rescue medication has been shown to reduce the risk of severe asthma exacerbation by 26% compared to albuterol alone 2.
• The incidence of adverse events was similar in the albuterol-budesonide 90-80 group and the albuterol-alone group 2.
• The combination of albuterol and budesonide has been proposed as a reliever therapy to reduce asthma exacerbations and oral corticosteroid burden in patients with moderate-to-severe asthma 4.

Study Design and Population

• The MANDALA study, a multinational, phase 3, double-blind, randomized, event-driven trial, evaluated the efficacy and safety of albuterol-budesonide 90-80 as a rescue medication in patients with uncontrolled moderate-to-severe asthma 2, 3.
• The study enrolled adults and adolescents (≥12 years of age) who were randomly assigned to one of three trial groups: albuterol-budesonide 90-80, albuterol-budesonide 90-40, or albuterol alone 2.
• Children 4 to 11 years of age were randomly assigned to either the albuterol-budesonide 90-40 group or the albuterol-alone group 2.