Does Proventil (albuterol) come in a higher dose than 5 mg per 3 mL inhalation solution?

Proventil Inhalation Solution Dosing

Yes, Proventil (albuterol) nebulizer solution is available in concentrations that allow for doses higher than 5 mg per 3 mL, as the standard adult dosing range is 2.5-5 mg per treatment, and doses can be doubled for severe exacerbations. 1

Available Concentrations and Dosing

The National Asthma Education and Prevention Program guidelines specify that albuterol nebulizer solution dosing varies by age and severity:

Pediatric Dosing:

• Children under 5 years: 0.63 mg/3 mL 1
• Children 5-11 years: 1.25-5 mg in 3 mL of saline 1

Adult Dosing:

• Standard dose: 2.5 mg in 3 mL of saline 1
• Higher dose option: Up to 5 mg per treatment 1
• Severe exacerbations: Doses may be doubled 1

Acute Exacerbation Protocol

For acute asthma exacerbations requiring higher doses, the recommended approach is:

• Initial treatment: 2.5-5 mg every 20 minutes for 3 doses 2, 3
• Maintenance: 2.5-10 mg every 1-4 hours as needed 2, 3
• Continuous nebulization for severe cases: 10-15 mg/hour for adults or 0.5 mg/kg/hour for children 2, 3

Important Clinical Considerations

Dilution requirements: Dilute aerosols to a minimum of 3 mL at a gas flow of 6-8 L/min for optimal delivery 2, 3

Combination therapy: Albuterol may be mixed with cromolyn solution, budesonide inhalant suspension, or ipratropium solution for nebulization in the same treatment 1

Monitoring: Watch for tachycardia, tremor, and hypokalemia, especially with frequent or high-dose administration 2, 3

Common Pitfall to Avoid

The 5 mg dose is not a ceiling—it represents the upper end of routine dosing, but severe exacerbations may require doubling this dose or transitioning to continuous nebulization at even higher hourly rates. 1, 2 Failing to escalate therapy appropriately in severe exacerbations can delay adequate bronchodilation and worsen outcomes.