Can Albuterol Cause Vomiting?
Yes, albuterol can cause vomiting, though it is not one of the most common side effects and typically occurs with higher doses or overdose situations.
Primary Adverse Effect Profile
The most frequently documented adverse effects of albuterol are cardiovascular (tachycardia, palpitations), metabolic (hypokalemia, hyperglycemia), and neurological (tremor, headache, nervousness) 1. Vomiting is notably absent from the primary adverse effect profiles in major guidelines 1, 2.
Evidence for Vomiting as an Adverse Effect
While not prominently featured in standard adverse effect lists, vomiting has been documented in specific clinical contexts:
Overdose and Ingestion Studies
- In pediatric overdose cases, vomiting was reported in 26% (20/78) of children who ingested excessive albuterol doses ranging from 0.2 to 8.8 mg/kg 3
- In a separate pediatric ingestion study, only 2 children out of 28 followed at home experienced transient mild symptoms including brief nausea and vomiting, with doses ranging from 0.1 to 1.9 mg/kg 4
- These studies suggest vomiting occurs more commonly with ingestion of higher doses than with standard inhaled therapeutic use 4, 3
Clinical Context
The key distinction is that vomiting appears to be a dose-related effect rather than a common side effect at therapeutic doses. The standard inhaled doses (2 puffs or 180-200 mcg) used for routine asthma management are far below the doses associated with gastrointestinal symptoms 5.
Common Pitfalls
- Don't confuse overdose effects with therapeutic dose effects: The cardiovascular and metabolic effects (tachycardia, tremor, hypokalemia) are the primary concerns at therapeutic doses, not gastrointestinal symptoms 1, 6
- Route matters: Systemic absorption is significantly higher with oral ingestion compared to inhaled administration, making gastrointestinal effects more likely with accidental ingestion 7, 4
Clinical Monitoring Recommendations
When vomiting occurs in a patient using albuterol, consider:
- Dose assessment: Verify the patient is using appropriate therapeutic doses (2 puffs every 4-6 hours as needed) rather than excessive amounts 5
- Alternative causes: Investigate other potential causes of vomiting, as it is not a hallmark albuterol side effect at standard doses 1
- Overdose evaluation: If overdose is suspected, monitor for the more typical signs including tachycardia, tremor, agitation, and metabolic derangements (hypokalemia, hyperglycemia) 3, 6