Ventolin (Albuterol, Salbutamol)

Brand name : Ventolin

Generic Name : Albuterol ,Salbutamol

Manufacturer : Glaxo Wellcome

Medicine Category : Minor Ranquillizer& Antiasthmatic Preparation & Antihistamine & Antiallergy

FDA Pregnant Category :

Category C : Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal or other) and there are no controlled studies in women, or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus.

What is it used for ?

- Asthma
- Chronic obstructive pulmonary disease (COPD)

How does it work ?

This medicine contains the active ingredient salbutamol, which is a type of medicine known as a short-acting beta 2 agonist. It works by acting on receptors in the lungs called beta 2 receptors. Stimulation of these receptors causes the muscles in the airways to relax, allowing the airways to open.

In conditions where there is narrowing of the airways, such as asthma, emphysema and bronchitis, it is difficult for air to get in and out of the lungs. By opening the airways, salbutamol makes it easier to breathe.

Salbutamol is most commonly taken using an inhaler device. Inhaling the medicine allows it to act directly in the lungs where it is needed most. It also reduces the potential for side effects occurring in other parts of the body, as the amount absorbed into the blood through the lungs is lower than if it is taken by mouth.

Salbutamol when used as an inhaler is known as a reliever. This is because it works very quickly to relieve asthma attacks or shortness of breath. Salbutamol inhalers can also be used to open the airways shortly before exercising.

Salbutamol tablets are sometimes prescribed if inhaled salbutamol is being used frequently to relieve shortness of breath. The tablets are taken regularly to help keep the airways open all the time and reduce the need for the inhaler.

How should Ventolin (Albuterol) be used ?

Ventolin comes as tablets, extended-release (long-acting) tablets, and syrup to take by mouth and as an aerosol, solution, and powder-filled capsules to inhale by mouth. The solution is inhaled using a nebulizer, and the powder-filled capsules are inhaled using a special dry powder inhaler. Ventolin tablets and syrup are usually taken three or four times a day, and extended-release tablets are usually taken twice a day. The oral inhalation is usually used every 4 to 6 hours for the treatment or prevention of asthma symptoms. It is used 15 minutes before exercise when used for the prevention of bronchospasm during exercise. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Ventolin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Do not chew or crush the extended-release tablets; swallow them whole.

Ventolin controls symptoms of asthma and other lung diseases but does not cure them. Do not stop taking Ventolin without talking to your doctor.

Before you use the Ventolin inhaler for the first time, read the written instructions that come with it. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler while he or she watches.

Warning

- If this medicine fails to provide up to 3 hours relief from shortness of breath, seek medical advice.
- Inhalers may cause an unexpected increase in wheezing (paradoxical bronchospasm) straight after using them. If this happens, stop using the inhaler immediately and consult your doctor. The medicine should be stopped and an alternative treatment found.
- Blood potassium levels should be monitored in people with severe asthma, as low oxygen levels in the blood (hypoxia) and various asthma medicines, including this one, can lower blood potassium.

Use with caution in

- Diabetes
- Heart disease
- High blood pressure (hypertension)
- Hyperthyroidism
- Irregular heart beats (arrhythmias)

Not to be used in

Known sensitivity or allergy to any ingredient
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby.Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.
- This medicine passes into breast milk in small amounts. The effect of this on the breastfed baby is unknown, therefore this medicine should be used with caution in breastfeeding mothers. Discuss with your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Faster than normal heart beat (tachycardia)
- Unexpected narrowing of the airways (paradoxical bronchospasm)
- Low blood potassium level (hypokalaemia)
- Shaking, usually of the hands (tremor)
- Anxiety and restlessness
- Headache
- Awareness of your heart beat (heart palpitations)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

This medicine should not be taken with beta-blockers, such as atenolol, propranolol or timolol. This is because beta-blockers have an opposite action to this medicine and cause the airways to narrow. This can result in breathing difficulties for people with asthma or chronic obstructive airways disease.

Salbutamol can potentially cause a serious decrease in the levels of potassium in the blood (hypokalaemia), which may result in adverse effects. This effect can be increased by the following medicines:-
- xanthine derivates, such as theophylline
- corticosteroids, such as beclometasone and prednisolone
- diuretics, such as bendrofluazide and frusemide
- other beta 2 agonists, such as salmeterol.

Recommended dosage

Tab Adult 1-2 tab. Childn 1/2-1 tab tid-qid. Syr Adult 2 tsp, up to 4 tsp. Childn >12 yr 1-2 tsp, 6-12 yr 1 tsp, 2-6 yr 1/2-1 tsp. All doses to be taken tid-qid. Nebules 2.5-5 mg up to qid. Adult Up to 40 mg/day under strict medical supervision. Evohaler 1-2 puff qid. Resp soln Adult 0.5-1 mL diluted to a vol of 2-2.5 mL or 2 mL to be used undiluted qid. Continuous administration: 50-100 mcg/mL administered at a rate of 1-2 mg/hr. Childn <12 yr 0.5 mL diluted to a vol of 2-2.5 mL. Max: 1 mL to be repeated qid. Inj Severe bronchospasm & status asthmaticus Adult 500 mcg SC/IM 4 hrly as required or 250 mcg by slow IV bolus or infusion. Repeat as required. Status asthmaticus 3-20 mcg/min by IV infusion.

Overdosage

The preferred antidote for overdosage with salbutamol is a cardioselective b-blocking agent. However, b-blocking drugs should be used with caution in patients with a history of bronchospasm.
Hypokalaemia may occur following overdosage with salbutamol. Serum potassium levels should be monitored.
Respirator Solution: During continuous administration of Ventolin respirator solution, any signs of overdosage can be usually counteracted by withdrawal of the drug.

When you miss a dose

Take the forgotten dose as soon as you remember; then take any remaining doses for that day at equally spaced intervals. Never take a double dose.

Storage

Tablet: Store at a temperature not exceeding 30 C. Store in a dry place and replace cap securely.

Syrup: Store at a temperature not exceeding 30 C. Protect from light.
Expectorant Syrup: Store at a temperature not exceeding 25 C. Protect form light. Ventolin expectorant may be diluted with unpreserved syrup BP. The resulting mixture should be protected from light and will keep for 14 days.

Respirator Solution: Store at a temperature below 25 C. Protect form light. Once the bottle has been opened, the contents should be discarded after 1 month.

Evohaler: Store below 30 C. Protect from frost and direct sunlight.

Nebules: Store at a temperature below 30 C. Protect from light. Any unused solution in the chamber of the nebuliser must be discarded.

Injection: Store below 30 C. Protect from light. All unused admixtures of Ventolin parenteral preparations with infusion fluids should be discarded 24 hrs after preparation.

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