Salbutamol

Indications
 Oral
Acute bronchospasm
Adult: 2-4 mg (up to 8 mg) 3-4 times daily. As modified-release tablet: 8 mg bid.
Child: 1 mth-2 yr: 100 mcg/kg (max: 2 mg), 2-6 yr: 1-2 mg, >6 yr: 2 mg. Doses to be taken 3-4 times daily.
Elderly: Initially, 2 mg 3-4 times daily.
Inhalation
Acute bronchospasm
Adult: As aerosol: 100 or 200 mcg (1-2 puffs) 3-4 times daily. 2 puffs may be given prior to exertion to prevent exercise-induced bronchospasm.
Inhalation
Acute severe asthma
Adult: As MDI: 4-6 inhalations may be given every 10-20 min via a large volume spacer.
Parenteral
Severe bronchospasm
Adult: 250 mcg (as a solution of 50 mcg/ml) via IV inj, or via IV infusion of a solution containing 5 mg in 500 ml at a rate of 3-20 mcg/min adjusted according to patient's need. Higher dosages may be used in respiratory failure. IM/SC: 500 mcg, repeated every 4 hr if necessary.
Intravenous
Uncomplicated premature labour
Adult: For arrest of preterm labor between 24 and 33 wk of gestation: Initially, 10 mcg/min using a dilute solution of 20 mcg/ml in glucose 5% (200 mcg/ml of salbutamol if using a syringe pump), increase rate gradually at 10-min intervals until there is response; then increase slowly until contractions cease. Maintain rate for 1 hr after contractions have stopped, then gradually reduce rate by 50% at intervals of 6 hr. Usual dose: 10-45 mcg/min. Avoid prolonged therapy.
Inhalation
Severe bronchospasm
Adult: Via nebuliser: 2.5-5 mg, may repeat up to 4 times daily. Alternatively, may be given continuously at a rate of 1-2 mg/hr. Patients with asthma may require supplemental oxygen.
Child: >18 mth: Via nebuliser: 2.5-5 mg, may repeat up to 4 times daily. Alternatively, may be given continuously at a rate of 1-2 mg/hr. Patients with asthma may require supplemental oxygen.
Contraindications
 Eclampsia and severe pre-eclampsia; intra-uterine infection, intra-uterine foetal death, antepartum haemorrhage, placenta praevia and cord compression, threatened miscarriage, cardiac disease.
Warnings / Precautions
 Pregnancy; mild to moderate pre-eclampsia. Arrhythmias, hyperthyroidism, hypertension, DM, myocardial insufficiency, susceptibility to QT-interval prolongation. Monitor serum potassium levels. In women treated for premature labour, monitor hydration status, cardiac and respiratory function. Minimise volume of infusion fluid. Discontinue treatment if patient develops signs of pulmonary oedema.
Adverse Reactions
 Fine skeletal muscle tremor especially hands, tachycardia, palpitations, muscle cramps, headache, paradoxical bronchospasm, angioedema, urticaria, hypotension and collapse.
Potentially Fatal: Potentially serious hypokalaemia after large doses.
Overdose Reactions
 May lead to tachycardia, tremor, CNS stimulation, hypokalaemia and hyperglycaemia. Symptomatic treatment is recommended.
Drug Interactions
 Diuretics, corticosteroids and xanthines may augment hypokalaemia. CV effects potentiated by MAOIs, TCAs, sympathomimetics. Increases absorption of sulfamethoxazole when used together. May markedly increase heart rate and BP when used with atomoxetine. Reduces serum levels of digoxin. Hypokalaemia induced by salbutamol increases the risk of digitalis toxicity. BP should be closely monitored if linezolid is used concurrently with salbutamol.
See Below for More salbutamol Drug Interactions
Mechanism of Actions
 Salbutamol is a direct-acting sympathomimetic with β-adrenergic activity and selective action on β2 receptors, producing bronchodilating effects. It also decreases uterine contractility.
Onset: Inhalation: 5-15 min; oral: 30 min.
Duration: Inhalation: 3-6 hr; oral: 8 hr; modified-release preparation: 12 hr.
Absorption: Readily absorbed from the GI tract.
Metabolism: Hepatic and in the gut wall.
Excretion: Via the urine as metabolites and unchanged drug. Some excretion in the faeces.
Administration
 Should be taken on an empty stomach. (Take 1 hr before or 2 hr after meals.)
Storage Conditions
 Inhalation: Store between 2-25°C (36-77°F). Intravenous: Store below 30°C. Protect from light. Oral: Store at 20-25°C (68-77°F). Parenteral: Store below 30°C. Protect from light.
ATC Classification
 R03AC02 - salbutamol ; Belongs to the class of adrenergic inhalants, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
R03CC02 - salbutamol ; Belongs to the class of adrenergics for systemic use, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
Storage
 Inhalation: Store between 2-25°C (36-77°F). Intravenous: Store below 30°C. Protect from light. Oral: Store at 20-25°C (68-77°F). Parenteral: Store below 30°C. Protect from light.
Available As
  • Salbutamol 0.5 mg
  • Salbutamol 0.50 mg
  • Salbutamol 1 mg
  • Salbutamol 1.0 mg
  • Salbutamol 1.00 mg
  • Salbutamol 1.5 mg
  • Salbutamol 10 mg
  • Salbutamol 100 mcg
  • Salbutamol 100 mg
  • Salbutamol 2 mg
  • Salbutamol 2.5 mg
  • Salbutamol 20 mg
  • Salbutamol 200 mcg
  • Salbutamol 300 mg
  • Salbutamol 4 mg
  • Salbutamol 400 mcg
  • Salbutamol 400 mg
  • Salbutamol 5 mg
  • Salbutamol 50 mcg
  • Salbutamol 500 mg
  • Salbutamol 8 mg

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