Salbutamol is used to prevent or relieve the wheezing, shortness of breath, and difficulty breathing caused by asthma. Salbutamol is in a class of medications called beta agonists. It works by relaxing and opening air passages, making it easier to breathe.

Directions

Salbutamol comes as a solution to inhale using a nebulizer. It is usually used three times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use Salbutamol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Salbutamol controls asthma but does not cure it. Continue to use Salbutamol even if you feel well. Do not stop using Salbutamol without talking to your doctor.

To use the solution for oral inhalation, follow these steps:

• Tear the serrated edge on the foil pouch to open and remove one vial. Look at the solution in the vial to be sure it is colorless. If it is not colorless, call your doctor or pharmacist and do not use the solution
• Twist off the top of the vial and squeeze all of the liquid into the reservoir of your nebulizer. Do not add any other medications to the nebulizer because it may not be safe to mix them with Salbutamol. Use all nebulized medications separately unless your doctor specifically tells you to mix them
• Connect the nebulizer reservoir to your mouthpiece or facemask
• Connect the nebulizer to the compressor
• Sit upright and place the mouthpiece in your mouth or put on the facemask
• Turn on the compressor
• Breathe calmly, deeply, and evenly until mist stops forming in the nebulizer. This should take between 5 and 15 minutes
• Clean the nebulizer according to the manufacturer's instructions

Special Warnings and Precautions

Ventolin Nebules must only be used by inhalation, to be breathed in through the mouth, and must not be injected or swallowed.

The management of asthma should normally follow a stepwise programme, and patient response should be monitored clinically and by lung function tests.

Increasing use of short-acting inhaled β2 agonists to control symptoms indicates deterioration of asthma control. Under these conditions, the patient's therapy plan should be reassessed. Sudden and progressive deterioration in asthma control is potentially life threatening and consideration should be given to starting or increasing corticosteroid therapy. In patients considered at risk, daily peak flow monitoring may be instituted.

Patients receiving treatment at home with Ventolin Nebules must be warned that if either the usual relief is diminished or the usual duration of action reduced, they should not increase the dose or its frequency of administration, but should seek medical advice.

Ventolin Nebules should be used with caution in patients known to have received large doses of other sympathomimetic agents.

Salbutamol should be administered cautiously to patients with thyrotoxicosis.

A small number of cases of acute angle closure glaucoma have been reported in patients treated with a combination of nebulised salbutamol and ipratropium bromide. A combination of nebulised salbutamol with nebulised anticholinergics should therefore be used cautiously. Patients should receive adequate instruction in correct administration and be warned not to let the solution or mist enter the eye.

Potentially serious hypokalaemia may result from β2 agonist therapy mainly from parenteral and nebulised administration. Particular caution is advised in acute severe asthma as this effect may be potentiated by concomitant treatment with xanthine derivatives, steroids, diuretics and by hypoxia. It is recommended that serum potassium levels are monitored in such situations.

In common with other β-adrenoceptor agonists, Ventolin can induce reversible metabolic changes, for example increased blood sugar levels.

The diabetic patient may be unable to compensate for this and the development of ketacidosis has been reported. Concurrent administration of corticosteroids can exaggerate this effect.

Pregnancy and Lactation

Administration of medicines during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the foetus.

During worldwide marketing experience, rare cases of various congenital anomalies, including cleft palate and limb defects have been reported in the offspring of patients being treated with salbutamol. Some of the mothers were taking multiple medications during their pregnancies.

Because no consistent pattern of defects can be discerned, and baseline rate for congenital anomalies is 2-3%, a relationship with salbutamol use cannot be established.

As salbutamol is probably secreted in breast milk its use in nursing mothers is not recommended unless the expected benefits outweigh any potential risk. It is not known whether salbutamol in breast milk has a harmful effect on the neonate.

Side Effects

Salbutamol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• dizziness
• nervousness
• shaking hands that you cannot control
• upset stomach
• vomiting
• flu-like symptoms
• cough
• runny nose
• weakness
• fever
• diarrhea
• constipation
• frequent urination

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• chest pain
• fast or pounding heartbeat
• hives
• skin rash
• itching
• increased difficulty breathing or difficulty swallowing
• hoarseness
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• depression
• muscle pain, weakness, or cramping
• difficulty moving a part of the body

Salbutamol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Overdose Information

In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services. Symptoms of overdose may include:

• seizures
• chest pain
• fainting
• dizziness
• blurred vision
• upset stomach
• fast, pounding, or irregular heartbeat
• nervousness
• headache
• dry mouth
• shaking hands that you cannot control
• extreme tiredness
• weakness
• difficulty falling or staying asleep
• frequent urination
• depression
• muscle weakness or cramps
• constipation
• vomiting
• difficulty moving a part of the body

Storage

Store it at room temperature, below 30°C (86°F), and away from excess heat and moisture (not in the bathroom).

Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Salbutamol must be protected from light. Store unused vials in the foil pouch, and discard all unused vials 2 weeks after you opened the pouch. If you remove a vial from the pouch, you should protect it from light and use it within one week.