Salbutamol inhaler: relief from asthma and COPD symptoms

People with asthma and chronic obstructive pulmonary disease (COPD) use a salbutamol inhaler to treat symptoms like wheezing, coughing, shortness of breath, and chest tightness. The inhaler delivers the drug salbutamol directly into the lungs for quick relief of symptoms. Salbutamol (also called albuterol) is a bronchodilator (NIH, 2016b). It opens the airways to make it easier to breathe (NIH, 2020). 

The familiar L-shaped inhaler releases either an aerosol or a powder form of salbutamol. This style of inhaler is a common, convenient, and fast-acting way to take salbutamol. However, it may not be easy for some people to use this type of inhaler. For younger children or anyone who may have difficulty with inhaling the medication, salbutamol is also available as a mist. Patients can inhale this mist, made by a nebulizer machine, through a mask or a mouthpiece (NIH, 2016b). For people who can't inhale medication at all, salbutamol is also available as a syrup or a tablet (NIH, 2016a).

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Patients with asthma or COPD (chronic obstructive pulmonary disease) may be prescribed salbutamol to treat acute attacks of difficulty breathing. Salbutamol can be used either as a "rescue" medication (a medicine taken to "rescue" you after symptoms begin) or as prevention (NIH, 2016b). 

Asthma is a common condition. About 7% of people in the U.S. have it (CDC, 2020). People who have asthma have sensitive airways that react to certain triggers by swelling up and causing it to become more difficult to breathe. Unlike asthma, which often begins in childhood, COPD is a preventable condition. Typically associated with long-term cigarette smoking, COPD is lung damage resulting from exposure to lung irritants (NIH, n.d.). Lung infections (e.g., the flu, pneumonia) are a trigger for COPD patients, causing chest tightness, trouble breathing, wheezing, and a productive (phlegm-producing) cough (Sapey, 2006; NIH, 2020).  

These two groups share many of the same symptoms, including coughing and trouble breathing (AAAAI, n.d.b). These symptoms are due to bronchospasm (tightening of airways). Salbutamol typically works within a few minutes, relaxing the airways and making it easier to breathe. The drug effect peaks after about two and a half hours and lasts for four to six hours total (Ejiofor, 2013). 

If you've had asthma for a while, you may be familiar with triggers that bring on asthma attacks. These are commonly exercise or cold, dry air (NIH, 2020). You can use salbutamol preventatively in these cases, taking it 15-30 minutes ahead of strapping on your running shoes or heading out into arctic temperatures (NIH, 2016b). However, it's essential to know that salbutamol helps to manage symptoms but isn't a cure.

In some cases, doctors prescribe salbutamol to treat hyperkalemia, a condition when there is too much potassium in the blood (Liu, 2019). In patients with a history of severe allergic reactions that cause difficulty breathing, a salbutamol inhaler may be prescribed to be used after initial treatment with a medication called epinephrine (EpiPen) to stop allergic reaction (Irani, 2015). It is important to note that salbutamol is not a medication used to treat allergic reactions. 

Yes. Salbutamol and albuterol are two different names for the same generic drug. Ventolin is a brand name. You may also be prescribed albuterol with the brand name ProAir or Acunneb (NIH, 2016b). It is a short-acting beta2-antagonist (or SABA), which means that it works quickly when you are short of breath, wheezing, or coughing. However, it means that it wears off quickly, too. Your healthcare provider may also prescribe an additional "control medication" that prevents your airways from narrowing (NIH, 2020). 

It's important to learn how to use your inhaler properly. It may be helpful to use it for the first time under the guidance of your healthcare professional. Your inhaler could be one of a few types: an aerosol spray, a powder inhaler, or a nebulizer (NIH, 2016b). Follow the instructions on the package of your medication, as instructions will vary. 

If you've been told to use salbutamol on a regular schedule and you miss a dose, take the missed dose, and resume the schedule. However, if it's almost time for your next scheduled dose, skip the missed dose, and wait for your next scheduled dose.

Some inhalers have counters to show how many doses you have left. If your inhaler doesn't come with a counter, keep track of how many puffs you've taken, and discard once you reach the number of doses indicated on the label or once you reach the expiration date, whichever comes first (NIH, 2016b). 

Your healthcare provider may advise you to use a spacer. The spacer helps to ensure the medication gets all the way into your airways instead of pooling at the back of the mouth, where it can cause oral candida infection (also called thrush). If you've been asked to use an inhaler, follow the guidance provided with your spacer device (NIH, 2020).

Store your salbutamol inhaler closed tightly in its original packaging, at room temperature, and out of reach of children (NIH, 2016b). 

Common side effects of salbutamol include (NIH, 2016b):

• Nervousness

• Shaking

• Throat irritation

• Cough

• Nausea or vomiting

• Muscle cramps

Speak to your healthcare provider if these side effects do not go away.

Follow your healthcare provider's instructions on how often to use your salbutamol inhaler and how much to use each time. Do not take this medication more than instructed. Overdose can result in chest pain, rapid heart rate, irregular heartbeat, swings in blood pressure, headaches, tremors, nervousness, insomnia, dizziness, nausea, or low potassium levels in the blood, which can cause muscle spasms, weakness, and heart problems (FDA, n.d.)

Talk to your healthcare provider before taking this medication if you:

• Have or have had any of the following conditions: heart disease, history of heart attack, irregular heartbeat (arrhythmias), or any other heart problems, high blood pressure (hypertension), diabetes, thyroid problems, seizures, or a history of low potassium levels in your blood (FDA, 2019)

• Take any of the following medications: MAOIs (monoamine oxidase inhibitors like Marplan and Nardil), beta-blockers (like Ternormin or Trandate), tricyclic antidepressants, diuretics (water pills), digoxin (Lanoxin), or other asthma medications (NIH, 2016b)

• Are pregnant, plan to become pregnant, or are breastfeeding (NIH, 2016b)

Other conditions, medications, or supplements may also interact with salbutamol. Be sure to discuss your medical history with your healthcare provider. 

Seek medical attention immediately if (FDA, 2019):

• Your breathing does not improve after taking salbutamol.

• Your wheezing, coughing, and breathing problems get worse after taking salbutamol.

• You notice you need to use salbutamol more frequently to address your symptoms.

These may be indications that salbutamol is not working or making your health conditions worse. 

You should also seek medical advice immediately if you experience any of the following serious side effects including rash, hives, itchiness, chest pain, irregular heartbeat, difficulty swallowing, swelling in the face (including throat, tongue, lips, or eyes), or hands, feet, or lower legs (NIH, 2016b).

Don't use salbutamol if:

• You are allergic to salbutamol (albuterol) or any ingredients in the medication (Some inhalers contain milk protein) (NIH, 2016)

There are no cures for asthma or COPD (chronic obstructive pulmonary disease). However, both can be managed by avoiding triggers like cigarette smoke, pollution, cold air, pollen, or other allergens and using medication like salbutamol. People with asthma and COPD are also more prone to lung infections, and lung infections exacerbate COPD symptoms (Sapey, 2006). Patients with asthma and COPD should get a flu shot every year (AAAAI, n.d.a; AAAAI, n.d.b).

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Current version

September 20, 2020

Written by

Hana Dethlefsen

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.