Salbutamol oral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Oral formulations of salbutamol.
Drugs List
Therapeutic Indications
Uses
Reversible airways obstruction
Dosage
Adults
Starting dose: 2mg three times a day.
Usual dose: 4mg three to four times a day, increasing to a maximum of 8mg three to four times a day if necessary.
Some patients may show an adequate response to 2mg three to four times a day.
Children
Children aged 12 to 18 years: 2mg to 4mg three to four times a day.
Children aged 6 to 12 years: 2mg three to four times a day.
Children aged 2 to 6 years: 1mg to 2mg three to four times a day.
Children aged 1 month to 2 years (unlicensed): 100 micrograms/kg - maximum 2mg three to four times a day.
Contraindications
Neonates under 1 month
Long QT syndrome
Torsade de pointes
Precautions and Warnings
Children 1 month to 2 years
Family history of long QT syndrome
Breastfeeding
Cardiac arrhythmias
Cardiovascular disorder
Diabetes mellitus
Electrolyte imbalance
Galactosaemia
Glucose-galactose malabsorption syndrome
History of torsade de pointes
Hypertension
Hyperthyroidism
Hypokalaemia
Hypoxia
Ischaemic heart disease
Lactose intolerance
Pregnancy
Severe cardiac failure
Thyrotoxicosis
Adjustment of hypoglycaemic therapy may be necessary in diabetes mellitus
Correct electrolyte disorders before treatment
Not to be used as the sole or main treatment for severe or unstable asthma
Oral solution contains sodium benzoate
Some formulations contain lactose
Consider monitoring ECG in patients at risk of QT prolongation
Monitor serum electrolytes
Monitor serum K+ in patients on high dose steroids/xanthines/diuretics
Monitor serum potassium regularly in severe asthmatic or hypoxic patients
Advise patient to report any chest pain
Advise patient to seek medical advice if asthma seems to be worsening
Patient should seek medical advice if usual relief is diminished
Concurrent use of corticosteroids increases the risk of diabetic ketoacidosis.
Pregnancy and Lactation
Pregnancy
Use salbutamol with caution during pregnancy.
Manufacturers recommend that oral salbutamol should only be used in pregnancy if essential.
At the time of writing there is limited published information regarding the use of salbutamol in the early stages of pregnancy but animal studies have shown harmful effects on the foetus at very high doses.
Lactation
Use with caution during breastfeeding.
The manufacturer recommends not to use salbutamol unless the potential benefits to the mother outweigh the potential risks to the neonate. Available data indicates salbutamol is present in human breast milk, the quantity is unknown. Effects on exposed infants are unknown.
Side Effects
Angioedema
Atrial fibrillation
Bronchospasm (paradoxical)
Cardiac arrhythmias
Collapse
Dyspnoea
Extrasystoles
Fine tremor (usually hands)
Headache
Hyperactivity
Hypersensitivity reactions
Hypokalaemia
Hypotension
Ketoacidosis
Muscle tension
Muscular cramps
Myocardial ischaemia
Nervous tension
Palpitations
Peripheral vasodilatation
Supraventricular tachycardia
Tachycardia
Urticaria
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: March 2021
Reference Sources
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.
Summary of Product Characteristics: Salbutamol Tablets 2mg. Accord UK Ltd. Revised February 2021.
Summary of Product Characteristics: Salbutamol Tablets 4mg. Accord UK Ltd. Revised February 2021.
Summary of Product Characteristics: Ventolin Syrup. GlaxoSmithKline UK. Revised November 2020.
Summary of Product Characteristics: Salbutamol Syrup 2mg/5ml. Pinewood Healthcare. Revised July 2020.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 18 March 2021
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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