Salbutamol (Albuterol Sulfate)
Salbutamol, also called albuterol, is a short-acting beta-2 agonist for relief of bronchospasm. Amounts in this record are expressed as salbutamol/albuterol base, including products that supply it as the sulfate.
It provides bronchodilation rather than adequate control of airway inflammation. Inhaled rescue treatment is generally paired with appropriate anti-inflammatory management.
Inhaled delivery generally acts faster than oral treatment. For a metered-dose inhaler, use an appropriate mask and holding chamber, shake and prepare the device as directed, and verify the amount delivered per actuation.
Monitor respiratory effort and rate, auscultation and clinical response; measure oxygenation or blood gases when indicated. Monitor heart rate/rhythm and potassium in susceptible patients.
A device delivering 90 mcg albuterol base per actuation is different from one delivering 100 mcg. Do not infer puff counts from canister mass or substitute sulfate mass for base mass.
A described equine emergency approach uses 360 mcg inhaled, with monitored repeats at 15-minute increments for up to two hours during severe obstruction, followed by reassessment and a less frequent schedule. Rapid tolerance can develop with sole beta-agonist treatment; concurrent anti-inflammatory treatment remains important.
Group
Short-acting beta-2 adrenergic bronchodilator
Mechanism of Action
Beta-2 receptor stimulation relaxes bronchial smooth muscle. Systemic adrenergic exposure can accelerate heart rate, shift potassium into cells and raise blood glucose.
Dose Rates
Dog
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bronchospasm | 20–50 mcg/kg | PO | Every 6–8 h | Do not use in: Pregnancy when uterine relaxation is undesirable; Oral doses are largely extrapolated; inhaled rescue treatment has a different regimen. |
| Bronchospasm | 100 mcg/kg | PO | Every 6 h | Do not use in: Pregnancy when uterine relaxation is undesirable; Reported upper oral dose, not an initial-dose recommendation. Monitor cardiovascular effects and potassium. |
| Bronchospasm | 20 mcg/kg | PO | Every 12 h | Lower initial oral course; if ineffective without adverse effects, a separately described escalation is 50 mcg/kg every 8-12 hours. Reduce to the lowest effective regimen. |
| Bronchospasm | 50 mcg/kg | PO | Every 8–12 h | Alternative oral regimen after response and adverse-effect assessment. |
| Bronchospasm | 2.5 mg/animal | INHALATION | Every 6 h | Reported nebulization regimen for an approximately 27 kg dog, not a universal canine fixed dose: 0.5 mL of 5 mg/mL solution added to 4 mL saline. Adjust the clinical plan for patient and device. |
Cat
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bronchospasm | 20–50 mcg/kg | PO | Every 6–8 h | Do not use in: Pregnancy when uterine relaxation is undesirable; Oral doses are largely extrapolated; inhaled rescue treatment has a different regimen. |
| Bronchospasm | 100 mcg/kg | PO | Every 6 h | Do not use in: Pregnancy when uterine relaxation is undesirable; Reported upper oral dose, not an initial-dose recommendation. Monitor cardiovascular effects and potassium. |
| Bronchospasm | 90–180 mcg/animal | INHALATION | As needed | One or two actuations only for a 90 mcg/actuation device, delivered through a fitted spacer and mask. In a crisis, monitored repeat treatment every 15 minutes for 3-4 treatments is described; reassess response and oxygenation. Continue appropriate anti-inflammatory treatment. |
Horse
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Bronchospasm | 360 mcg/animal | INHALATION | As needed | Do not use in: Pregnancy when uterine relaxation is undesirable; Adult horses: up to four treatments daily using a suitable adaptor. Equivalent to four actuations only for a device delivering 90 mcg base per actuation. |
| Bronchospasm | 0.01–0.02 mg/kg | PO | Every 8–12 h | Do not use in: Pregnancy when uterine relaxation is undesirable; Foals; monitor heart rate and clinical response. |
| Bronchospasm | 2–3 mcg/kg | INHALATION | As needed | Alternative delivered-dose regimen using an equine mask and spacer; determine the device-specific actuation count. |
| Bronchospasm | 0.8–2 mcg/kg | INHALATION | As needed | Separate lower inhaled-dose regimen for equine airway obstruction; assess response and device delivery. |
Bronchospasm — PO VDI-0009-D001
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 20–50 mcg/kg · PO · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — PO VDI-0009-D002
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 100 mcg/kg · PO · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — PO VDI-0009-D007
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 20 mcg/kg · PO · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — PO VDI-0009-D008
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 50 mcg/kg · PO · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — INHALATION VDI-0009-D009
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 2.5 mg/animal · INHALATION · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — PO VDI-0009-D003
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 20–50 mcg/kg · PO · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — PO VDI-0009-D004
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 100 mcg/kg · PO · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — INHALATION VDI-0009-D010
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 90–180 mcg/animal · INHALATION · as needed · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — INHALATION VDI-0009-D005
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 360 mcg/animal · INHALATION · as needed · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — PO VDI-0009-D006
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 0.01–0.02 mg/kg · PO · interval · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — INHALATION VDI-0009-D011
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 2–3 mcg/kg · INHALATION · as needed · UNSPECIFIED · start offset 0 h · Start selected course.
Bronchospasm — INHALATION VDI-0009-D012
- Alternative regimen: select one option in this treatment group; do not add alternatives together.
- Step 1: Bronchospasm — 0.8–2 mcg/kg · INHALATION · as needed · UNSPECIFIED · start offset 0 h · Start selected course.
Dog · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Dog · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Dog · Bronchospasm · Unspecified
- Duration · Maximum Days: 5
- Dilution · Concentration Basis: Active
Dog · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Dog · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Cat · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Cat · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Cat · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Horse · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Horse · Bronchospasm · Unspecified
- Eligibility · · Field: Life Stage
- Eligibility · · Operator: In
- Eligibility · · Values: Juvenile
- Eligibility · · Message: Foal-specific Regimen; Exact Age Limits Are Not Established.
- Dilution · Concentration Basis: Active
Horse · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Horse · Bronchospasm · Unspecified
- Dilution · Concentration Basis: Active
Indications
- Relief of reversible bronchospasm in dogs, cats and horses.
- Intermittent rescue bronchodilation during exacerbations, alongside treatment of airway inflammation.
Contraindications
- Avoid in pregnancy when inhibition of uterine contractions is undesirable.
- Use cautiously with tachyarrhythmias, cardiovascular disease, hypokalemia or hyperglycemia.
- Do not administer to animals intended for food under these regimens.
- Known salbutamol or formulation hypersensitivity.
- Use cautiously in hyperthyroidism, hypertension, seizure disorders and diabetes.
- Frequent scheduled racemic albuterol exposure may aggravate feline airway inflammation; reserve it principally for rescue and reassess control if frequent doses are required.
Interactions
- Other sympathomimetics can increase tachycardia and arrhythmia risk.
- Nonselective beta blockers can oppose bronchodilation.
- Potassium-depleting drugs can increase hypokalemia risk.
- Digoxin and inhalation anesthetics may increase arrhythmia risk.
- Tricyclic antidepressants and monoamine oxidase inhibitors may potentiate cardiovascular effects.
Adverse effects
- Tachycardia, tremors, agitation or arrhythmias.
- Hypokalemia and hyperglycemia with substantial systemic exposure.
- Inhibition of uterine contractions near term.
Toxicity
Excess exposure, including chewing an inhaler, can cause marked tachycardia, tremors, arrhythmias and hypokalemia. Monitor ECG, potassium and glucose; correct abnormalities according to measured values and clinical response.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Ventolin Syrup 2 mg/5 mL Contains salbutamol sulfate equivalent to 2 mg salbutamol base per 5 mL. | Oral Liquid | 2 mg / 5 mL | PO |
| Albuterol Sulfate Syrup 2 mg/5 mL (Quagen) Quagen Pharmaceuticals LLC Each 5 mL contains 2 mg albuterol base supplied as 2.4 mg albuterol sulfate. | Oral Liquid | 2 mg / 5 mL | PO |
| Albuterol Inhalation Solution USP 0.083% (Mylan) The Ritedose Corporation Unit-dose nebulizer solution; potency is expressed as albuterol base. Store in the pouch protected from light at 2-25 C. Not for injection. | Other | 2.5 mg / 3 mL | INHALATION |
| Albuterol Inhalation Solution USP 0.5% (Rising) Nephron Pharmaceuticals Corporation Concentrated nebulizer solution; potency is expressed as albuterol base. Dilute for nebulization. Store in pouch protected from light at 20-25 C; not for injection. | Other | 5 mg / mL | INHALATION |
Ventolin Syrup 2 mg/5 mL · preparation instructions
- Formulation Id: Salbutamol Conventional Oral
Albuterol Sulfate Syrup 2 mg/5 mL (Quagen) · preparation instructions
- Formulation Id: Salbutamol Conventional Oral
