Albuterol

Medically Reviewed By University of Illinois Chicago Drug Information Group

Albuterol at a glance

Key highlights to know about albuterol are:

  • Albuterol is used to treat and prevent breathing problems (bronchospasms) in patients with reversible obstructive airway disease (asthma), as well as prevent exercise-induced asthma.
  • Albuterol is available as an inhaler and as a solution for nebulizers. The inhaler may contain an aerosol solution (sometimes called an HFA inhaler; HFA stands for hydrofluoroalkane, a propellant) or a dry powder. A tablet and syrup are also available, which are taken by mouth.
  • Albuterol aerosol inhalers and albuterol sulfate nebulizer solution are typically a moderate-cost drug, defined in this article as costing between $30-100/month.
  • Albuterol aerosol inhaler is available as a generic medication—albuterol HFA—and by the brand names ProAir HFA, Proventil HFA, and Ventolin HFA. The powder inhaler is available by the brand names ProAir Digihaler and ProAir RespiClick, and it is not available as a generic. The nebulized solution is available as a generic product and by the brand name Accuneb.

Important safety warnings for albuterol

Users of albuterol should be aware of these safety warnings:

  • Cardiovascular effects warning: Albuterol may increase your heart rate or blood pressure. Your healthcare provider will monitor you and may discontinue albuterol if these occur. Albuterol may also cause an abnormal heart rhythm. For this reason, your doctor may be extra cautious when starting albuterol if you have another heart condition, such as coronary artery disease, an arrhythmia, or high blood pressure (hypertension).
  • Coexisting conditions warning: Certain conditions can make you more likely to have side effects from albuterol. This may present as a worsening in your coexisting condition. If you have a heart condition, seizure disorder, hyperthyroidism, or diabetes, your healthcare provider may monitor you closely for worsening of your coexisting conditions and albuterol side effects.
  • Do not exceed recommended dose warning: Using doses of inhaled albuterol that are higher than prescribed has caused death. The reason for death is not completely known, but it may be due to worsening of severe asthma symptoms and trouble breathing (hypoxia), followed by cardiac arrest. Speak with your healthcare provider if your asthma becomes worse, and they will determine whether your dose should be increased.
  • Immediate allergic reaction warning: This drug may cause allergic reactions. Contact your healthcare provider immediately or get emergency help if you experience rash, hives, breathing problems, or swelling in the face, mouth or tongue. Some albuterol inhalers contain lactose, which can also cause allergic reactions if you have an allergy to milk protein.
  • Low potassium warning: Albuterol can cause low potassium levels in your blood (hypokalemia). This usually resolves on its own. Talk with your healthcare provider if you have a history of low potassium levels.
  • Paradoxical bronchospasm warning: Albuterol may cause serious breathing problems (bronchospasms). This may occur with all forms of albuterol. For inhaled forms, it is more common with the first use of a new canister. Talk with your healthcare provider immediately if you experience wheezing, coughing, or trouble breathing. If this occurs, albuterol should be discontinued immediately, and a new drug will be prescribed.
  • Use of anti-inflammatory agents warning: Albuterol alone may not be enough to control your asthma. It commonly needs to be given with an anti-inflammatory agent, such as a corticosteroid, to control symptoms. Your healthcare provider will determine if this is necessary.
  • Worsening of asthma warning: If you are using more doses of albuterol than usual for asthma symptoms, this may mean your asthma is getting worse. Talk with your healthcare provider if you are using albuterol more often. They can evaluate your asthma symptoms and adjust your current medications.

Talk with your doctor about these warnings in the context of your individual treatment plan and medical history.

What albuterol treats

This medication is used for the following reasons:

  • Treatment of bronchospasm in adults and children with reversible obstructive airway disease (asthma). Inhalers can be used in children 4 years of age and older.
  • Prevention of bronchospasm in adults and children 4 years of age and older with reversible obstructive airway disease 
  • Prevention of exercise induced bronchospasm in adults and children 4 years of age and older

Doctors sometimes prescribe medications for different uses. Ask your doctor or pharmacist for information about other uses of this medication.

How it works

Albuterol is in a class of medications called bronchodilators. It works by relaxing the blood vessels in the lungs. This makes it easier to breathe and increases the amount of oxygen that you get with each breath. Albuterol is not a steroid.

Albuterol inhalers

Albuterol comes in multiple formulations and devices. Albuterol is typically an inhaled medication, which is available as an aerosol inhaler, a dry powder inhaler, or a nebulizer solution. The dry powder inhaler is available by the brand names ProAir Digihaler and ProAir RespiClick. The dry powder inhaler is not available as a generic. The aerosol inhaler (also referred to as an inhaled suspension or an HFA inhaler; HFA stands for hydrofluoroalkane, a propellant) is available by several brand names and as a generic medication, albuterol HFA. The brand names are ProAir HFA, Proventil HFA, and Ventolin HFA. Each inhaler device is slightly different. Your healthcare provider or pharmacist will determine which one is right for you. The nebulizer solution is available as a generic product, albuterol sulfate solution, and some strengths are available by the brand name Accuneb.

Albuterol pills and syrup

Albuterol also comes as an oral medication that should be taken by mouth. They are also used for the treatment of bronchospasm in adults and children with reversible obstructive airway disease (asthma). These oral formulations include an immediate release tablet, extended-release tablet, and syrup. The nebulizer and oral syrup can be used for children 2 years of age and older. Oral tablets can be used in children 6 years of age and older. These are available as generic products only.

Side effects of albuterol

Albuterol side effects are possible and may go away with continued use. Serious side effects are rare.

Common side effects

The more common side effects that occur with albuterol include:

  • Chest pain
  • Cough
  • Fast heart rate or pounding feeling in your heart
  • Headache
  • Muscle or back pain
  • Nervousness
  • Shakiness
  • Sore throat
  • Upset stomach and vomiting

Serious side effects

Call your doctor right away if you have serious side effects. Seek emergency care (call 911) if you experience life-threatening symptoms, such as difficulty breathing; chest pain; loss of consciousness; sudden vision changes; or swelling of the face, mouth, tongue or throat.

Serious side effects and their symptoms can include the following:

  • Heart problems. Symptoms can include:
    • Fast heart rate
    • High blood pressure
  • Paradoxical bronchospasm. Symptoms can include:
    • Coughing
    • Wheezing
    • Worsening in trouble breathing
  • Serious allergic reactions. Symptoms can include:
    • Breathing problems
    • Hives
    • Rash
    • Swelling in your face, mouth or tongue

Other side effects are possible. Talk to your doctor or pharmacist if you have any side effect that bothers you or that does not go away.

Costs of albuterol

Without insurance, albuterol suspension for inhalation (an HFA inhaler) and albuterol sulfate nebulizer solution are typically moderate-cost drugs (defined in this article as costing between $30-100/month). You can check the out-of-pocket cash pay price for albuterol on prescription drug discount websites.

With insurance, prices can vary considerably. Individual health plans may have preferred drugs with better pricing. Insurances may prefer certain formulations of albuterol and determine which device you will receive. If the price of albuterol on your health plan is too expensive, ask your doctor or pharmacist if there is an equivalent drug you can substitute.

How albuterol may interact with other medicines

Albuterol may interact with other prescription and over-the-counter medications, vitamins, or herbal supplements you may be taking. To avoid harmful interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbal supplements you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

This is not a complete list of drugs that may interact with albuterol. However, examples of drugs that may interact with albuterol include:

Digoxin (Digox, Lanoxin)

Digoxin is used to treat several heart conditions. Using albuterol with digoxin can decrease the amount of digoxin in your blood. If you are taking albuterol with digoxin, your healthcare provider may order blood tests to monitor your digoxin level. This will ensure that you are receiving enough digoxin.

Disclaimer: Since drugs interact differently in each person, this information is not guaranteed to include all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbal supplements, and over-the-counter drugs that you are taking.

Other albuterol alerts

This drug comes with several alerts and warnings:

Lactose or milk protein allergy

  • Several formulations of the albuterol inhaler contain lactose (to improve stability) and may contain milk proteins. If you are allergic to either lactose or milk proteins, talk with your doctor or pharmacist to make sure you receive a formulation that is safe for you.

Call your doctor right away if you have serious side effects. Seek emergency care (call 911) if you experience life-threatening symptoms, such as difficulty breathing; chest pain; loss of consciousness; sudden vision changes; or swelling of the face, mouth, tongue or throat.

For pregnant and breastfeeding women

Can I take albuterol when pregnant?

It is not fully known if taking albuterol during pregnancy will harm your unborn baby. Uncontrolled asthma can also cause harm and complications to the unborn baby. Your doctor will work with you to determine whether you should continue taking albuterol during pregnancy, based on the risks and benefits. Talk with your doctor if you are pregnant or plan to become pregnant and are taking albuterol.

A pregnancy exposure registry exists for women who take this drug, and other drugs for asthma, during pregnancy in order to collect information about the health of you and your baby. To enroll yourself or get more information call 1-877-311-8972 or visit https://mothertobaby.org/ongoing-study/asthma/.

Can I take albuterol when breastfeeding?

It is unknown whether albuterol is present in breast milk, if it affects the breastfeeding infant, or if it affects milk production. The amount of albuterol in the blood after inhalation is low, so the amount transferred to milk is expected to be low. Talk with your healthcare provider about the risks and benefits of breastfeeding while using albuterol to come up with a plan that is right for you.

How and when to take albuterol

Albuterol may be used as needed to treat bronchospasm (trouble breathing, wheezing, coughing). It may also be taken around-the-clock on a schedule. Your healthcare provider or pharmacist will explain how to take your albuterol. Each form of albuterol is used differently. Correct use of inhalers and nebulizers is needed to obtain full benefit from albuterol.

Drug forms and strengths

  • Nebulizer solution
    • Albuterol sulfate 0.63 mg/3 mL (0.021%)
    • Albuterol sulfate 1.25 mg/3 mL (0.042%) (Accuneb)
    • Albuterol sulfate 2.5 mg/3 mL (0.083%)
    • Albuterol sulfate 2.5 mg/0.5 mL (0.5%)
  • Pressurized suspension (aerosol) inhaler (90 mcg/actuation)
    • ProAir HFA
    • Proventil HFA
    • Ventolin HFA
  • Powder inhaler (90 mcg/actuation)
    • ProAir Digihaler
    • ProAir RespiClick

Dosage for treatment of bronchospasm

  • Inhaler
    • Two puffs every 4 to 6 hours
  • Nebulizer
    • 2.5 mg administered 3 to 4 times per day
    • Children weighing < 15 kg may require lower doses.

Dosage for prevention of bronchospasm

  • Inhaler: two puffs every 4 to 6 hours

Dosage for prevention of exercise-induced bronchospasm

  • Inhaler: two puffs 15 to 30 minutes before exercise

If you miss a dose of albuterol

If you forget to take a dose, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the dose at the regular time. Do not take two doses at a time.

If you take too much albuterol

If you take too much albuterol, you are at a higher risk of having side effects. Serious side effects include seizures, chest pain, high or low blood pressure, fast heart rate, abnormal heart rhythm, nervousness, headache, shakiness, dry mouth, nausea, dizziness, tiredness,  and lack of energy. Albuterol overdose can lead to death. If you think you’ve taken too much of this drug, call your doctor or local poison control center at 1-800-222-1222.

Seek emergency care (call 911) if you experience life-threatening symptoms, such as difficulty breathing; chest pain; loss of consciousness; sudden vision changes; or swelling of the face, mouth, tongue or throat.

Helpful tips when taking albuterol

Keep these considerations in mind if your doctor prescribes albuterol for you.

General

  • The number of inhalations that each inhaler provides varies. Aerosol inhalers provide 60 to 200, and powder inhalers provide 200. Replace your inhaler when you have used all the inhalations. Using your inhaler for additional doses may not deliver enough medication.
  • Some inhalers may have counters to keep track of the number of doses you have left. Do not try to change the numbers on the counter.
  • Do not float the inhaler in water to find out if any medication is left in the canister.
  • Do not use the inhaler near an open flame or in extreme heat; certain types of inhalers can explode in extreme heat.
  • Instructions for using nebulizers and inhalers differ based on the device. Before your first use, read the complete instructions for using the device that your doctor or pharmacist gives you. Ask your pharmacist or healthcare provider how to use the device if you have any questions from the instructions. Practice using the device before your first use.
  • Clean the device on a regular schedule, using the instructions from the manufacturer.

Aerosol inhalers (Proventil HFA, Ventolin HFA, ProAir HFA, albuterol HFA)

  • Remove the cap before using.
  • Ensure no dirt is on the mouthpiece before using, if the cap was not replaced after last use.
  • You will need to prime the inhaler before you use it for the first time, if you drop it, or if you have not used it for fourteen days. To prime, shake the inhaler, then press down on the canister four times to release four sprays. Point the inhaler away from your face when doing this. Do not spray into your eyes.
  • Shake the inhaler before each use.
  • Breathe out completely before using the inhaler.
  • Hold your breath for ten seconds after using the inhaler.
  • Wait for one minute before repeating inhalation, if told to use two puffs.

Powder inhalers (ProAir RespiClick and Digihaler)

  • Do not open the inhaler cap until you are ready to use it. When you open the cap, you will hear a click, which means that your dose has been loaded into the inhaler. Opening the cap when you do not need a dose will waste doses.
  • Hold the inhaler upright. Do not shake the inhaler. This may result in wasting a dose.
  • Breathe out completely before using the inhaler.
  • Hold your breath for ten seconds after using the inhaler.
  • If you are told to use two puffs, close the cap between puffs.
  • Use a dry tissue or cloth to clean the inhaler.

Nebulizer

  • Remove one vial from the foil pouch at a time. Leave all other vials in the foil pouch until you use them.
  • The liquid should be clear and colorless. Do not use the vial if it is cloudy or discolored.
  • When using the nebulizer, sit in an upright position.
  • Your breathing should be calm, deep and even while using the nebulizer.
  • Continue using the nebulizer until no more mist forms in the nebulizer chamber.

Storage

Inhaler

  • Storage conditions will depend on the type of inhaler you receive.
  • For most inhalers, store at room temperature between 59°F and 77°F (20°C to 25°C). Ventolin HFA should be stored at room temperature between 68°F and 77°F (20°C to 25°C).
  • Keep the cap on during storage.
  • Keep this drug out of excessive heat and cold temperatures. Some inhalers are pressurized (aerosol inhalers), and temperatures above 120°F may cause the inhaler to burst.
  • For dry powder inhalers, always keep dry. Replace your inhaler if it gets wet. Store powder inhalers away from humidity.
  • For Proventil HFA and Ventolin HFA, store with the mouthpiece down.

Nebulizer

  • Storage conditions will depend on the nebulizer strength you receive.
  • For 0.5% (2.5 mg/0.5 mL), 0.042% (1.25 mg/3 mL), and 0.021% (0.63 mg/3 mL) solution, store between 36°F and 77°F (2°C to 25°C). For 0.083% (2.5 mg/3 mL) solution, store at room temperature between 68°F and 77°F (20°C to 25°C).
  • Store solution in foil pouch until ready to use. Contact your pharmacist for directions, if you leave the solution out of the foil pouch for an extended period of time.
  • Keep this drug away from light.
  • Keep this drug out of excessive heat.

Alcohol

There are no known interactions with albuterol and alcohol. If you are concerned about taking albuterol while drinking alcohol, talk with your doctor.

Refills

Your doctor will write the number of authorized refills on your prescription. Talk with your pharmacist if you have questions about refills.

Travel

When planning to travel, keep these tips in mind for packing your medication:

  • Bring enough medication for the entire trip based on when your next dose is due.
  • Keep your medication with you, in a purse or a carry-on bag if flying. Do not put it into a checked bag in case you are separated from your luggage.
  • Liquid medications are allowed through security when flying. They are also exempt from the 3-1-1 liquid rule.
  • Keep your medications in their original containers, if possible, to reduce delays during airport or security screening. Keep all medication together to expedite the process.
  • Avoid leaving your medication in a parked car for extended periods to protect it from extreme temperatures (hot or cold).

Availability

Many pharmacies stock this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it and has it in stock.

Prior Authorization

Many insurance companies do not require a prior authorization for this drug. Health plans may prefer certain formulations over others. If a prior authorization is needed, your doctor will need to get approval from your insurance company before your insurance company will pay for your prescription.

Medications similar to albuterol

Albuterol is considered a short-acting beta-2 agonist. Other medications in this class include: levalbuterol (Xopenex) and terbutaline. Albuterol is the most commonly used short-acting beta-2 agonist. The side effects and benefits of each agent differ.

Discontinuing use of albuterol

Do not stop taking this drug unless instructed by your doctor.

Healthgrades Disclaimer:

This information is for educational purposes only. It should not be interpreted as medical advice, diagnosis or treatment. Healthgrades takes every effort to ensure this information is accurate and up to date. This content is not intended to cover all possible uses, side effects, warnings, precautions, allergic reactions, or drug interactions. Do not assume that the absence of such information means the medication is safe for your personal use. Always consult your doctor, pharmacist, or healthcare professional before taking or discontinuing any medication.

Medical Reviewer: University of Illinois Chicago Drug Information Group
Last Review Date: 2021 Jul 30
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Ventolin HFA package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d92c5d6b-ff10-4087-36a2-1cfc464cb967
  2. Albuterol. MedlinePlus, National Library of Medicine, National Institutes of Health. https://medlineplus.gov/druginfo/meds/a607004.html
  3. Albuterol oral inhalation. MedlinePlus, National Library of Medicine, National Institutes of Health. https://medlineplus.gov/druginfo/meds/a682145.html
  4. Albuterol sulfate inhalation solution 0.021% & 0.042% package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=285a656c-f77f-4e77-b0a8-a0e9c901803f
  5. Albuterol sulfate inhalation solution 0.083% package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bb538b7d-e390-419a-9404-a57c1db4a447
  6. Albuterol sulfate inhalation solution, 0.5% package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ecc00500-58b8-491f-80df-dc6c89a08cae
  7. ProAir Digihaler medication guide. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=667ce3ec-5217-4b10-b712-f3e54fbbf087
  8. ProAir Digihaler package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=667ce3ec-5217-4b10-b712-f3e54fbbf087
  9. ProAir HFA package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8e701d71-1dcb-4b84-bada-84e4f04f5e62
  10. ProAir HFA medication guide. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8e701d71-1dcb-4b84-bada-84e4f04f5e62
  11. ProAir RespiClick medication guide. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9324e2eb-26fd-4f14-9f10-e5aa467306f4
  12. ProAir RespiClick package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9324e2eb-26fd-4f14-9f10-e5aa467306f4
  13. Proventil HFA package insert. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=917b6148-61f2-4e4d-9560-d261bac97060
  14. Ventolin HFA medication guide. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d92c5d6b-ff10-4087-36a2-1cfc464cb967