Albuterol, or salbutamol, is a short-acting bronchodilator that helps ease breathing difficulties due to chronic obstructive pulmonary disease (COPD). It comes as an inhaler or nebulizer.

A bronchodilator opens the bronchi, the passages that allow air to enter the lungs. When the airways relax and open, more air can flow, making breathing easier.

Albuterol comes in two forms: nebulizers and metered-dose inhalers (MDI). Nebulizers create a mist that a person inhales through a face mask or mouthpiece over several minutes. The MDI delivers medication directly into the lungs through a fine mist when the user inhales while pressing down on the inhaler’s canister.

This article looks at albuterol for COPD, including how it works, how to use it, and its potential side effects.

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The medication treats various COPD symptoms, including:

  • bronchospasms, when the muscles in the lung begin to tighten and interrupt airflow
  • breathing difficulties
  • coughing
  • wheezing

Albuterol is a selective beta2-adrenergic receptor (B2AR) agonist. This means that it only binds to B2ARs on the smooth muscles in the airways and activates them. As a result, the airway walls relax.

Albuterol is a quick-acting medication that begins working within minutes and lasts for about 4 to 6 hours.

Combining albuterol with other medications for COPD management, such as corticosteroids or long-acting beta-agonists, can provide even greater relief. A doctor will design a treatment plan according to a person’s needs.

Albuterol comes in various dosing forms and strengths. Doctors may use certain factors, such as the severity of their condition and the person’s reaction to albuterol, to help them decide how and when to use it for COPD.

Dosing

Someone with COPD can take albuterol through a nebulizer machine or MDI. Doctors determine the appropriate dose, for example:

Nebulizer

If a person experiences bronchospasms and breathing difficulties, a nebulized solution of 2.5 milligrams (mg) two or three times daily when necessary can ease symptoms quickly.

For severe bronchospasm, a person can increase the dosage from 2.5 to 5 mg every 20 minutes for three times the first hour, then 2.5 to 10 mg every 1-4 hours as necessary.

MDIs

Doctors often advise 1–2 puffs of 90 micrograms (mcg) every 4 to 6 hours with inhalers.

For severe bronchospasm, the dose can increase to 4–8 puffs of 90 mcg every 20 minutes for up to 4 hours, followed by 4–8 puffs every 1-4 hours as necessary.

A person must not exceed 12 puffs within 24 hours.

Special precautions

Albuterol carries several warnings and precautions, including the risk of experiencing:

  • potentially life threatening paradoxical bronchospasms, meaning it can worsen breathing or wheezing
  • deterioration of asthma symptoms
  • inadequate symptom control

Furthermore, doctors may advise people with certain health conditions to use alternative medications instead, such as those with:

Additionally, a person should not take albuterol during pregnancy and while chestfeeding unless necessary. Pregnant people should only use albuterol if the potential benefits outweigh the risks.

The most common side effects of albuterol are jitteriness, tremors, and nervousness. These issues happen primarily in children aged 2 to 6 years but can occur at any age.

Tremors occur because of the activation of the B2ARs and affect around 1 in 5 people.

About 1 in 10 individuals experience insomnia or nausea. Less commonly, individuals may experience the following:

  • fever
  • vomiting
  • headache
  • dizziness
  • cough
  • nosebleeds
  • swollen lymph nodes
  • allergic reactions

Albuterol may also increase blood pressure and can cause hypokalemia.

Doctors may also recommend albuterol to treat asthma, bronchitis, and other breathing problems. It also has uses in emergencies for those with severe asthma or COPD attacks.

Doctors may even recommend albuterol for breathing difficulties during exercise.

Additionally, albuterol has off-label use as a treatment for hyperkalemia, which refers to high potassium levels in the blood. However, a person should not use it as the sole therapy for this condition. Doctors should only recommend its use after attempting to treat the condition by other means first.

Albuterol is a bronchodilator that helps relax the airways to make breathing easier. Doctors use it to treat COPD, asthma, and other breathing issues. A person takes albuterol through an inhaler or nebulizer.

Common side effects of this medication include jitteriness, tremors, and nervousness. It may also cause insomnia or nausea.

People with certain health conditions or during pregnancy should not take albuterol unless necessary. As with any medication, individuals should discuss the risks and benefits of using albuterol with a doctor, who can recommend the best course of action.