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ProAir HFA Disease Interactions

There are 5 disease interactions with ProAir HFA (albuterol).

Moderate

Beta- 2 adrenergic bronchodilators (applies to ProAir HFA) cardiovascular

Moderate Potential Hazard, High plausibility. Applicable conditions: Heart Disease, Hypertension, Hyperthyroidism

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

References

  1. Chazan R, Droszcz W, Maruchin JE (1988) "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol, 26, p. 385-7
  2. Larsson S (1977) "Long-term treatment with beta2-adrenostimulants in asthma. Side effects, selectivity, tolerance, and routes of administration." Acta Med Scand Suppl, 608, p. 1-40
  3. Mettauer B, Rouleau JL, Burgess JH (1985) "Detrimental arrhythmogenic and sustained beneficial hemodynamic effects of oral salbutamol in patients with chronic congestive heart failure." Am Heart J, 109, p. 840-7
  4. Larsson S, Svedmyr N (1977) "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis, 116, p. 861-9
  5. Vathenen AS, Britton JR, Ebden P, Cookson JB, Wharrad HJ, Tattersfield AE (1988) "High-dose inhaled albuterol in severe chronic airflow limitation." Am Rev Respir Dis, 138, p. 850-5
  6. Godfrey S (1981) "Worldwide experience with albuterol (salbutamol)." Ann Allergy, 47, p. 423-6
  7. Finch JS (1981) "Cardiovascular toxicity: clinical evaluation of albuterol, isoproterenol and placebo in rising dose tolerance trial." Ann Allergy, 47, p. 402-4
  8. Neville E, Corris PA, Vivian J, Nariman S, Gibson GJ (1982) "Nebulised salbutamol and angina." Br Med J (Clin Res Ed), 285, p. 796-7
  9. Breeden CC, Safirstein BH (1990) "Albuterol and spacer-induced atrial fibrillation." Chest, 98, p. 762-3
  10. Wolfe JD, Yamate M, Biedermann AA, Chu TJ (1985) "Comparison of the acute cardiopulmonary effects of oral albuterol, metaproterenol, and terbutaline in asthmatics." JAMA, 253, p. 2068-72
  11. Wong CS, Pavord ID, Williams J, Britton JR, Tattersfield AE (1990) "Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma." Lancet, 336, p. 1396-9
  12. Shovlin CL, Tam FW (1990) "Salbutamol nebuliser and precipitation of critical cardiac ischaemia." Lancet, 336, p. 1258
  13. Spitzer WO, Suissa S, Ernst P, Horwitz RI, Habbick B, Cockcroft D, Boivin JF, McNutt M, Buist AS, Rebuck AS (1992) "The use of beta-agonists and the risk of death and near death from asthma." N Engl J Med, 326, p. 501-6
  14. Price AH, Clissold SP (1989) "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs, 38, p. 77-122
  15. Richards DM, Brogden RN (1985) "Pirbuterol. A preliminary review of its pharmacological properties and therapeutic efficacy in reversible bronchospastic disease." Drugs, 30, p. 6-21
  16. Lampert MB, Hibbard J, Weinert L, Briller J, Lindheimer M, Lang RM (1993) "Peripartum heart failure associated with prolonged tocolytic therapy." Am J Obstet Gynecol, 168, p. 493-5
  17. Al-Hillawi AH, Hayward R, Johnson NM (1984) "Incidence of cardiac arrhythmias in patients taking slow release salbutamol and slow release terbutaline for asthma." Br Med J (Clin Res Ed), 288, p. 367
  18. Bengtsson B, Fagerstrom PO (1982) "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther, 31, p. 726-32
  19. (1985) "Adverse effects and complications of treatment with beta-adrenergic agonist drugs. Committee on drugs, the American Academy of Allergy and Immunology." J Allergy Clin Immunol, 75, p. 443-9
  20. Wagner JM, Morton MJ, Johnson KA, O'Grady JP, Speroff L (1981) "Terbutaline and maternal cardiac function." JAMA, 246, p. 2697-701
  21. Kinney EL, Trautlein JJ, Harbaugh CV, Lambert D, Zelis RF (1978) "Ventricular tachycardia after terbutaline." JAMA, 240, p. 2247
  22. Whitsett TL, Manion CV, Wilson MF (1981) "Cardiac, pulmonary and neuromuscular effects of clenbuterol and terbutaline compared with placebo." Br J Clin Pharmacol, 12, p. 195-200
  23. Brogden RN, Speight TM, Avery GS (1973) "Terbutaline: a preliminary report of its pharmacological properties and therapeutic efficacy in asthma." Drugs, 6, p. 324-32
  24. Trautlein J, Allegra J, Gillin M (1977) "Aerosolized terbutaline sulfate--an evalution of efficacy and side effects in patients with reversible airway disease." J Clin Pharmacol, 17, p. 76-80
  25. Maguire GP, Emirgil C (1986) "Bronchodilator and side effects of different modes of administration of metaproterenol: inhaled, oral, and in combination." Am J Med Sci, 291, p. 168-74
  26. Ence TJ, Tashkin DP, Ho D, Child JS (1979) "Acute bronchial and cardiovascular effects of oral pirbuterol and metaproterenol." Ann Allergy, 43, p. 229-36
  27. Sanders JP, Potter DE, Ellis S, Bee DE, Grant JA (1977) "Metabolic and cardiovascular effects of carbuterol and metaproterenol." J Allergy Clin Immunol, 60, p. 174-9
  28. (2002) "Product Information. Proventil (albuterol)." Schering Corporation
  29. (2002) "Product Information. Ventolin (albuterol)." Glaxo Wellcome
  30. (2001) "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals
  31. Meyer JM, Wenzel CL, Kradjan WA (1993) "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother, 27, p. 1478-87
  32. Maconochie JG, Forster JK (1992) "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol, 33, p. 342-5
  33. Brogden RN, Faulds D (1991) "Salmeterol xinafoate. A review of its pharmacological properties and therapeutic potential in reversible obstructive airways disease." Drugs, 42, p. 895-912
  34. Littner MR, Tashkin DP, Calvarese B, Bautista M (1982) "Acute bronchial and cardiovascular effects of increasing doses of pirbuterol acetate aerosol in asthma." Ann Allergy, 48, p. 14-20
  35. Chodosh S, Crooks LA, Tuck J (1989) "Comparative effects of pirbuterol acetate, metaproterenol, and placebo aerosols on pulmonary function and incidence of cardiac ectopy." J Asthma, 26, p. 309-15
  36. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
  37. (2001) "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals
  38. (2001) "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim
  39. Hibbard JU (1996) "Chronic terbutaline therapy and peripartum cardiomyopathy: a case-control study." Hypertens Pregnancy, 15, p. 183-91
  40. Katz M, Robertson PA, Creasy RK (1981) "Cardiovascular complications associated with terbutaline treatment for preterm labor." Am J Obstet Gynecol, 139, p. 605-8
  41. Suissa S, Hemmelgarn B, Blais L, Ernst P (1996) "Bronchodilators and acute cardiac death." Am J Respir Crit Care Med, 154, p. 1598-602
  42. Tranfa CME, Pelaia G, Grembiale RD, Naty S, Durante S, Borrello G (1998) "Short-term cardiovascular effects of salmeterol." Chest, 113, p. 1272-6
  43. Braden GL, Germain MJ, Mulhern JG, Hafer JG, Bria WF (1998) "Hemodynamic, cardiac, and electrolyte effects of low-dose aerosolized terbutaline sulfate in asthmatic patients." Chest, 114, p. 380-7
  44. Jenne JW (1998) "Can oral beta(2) agonists cause heart failure?" Lancet, 352, p. 1081-2
  45. (2022) "Product Information. Tornalate (bitolterol)." Apothecon Inc
  46. Nathan RA, Bronsky EA, Dockhorn RJ, Kemp JP (1994) "Multicenter dose-ranging study of bitolterol mesylate solution for nebulization in children with asthma." Ann Allergy, 72, p. 209-16
  47. Bierman CW, Kemp JP, Nathan RA (1996) "Efficacy and safety of inhaled bitolterol mesylate via metered-dose inhaler in children with asthma." Ann Allergy Asthma Immunol, 76, p. 27-35
  48. Pinnas JL, Bhatt BD, Campbell SC, Kemp JP, Tinkelman DG (1987) "Dose-response study of nebulized bitolterol mesylate solution in asthmatic patients." Chest, 91, p. 533-9
  49. (2001) "Product Information. Xopenex (levalbuterol)." Sepracor Inc
  50. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS (1999) "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol, 103, p. 615-21
  51. (2014) "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim
View all 51 references
Moderate

Beta- 2 adrenergic bronchodilators (applies to ProAir HFA) diabetes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus

Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

References

  1. Chazan R, Droszcz W, Maruchin JE (1988) "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol, 26, p. 385-7
  2. Hastwell G, Lambert BE (1978) "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol, 85, p. 767-9
  3. Price AH, Clissold SP (1989) "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs, 38, p. 77-122
  4. Bengtsson B, Fagerstrom PO (1982) "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther, 31, p. 726-32
  5. (2002) "Product Information. Proventil (albuterol)." Schering Corporation
  6. (2002) "Product Information. Ventolin (albuterol)." Glaxo Wellcome
  7. (2001) "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals
  8. Meyer JM, Wenzel CL, Kradjan WA (1993) "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother, 27, p. 1478-87
  9. Maconochie JG, Forster JK (1992) "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol, 33, p. 342-5
  10. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
  11. (2001) "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals
  12. (2001) "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim
  13. (2022) "Product Information. Tornalate (bitolterol)." Apothecon Inc
  14. (2001) "Product Information. Xopenex (levalbuterol)." Sepracor Inc
  15. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS (1999) "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol, 103, p. 615-21
  16. (2001) "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals
  17. (2014) "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim
View all 17 references
Moderate

Beta- 2 adrenergic bronchodilators (applies to ProAir HFA) hypokalemia

Moderate Potential Hazard, Moderate plausibility.

Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.

References

  1. Whyte KF, Addis GJ, Whitesmith R, Reid JL (1987) "The mechanism of salbutamol-induced hypokalaemia." Br J Clin Pharmacol, 23, p. 65-71
  2. Larsson S, Svedmyr N (1977) "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis, 116, p. 861-9
  3. Allon M, Dunlay R, Copkney C (1989) "Nebulized albuterol for acute hyperkalemia in patients on hemodialysis." Ann Intern Med, 110, p. 426-9
  4. Hastwell G, Lambert BE (1978) "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol, 85, p. 767-9
  5. (1981) "Hypokalaemia due to salbutamol overdosage." Br Med J (Clin Res Ed), 283, p. 500-1
  6. Kantola I, Tarssanen L (1986) "Hypokalemia from usual salbutamol dosage ." Chest, 89, p. 619-20
  7. Montoliu J, Almirall J, Ponz E, Campistol JM, Revert L (1990) "Treatment of hyperkalaemia in renal failure with salbutamol inhalation." J Intern Med, 228, p. 35-7
  8. Wong CS, Pavord ID, Williams J, Britton JR, Tattersfield AE (1990) "Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma." Lancet, 336, p. 1396-9
  9. Price AH, Clissold SP (1989) "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs, 38, p. 77-122
  10. Gross TL, Sokol RJ (1980) "Severe hypokalemia and acidosis: a potential complication of beta- adrenergic treatment." Am J Obstet Gynecol, 138, p. 1225-6
  11. Hurlbert BJ, Edelman JD, David K (1981) "Serum potassium levels during and after terbutaline." Anesth Analg, 60, p. 723-5
  12. Bengtsson B, Fagerstrom PO (1982) "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther, 31, p. 726-32
  13. Gelmont DM, Balmes JR, Yee A (1988) "Hypokalemia induced by inhaled bronchodilators." Chest, 94, p. 763-6
  14. Sanders JP, Potter DE, Ellis S, Bee DE, Grant JA (1977) "Metabolic and cardiovascular effects of carbuterol and metaproterenol." J Allergy Clin Immunol, 60, p. 174-9
  15. (2002) "Product Information. Proventil (albuterol)." Schering Corporation
  16. (2002) "Product Information. Ventolin (albuterol)." Glaxo Wellcome
  17. (2001) "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals
  18. Meyer JM, Wenzel CL, Kradjan WA (1993) "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother, 27, p. 1478-87
  19. Maconochie JG, Forster JK (1992) "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol, 33, p. 342-5
  20. Windom H, Grainger J, Burgess C, Crane J, Pearce N, Beasley R (1990) "A comparison of the haemodynamic and hypokalaemic effects of inhaled pirbuterol and salbutamol." N Z Med J, 103, p. 259-61
  21. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
  22. (2001) "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals
  23. Tveskov C, Djurhuus MS, Klitgaard NAH, Egstrup K (1994) "Potassium and magnesium distribution, ECG changes, and ventricular ectopic beats during beta(2)-adrenergic stimulation with terbutaline in healthy subjects." Chest, 106, p. 1654-9
  24. (2001) "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim
  25. Braden GL, vonOeyen PT, Germain MJ, Watson DJ, Haag BL (1997) "Ritodrine- and terbutaline-induced hypokalemia in preterm labor: Mechanisms and consequences." Kidney Int, 51, p. 1867-75
  26. Rakhmanina NY, Kearns GL, Farrar HC (1998) "Hypokalemia in an asthmatic child from abuse of albuterol metered dose inhaler." Pediatr Emerg Care, 14, p. 145-7
  27. (2022) "Product Information. Tornalate (bitolterol)." Apothecon Inc
  28. (2001) "Product Information. Xopenex (levalbuterol)." Sepracor Inc
  29. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS (1999) "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol, 103, p. 615-21
  30. (2014) "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim
View all 30 references
Moderate

Beta- 2 adrenergic bronchodilators (applies to ProAir HFA) seizures

Moderate Potential Hazard, Low plausibility.

Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

References

  1. Larsson S, Svedmyr N (1977) "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis, 116, p. 861-9
  2. Price AH, Clissold SP (1989) "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs, 38, p. 77-122
  3. (2002) "Product Information. Proventil (albuterol)." Schering Corporation
  4. (2002) "Product Information. Ventolin (albuterol)." Glaxo Wellcome
  5. (2001) "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals
  6. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
  7. (2001) "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals
  8. (2001) "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim
  9. (2022) "Product Information. Tornalate (bitolterol)." Apothecon Inc
  10. (2001) "Product Information. Xopenex (levalbuterol)." Sepracor Inc
  11. (2001) "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals
  12. (2014) "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim
View all 12 references
Moderate

Levalbuterol (applies to ProAir HFA) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Levalbuterol is substantially excreted by the kidney, and the risk of toxic reactions may be greater in patients with impaired renal function. Care should be taken in dose selection in patients with renal impairment and it may be useful to monitor renal function.

References

  1. (2001) "Product Information. Xopenex (levalbuterol)." Sepracor Inc

ProAir HFA drug interactions

There are 420 drug interactions with ProAir HFA (albuterol).

ProAir HFA alcohol/food interactions

There are 2 alcohol/food interactions with ProAir HFA (albuterol).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.