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Albuterol (Monograph)

Brand names: AccuNeb, ProAir HFA, Proventil, Proventil HFA, Ventolin HFA, ... show all 8 brands
Drug class: Selective beta-2-Adrenergic Agonists
VA class: RE102
CAS number: 18559-94-9

Medically reviewed by Drugs.com on Aug 3, 2023. Written by ASHP.

Introduction

Bronchodilator; relatively selective, short-acting β2-adrenergic agonist.j

Uses for Albuterol

Bronchospasm in Asthma

Symptomatic management or prevention of bronchospasm in patients with reversible, obstructive airway disease (e.g., asthma).132 139 154 181 241 249 255 282

Exercise-induced Bronchospasm

Prevention of exercise-induced bronchospasm.132 181 249

Chronic Obstructive Pulmonary Disease

Albuterol sulfate in fixed combination with ipratropium bromide: Symptomatic management of reversible bronchospasm associated with COPD in patients who continue to have evidence of bronchospasm despite regular use of an orally inhaled bronchodilator and who require a second bronchodilator.233 250 251 252

Albuterol sulfate: Symptomatic management of reversible bronchospasm associated with COPD† [off-label] when given on an as-needed or regular (e.g., 4 times daily) basis, either alone or concomitantly with other inhaled bronchodilators.181 206 251 266 267 268 269 Regular use of a selective, short-acting inhaled β2-adrenergic agonist (e.g., albuterol) in the management of COPD, in contrast to that in asthma, does not appear to be detrimental.206 247 250 251

Albuterol Dosage and Administration

General

Administration

Oral Inhalation

Metered-dose Aerosol Inhaler

Administer inhalation aerosol only with the actuator provided by the manufacturer.146 181 210 215

Shake inhaler well before use.146 181 210 215

Test-spray inhalation aerosol (3 times for ProAir HFA, 4 times for Ventolin HFA or Proventil HFA) into the air (away from the face) before first use and whenever the inhaler not used for prolonged periods (i.e., >2 weeks).181 215 237 248 282 Test spray Ventolin HFA aerosol inhaler whenever dropped.237

Avoid spraying aerosols into the eyes.181 210 215

Exhale slowly and completely and place the mouthpiece of the inhaler well into the mouth with the lips closed around it.210 215 Inhale slowly and deeply through the mouth.210 215 Actuate aerosol inhaler, hold breath for as long as possible, withdraw mouthpiece, and exhale slowly.210 215

Allow 1 minute to elapse between subsequent inhalations from aerosol inhaler.248 261

Clean the albuterol sulfate inhalation aerosol (ProAir HFA, Proventil HFA, Ventolin HFA) inhaler by removing the metal canister and running warm water through the plastic mouthpiece of the actuator for 30 seconds at least once a week.181 237 282 Dry thoroughly the mouthpiece before replacing the metal canister and mouthpiece cap.181 215 237 282 If the inhaler is to be used before it is completely dry, shake off excess water, replace the canister, and test the inhaler by spraying once (Ventolin HFA) or twice (ProAir HFA, Proventil HFA) away from the face before administering the dose.237 248 282 After such use, rewash the mouthpiece and allow to air dry.248 282 Proper cleaning of the albuterol sulfate inhaler (ProAir HFA, Proventil HFA, Ventolin HFA) mouthpiece will prevent medication build-up and blockage.181 237 248 282

Discard canister after the labeled number of actuations used.181 233 237 282

Nebulization

When administering via nebulization, use proper aseptic technique to avoid microbial contamination.114 241

For administration of albuterol sulfate solution for nebulization in single-use units, empty the entire contents of a single-use unit into the nebulizer reservoir and use immediately to avoid microbial contamination.241 242 243 255 256 263 283 For administration of single-use units of albuterol sulfate 0.5% concentrate solution for nebulization, empty the entire contents of the plastic vial into the nebulizer reservoir and add 2.5 mL of 0.9% sodium chloride solution into the nebulizer reservoir to provide a final volume of 3 mL.272 273

Attach the reservoir to the mouthpiece or face mask and to the compressor according to the manufacturer’s instructions.213 256 257 263 283

Place the mouthpiece of the nebulizer in the mouth or put on the nebulizer face mask and turn on the compressor.213 256 257 263 283 Breathe as calmly, deeply, and evenly as possible until the nebulizer stops producing mist (flow rate of nebulizer should be adjusted to provide the full dose over about 5–15 minutes).213 256 257 263 283

Clean the nebulizer after use according to the manufacturer’s instructions.213 241 244 245 246 256 257 263 283

Continue nebulization therapy as necessary to control recurrent bronchospasm.249 258 Optimum benefit is obtained when nebulization is used regularly.249 258

Oral Administration

Albuterol sulfate extended-release tablets should not be chewed or crushed.100 154 271

Dosage

Available as albuterol sulfate; dosage expressed in terms of albuterol.114 153 154 181 272 281

Pediatric Patients

Bronchospasm in Asthma
Oral Inhalation Aerosol

Children ≥4 years of age: 180 mcg (2 inhalations) every 4–6 hours (ProAir HFA, Proventil HFA, Ventolin HFA).181 237 295 Do not increase dosage or dosage frequency.181 237 295 Alternatively, 90 mcg (1 inhalation) every 4 hours may be sufficient.181 237 295

Oral Nebulization Solution

0.042% Inhalation solution for nebulization in children 2–12 years of age: 0.63 or 1.25 mg 3 or 4 times daily.255 Dosage of 1.25 mg 3 or 4 times daily may improve initial response in children 6–12 years of age with more severe asthma (baseline FEV1 <60% of predicted), patients weighing >40 kg, or children 11–12 years of age.255 For acute exacerbations, a 0.083% solution containing 2.5 mg of albuterol per 3 mL may be more appropriate, particularly in children ≥6 years of age.255 258

0.083% Inhalation solution for nebulization in children 2–12 years of age: 2.5 mg 3 or 4 times daily in children weighing ≥15 kg.153 258 Do not increase dosage or dosage frequency.114 153 212 241 255 258 In children 2–12 years of age weighing<15 kg who require <2.5 mg per dose, the 0.5% inhalation solution should be used to prepare the appropriate dose for nebulization.153 255 258 212

0.083% Inhalation solution for nebulization in adolescents ≥12 years of age: 2.5 mg 3 or 4 times daily (Proventil single-use inhalation solution).241 258

0.5% Inhalation solution for nebulization in adolescents ≥12 years of age: 2.5 mg 3–4 times daily.272

Oral Conventional Tablets

Children 6–12 years of age: Initially, 2 mg 3 or 4 times daily.280 If necessary, increase dosage cautiously and gradually as tolerated to a maximum of 6 mg 4 times daily (maximum 24 mg total daily dosage).280

Adolescents ≥12 years of age: Initially, 2 or 4 mg 3 or 4 times daily.280 If necessary, increase dosage cautiously and gradually as tolerated to a maximum of 8 mg 4 times daily (maximum 32 mg total daily dosage).280

Oral Extended-release Tablets

Children 6–12 years of age: Initially, 4 mg every 12 hours (VoSpire ER).271 If necessary, increase dosage cautiously and gradually as tolerated to a maximum of 12 mg twice daily (maximum 24 mg total daily dosage).271

Adolescents ≥12 years of age: Initially, 8 mg every 12 hours.271 In some patients, 4 mg every 12 hours may be sufficient (e.g., low body weight).271 If necessary, increase dosage cautiously and gradually as tolerated to a maximum of 16 mg twice daily (maximum 32 mg total daily dosage).271 When transferring from conventional tablets to extended-release tablets, each 2 mg administered every 6 hours as conventional tablets is approximately equivalent to 4 mg every 12 hours as extended-release tablets.271

Oral Solution

Children 2–6 years of age: Initially, 0.1 mg/kg (up to 2 mg) 3 times daily.281 If necessary, increase dosage cautiously and gradually as tolerated to 0.2 mg/kg (up to 4 mg) 3 times daily (maximum 12 mg total daily dosage).281

Children or adolescents >6–14 years of age: Initially, 2 mg 3 or 4 times daily.281 If necessary increase dosage cautiously and gradually as tolerated to a maximum of 24 mg daily in divided doses.281

Adolescents >14 years of age: 2 or 4 mg 3–4 times daily.281 If necessary, increase dosage cautiously and gradually to a maximum of 8 mg 4 times daily.281

Prevention of Exercise-induced Bronchospasm
Oral Inhalation Aerosol

Children ≥4 years of age: 180 mcg (2 inhalations) administered 15–30 minutes before exercise via metered-dose inhaler (ProAir HFA, Proventil HFA, Ventolin HFA).181 237 295

Adults

Bronchospasm in Asthma
Oral Inhalation Aerosol

180 mcg (2 inhalations) every 4–6 hours.181 237 282 Do not increase dosage or dosage frequency of orally inhaled albuterol aerosol.137 282 Alternatively, 90 mcg (1 inhalation) every 4 hours.145 146 181 237 282

Oral Nebulization Solution

2.5 mg 3 or 4 times daily.114 212 241 258 Do not increase dosage or dosage frequency.114 153 212 241 255 258

Oral Conventional Tablets or Solution

Initially, 2 or 4 mg 3 or 4 times daily.100 139 262 208 280 If necessary, increase dosage cautiously and gradually as tolerated to a maximum of 8 mg 4 times daily.100 139 208 262 280

Oral Extended-release Tablets

Initially, 4 or 8 mg every 12 hours.271 In some patients (e.g., low body weight), 4 mg every 12 hours may be sufficient.271 If necessary, increase dosage cautiously and gradually as tolerated to maximum of 16 mg twice daily.271

Prevention of Exercise-induced Bronchospasm
Oral Inhalation Aerosol

180 mcg (2 inhalations) administered 15–30 minutes before exercise via the metered-dose inhaler (ProAir HFA, Proventil HFA, Ventolin HFA).181 237 282

Chronic Obstructive Pulmonary Disease
Oral Inhalation Aerosol

Initially, 180 mcg (2 inhalations) 4 times daily in fixed combination with ipratropium bromide (18 mcg per inhalation).233 If necessary, additional inhalations may be used, with dosage not >12 inhalations in 24 hours.233

Oral Nebulization Solution

Initially, 2.5 mg 4 times daily in fixed combination with ipratropium bromide (0.5 mg per dose) (DuoNeb).243 If necessary, may administer 2.5 mg in fixed combination with ipratropium bromide (0.5 mg per dose) up to 6 times daily.243

Prescribing Limits

Pediatric Patients

Bronchospasm in Asthma
Oral Nebulization Solution

Children 2–12 years of age: Maximum 2.5 mg 4 times daily in children weighing at least 15 kg.153 258

Adolescents ≥12 years of age: Maximum 2.5 mg 4 times daily.153

Oral Conventional Tablets

Children 6–12 years of age: Maximum 24 mg daily (in divided doses).280

Adolescents ≥12 years of age: Maximum 8 mg 4 times daily.100 139 280

Oral Extended-release Tablets

Children 6–12 years of age: Maximum 12 mg twice daily.271

Adolescents >12 years of age: Maximum 16 mg twice daily.271

Oral Solution

Children 2–6 years of age: Maximum 4 mg 3 times daily.281

Children or adolescents >6 to 14 years of age: Maximum 24 mg daily in divided doses.270 281

Adolescents >14 years of age: Maximum 8 mg 4 times daily.281

Adults

Bronchospasm in Asthma
Oral Nebulization Solution

Maximum 2.5 mg 4 times daily.114 153 241 258 212

Oral Conventional Tablets or Solution

Maximum 8 mg 4 times daily.270 280 281

Oral Extended-release Tablets

Maximum 16 mg twice daily.271

Chronic Obstructive Pulmonary Disease
Oral Inhalation Aerosol

Maximum 180 mcg (2 inhalations) 4 times daily in fixed combination with ipratropium bromide (18 mcg per inhalation).233

Oral Nebulization Solution

Maximum 2.5 mg 6 times daily in fixed combination with ipratropium bromide (0.5 mg per dose).243

Special Populations

Geriatric Patients

Oral Conventional Tablets or Solution

Initially, 2 mg 3 or 4 times daily.280 281 May increase gradually as tolerated up to a maximum of 8 mg 3 or 4 times daily (conventional tablets).280

Oral Inhalation Aerosol

Initiate therapy with dosages at the lower end of the usual range.237 282

Patients Sensitive to Sympathomimetic Amines

Oral Conventional Tablets or Solution

Initially, 2 mg 3 or 4 times daily.280 281 May increase gradually as tolerated up to 8 mg 3 or 4 times daily.280

Detailed Albuterol dosage information

Cautions for Albuterol

Contraindications

Warnings/Precautions

Warnings

Acute or Worsening Asthma

Oral inhalation therapy is intended for the acute symptomatic relief of bronchospasm.188 189 190 191 192 249 If control of mild asthma deteriorates such that regular (i.e., exceeding 4 times daily) use of a short-acting β2-agonist becomes necessary, institute maintenance therapy (e.g., inhaled corticosteroids)188 189 191 249 and discontinue regular use of short-acting β2-agonists in such patients; instead, use short-acting β2-agonists only as a supplement for relief of acute asthma symptoms.188 189 190 191 192 194 197 249 Contact a clinician for reevaluation if control of mild asthma deteriorates.114 154 192 193 196

Failure to respond to a previously effective dosage of albuterol may indicate seriously worsening asthma.156 157 181 188 189 190 191 192 193 194 196 197 237 241 242 243 244 249 Reevaluate asthma therapy and institute alternative regimens or therapy.156 157 181 188 189 190 191 192 193 194 196 197 237 241 242 243 244 249 Discontinue and contact a clinician if decreased effectiveness occurs; do not increase the dose or frequency of administration.241

Excessive Doses

Possible fatalities associated with excessive use of inhaled sympathomimetic drugs.114 139 153 237 241 243 255 258 145 154 212 262 208 146 181 233 The safety of concomitant use of >8 inhalations per day of a short-acting β2-adrenergic agonist with a long-acting β2-agonist (e.g., salmeterol) oral inhalation therapy has not been established.192 287 (See Sympathomimetic Agents under Interactions.)

Paradoxical Bronchospasm

Possible life-threatening, acute paradoxical bronchospasm.181 241 255 Frequently occurs with the first use of a new canister or vial (oral inhalation aerosol),181 241 255 but also may occur with orally administered conventional or extended-release tablets.271 280

Discontinue therapy immediately if bronchoconstriction occurs and institute alternative therapy.271 280

Cardiovascular Effects

Possible clinically important cardiovascular effects, including cardiac arrhythmias (e.g., atrial fibrillation, supraventricular tachycardia, extrasystoles) , increased or decreased BP, and related symptoms.146 153 181

Cautious use recommended in patients with cardiovascular disorders (e.g., coronary insufficiency, cardiac arrhythmias), hypertension, and those with sensitivity to sympathomimetic amines.114 181 237 241 281 May require drug discontinuance.139 181

Sensitivity Reactions

Immediate hypersensitivity reactions (e.g., urticaria,139 146 153 181 angioedema,139 146 153 181 227 rash,100 139 146 153 181 bronchospasm,139 146 153 181 anaphylaxis,146 oropharyngeal edema)139 146 153 181 have been reported.139 153 181 Possible acute bronchospasm.181 185 186 (See Paradoxical Bronchospasm under Cautions.)

General Precautions

Nervous System Effects

Possible CNS stimulation and adverse nervous system effects.100 139 181

Cautious use recommended in patients with seizure disorders and in those with sensitivity to sympathomimetic amines.114 237

Metabolic Effects

Possible hypokalemia, which may increase risk of adverse cardiovascular effects.100 114 139 153 237 241 243 255 258 145 154 212 262 208 146 181 233 (See Cardiovascular Effects under Cautions.) Serum potassium decrease generally is transient and usually does not require supplementation.181 281

Diabetes mellitus or increased blood glucose in patients receiving orally inhaled or nebulized albuterol.112 181

Cautious use recommended in patients with diabetes mellitus or hyperthyroidism.181 237 241 281

GI Effects

Possible GI obstruction when extended-release tablets are used in patients with preexisting GI narrowing; cautious use recommended.154

Use of Fixed Combination

When used in fixed combination with other agents, consider the cautions, precautions, and contraindications associated with the concomitant agents.

Specific Populations

Pregnancy

Category C.237

Lactation

Not known whether albuterol is distributed into milk.114 154 Discontinue nursing or the drug.114 154

Pediatric Use

Safety and efficacy of orally inhaled albuterol sulfate inhalation aerosols (ProAir HFA, Proventil HFA, Ventolin HFA) not established in children <4 years of age.181 237 295 Safety and efficacy of orally inhaled racemic albuterol sulfate inhalation solution (Proventil) not established in children <12 years of age.241 244 Safety and efficacy of some albuterol inhalation solutions for nebulization (e.g., AccuNeb, albuterol sulfate 0.083%) not established in children <2 years of age.242 255 258 Safety and efficacy of albuterol sulfate in fixed combination with ipratropium bromide not established in pediatric patients233 243 <18 years of age.243

Safety and efficacy of albuterol conventional and extended-release tablets not established in children <6 years of age.100 139 154 Safety and efficacy of albuterol sulfate oral solutions not established in children younger <2 years of age.270 281

Geriatric Use

No overall differences in safety and efficacy observed between geriatric and younger patients for albuterol sulfate in fixed combination with ipratropium bromide inhalation solution.243

Special caution should be used in geriatric patients who have cardiovascular disease.181 (See Cautions: Cardiovascular Effects.) Cannot rule out possibility that some geriatric patients may exhibit increased sensitivity to the drug.243

Substantially eliminated by kidneys; assess renal function periodically since geriatric patients more likely to have decreased renal function.279 282 Risk of toxicity greater in patients with renal impairment, including geriatric patients.282

Common Adverse Effects

Albuterol sulfate: Tremor,100 139 146 153 181 208 asthma exacerbation, bronchospasm, nervousness, shakiness, otitis media, nausea, cough, bronchitis, headache, tachycardia/palpitations, muscle cramps, hypokinesia, insomnia, weakness, dizziness, excitement, hyperactivity, increased appetite, flu syndrome, lymphadenopathy, skin/appendage infection, urticaria.100 114 139 146 153 181 208 212 241 255 258 154 262 208

Albuterol sulfate in fixed combination with ipratropium bromide: Bronchitis, upper respiratory tract infection, lung disease, headache, dyspnea, pharyngitis, coughing, chest pain, pain, respiratory disorder, sinusitis, nausea, diarrhea, urinary tract infection, influenza, pneumonia, leg cramps, dyspepsia, constipation, voice alterations, bronchospasm.233 243

Drug Interactions

Specific Drugs

Drug

Interaction

Comments

β-Adrenergic blocking agents

Antagonism of pulmonary effects resulting in severe bronchospasm in asthmatic patients181 241

If concomitant therapy required, consider cautious use of cardioselective β-adrenergic blocking agents181 241 281

Digoxin

Decreased serum digoxin concentrations181 241

Careful evaluation of serum digoxin concentrations recommended181 241

Diuretics, nonpotassium-sparing

Decreased serum potassium concentrations and/or ECG changes, especially when the recommended β-agonist dose is exceeded181 241 281

Cautious use recommended181 241 281

MAO inhibitors

Increased effect on vascular system181 241

Extreme caution recommended with concomitant therapy181 241 or in patients receiving albuterol within 2 weeks of discontinuance of these agents115 132 139 146 153 154 181

Sympathomimetic agents (e.g., epinephrine)

Increased cardiovascular adverse effects241

Avoid concomitant use of inhaled albuterol and other short-acting inhaled sympathomimetic amine bronchodilators or oral albuterol and other oral sympathomimetic agents114 237 241

Concomitant oral albuterol and inhaled sympathomimetic agent may be used on individualized basis270 271 280 281

If such concomitant use regularly required, consider alternative therapy270 271 280 281
Albuterol drug interactions (more detail)

Albuterol Pharmacokinetics

Absorption

Single-dose oral bioavailability of extended-release albuterol sulfate tablets is about 80% that of conventional tablets.271

Efficacy of orally inhaled drug appears to result from local action rather than systemic absorption.j Drug plasma concentrations do not predict therapeutic effect.j

Onset

Oral conventional tablets or solution: Within 30 minutes.100 208 262 281

Oral inhalation aerosol: Within 5–15 minutes.145 146 181 237

Oral nebulization solution: Within 5 minutes.114 153 212 241 258

Duration

Oral inhalation aerosol: 3–6 hours.145 146 181 237

Oral nebulization solution: 2–4 hours, occasionally ≥6 hours.114 153 212 237 255

Oral conventional tablets: Up to 8 hours.100

Oral extended-release tablets: Up to 12 hours.271

Oral solution: Up to 6 hours.281

Food

Reduces the rate of absorption of albuterol sulfate extended-release tablets.271

Distribution

Extent

Albuterol crosses the placenta.j Not known whether albuterol distributes into milk.100

Elimination

Metabolism

Extensively metabolized in the intestinal wall282 and liver to inactive metabolites.279

Elimination Route

Substantially eliminated by kidneys.279 282 Approximately 72% of a dose (oral inhalation) excreted in urine as unchanged drug and metabolites within 24 hours.145 About 76% of a single dose (oral administration) excreted in urine over 3 days; about 4% is excreted in feces.280 281

Half-life

Oral inhalation: 3.8–6 hours in healthy adults,145 282 j 1.7–7.1 hours in patients with asthma.j

Conventional tablets: 5–7.2 hours.271 280

Extended-release tablets: 9.3 hours.271

Oral solution: 5 hours in healthy individuals.270 281

Stability

Storage

Oral

Extended-release tablets: 20–25°C; protect from light.271

Conventional tablets: 20–25°C; protect from light.280

Oral solution: 2–30°C or 20–25°C, depending on manufacturer; protect from light.270 281

Oral Inhalation

Albuterol sulfate inhalation aerosol: 15–25°C (ProAir HFA, Proventil HFA, Ventolin HFA).181 237 282 Failure to use inhalers within these respective temperature ranges could result in delivery of improper doses.145

Albuterol sulfate in fixed combination with ipratropium bromide inhalation aerosol: 25°C (may be exposed to 15–30°C); protect from excessive humidity.233

Albuterol sulfate oral inhalation solution: 2–25°C or 15–30°C depending on manufacturer.114 241 242 244 272 Discard albuterol sulfate oral inhalation concentrate solution if the solution changes color or becomes cloudy.244 Discard albuterol sulfate solution for nebulization (in single-use units) if it becomes discolored.242 255

Albuterol sulfate in fixed combination with ipratropium bromide oral inhalation solution: 2–25°C.243

Actions

Advice to Patients

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Albuterol Sulfate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Solution

2 mg (of albuterol) per 5 mL*

Albuterol Sulfate Syrup

Tablets

2 mg (of albuterol)*

Albuterol Sulfate Tablets

4 mg (of albuterol)*

Albuterol Sulfate Tablets

Tablets, extended-release

4 mg (of albuterol)*

VoSpire ER

Dava

Albuterol Sulfate Extended-Release Tablets

8 mg (of albuterol)*

VoSpire ER

Dava

Albuterol Sulfate Extended-Release Tablets

Oral Inhalation

Aerosol

90 mcg (of albuterol) per metered spray

ProAir HFA (with hydrofluoroalkane propellant)

Teva

Proventil HFA (with hydrofluoroalkane propellant)

Schering

Ventolin+ HFA (with hydrofluoroalkane propellant)

GlaxoSmithKline

Solution, for nebulization

0.021% (of albuterol)*

AccuNeb (available as TwistFlex polyethylene vials)

Dey

Albuterol Sulfate Inhalation Solution

0.042% (of albuterol)*

AccuNeb (available as TwistFlex polyethylene vials)

Dey

Albuterol Sulfate Inhalation Solution

0.083% (of albuterol)*

Albuterol Sulfate Inhalation Solution

Proventil

Schering

Solution, concentrate, for nebulization

0.5% (of albuterol)*

Albuterol Sulfate Inhalation Solution
Albuterol Sulfate Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral Inhalation

Aerosol

90 mcg (of albuterol) with Ipratropium Bromide 18 mcg per metered spray

Combivent (with chlorofluorohydrocarbon propellants)

Boehringer Ingelheim

Solution, for nebulization

2.5 mg (of albuterol) with Ipratropium Bromide 0.5 mg per 3 mL

DuoNeb

Dey
Levalbuterol Hydrochloride

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Solution, for nebulization

0.103 mg (of levalbuterol) per mL (0.31 mg)

Xopenex (available as polyethylene vials)

Sepracor

0.21 mg (of levalbuterol) per mL (0.63 mg)

Xopenex (available as polyethylene vials)

Sepracor

0.417 mg (of levalbuterol) per mL (1.25 mg)

Xopenex (available as polyethylene vials)

Sepracor
Levalbuterol Tartrate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral Inhalation

Aerosol

45 mcg (of levalbuterol) per metered spray

Xopenex HFA (with hydrofluoroalkane propellant)

Sepracor

AHFS DI Essentials™. © Copyright 2024, Selected Revisions August 13, 2012. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

100. Schering Corporation. Proventil (albuterol sulfate) Repetabs and tablets prescribing information. Kenilworth, NJ; 1997 Oct.

101. Powell ML, Weisberger M, Dowdy Y et al. Comparative steady state bioavailability of conventional and controlled-release formulations of albuterol. Biopharm Drug Dispos. 1987; 8:461-8. http://www.ncbi.nlm.nih.gov/pubmed/3663882?dopt=AbstractPlus

102. Anon. Drugs for asthma. Med Lett Drugs Ther. 1987; 29:11-6. http://www.ncbi.nlm.nih.gov/pubmed/2880281?dopt=AbstractPlus

103. Sears MR, Rea HH, Fenwick J et al. 75 Deaths in asthmatics prescribed home nebulisers. BMJ. 1987; 294:477-80. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1245521&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/3103732?dopt=AbstractPlus

104. Jenkins SC, Heaton RW, Fulton TJ et al. Comparison of domiciliary nebulized salbutamol and salbutamol from a metered-dose inhaler in stable chronic airflow limitation. Chest. 1987; 91:804-7. http://www.ncbi.nlm.nih.gov/pubmed/3556051?dopt=AbstractPlus

105. Robertson CF, Smith F, Beck R et al. Response to frequent low doses of nebulized salbutamol in acute asthma. J Pediatr. 1985; 106:672-4. http://www.ncbi.nlm.nih.gov/pubmed/3981324?dopt=AbstractPlus

106. Newhouse M, Dolovich M. Aerosol therapy: nebulizer vs metered dose inhaler. Chest. 1987; 91:799-80. http://www.ncbi.nlm.nih.gov/pubmed/3581925?dopt=AbstractPlus

107. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis. 1987; 136:225-44. http://www.ncbi.nlm.nih.gov/pubmed/3605835?dopt=AbstractPlus

108. Pearce JL, Wesley HWW. Children with asthma: will nebulised salbutamol reduce hospital admissions? Br Med J. 1985; 290:1077. Reply.

109. Freelander M, Van Asperen PP. Nebuhaler versus nebuliser in children with acute asthma. BMJ. 1984; 288:1873-4. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1441767&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/6428582?dopt=AbstractPlus

110. Currie DC, Cole PJ. Domiciliary nebulisers in asthma. BMJ. 1985; 291:215-6. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1416414&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/3926126?dopt=AbstractPlus

111. Ullah MI, Fegan O. Potential hazard of nebulised salbutamol in patients with haemoptysis. BMJ. 1983; 286:844-5. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1547204&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/6403108?dopt=AbstractPlus

112. Smith SR, Ryder C, Kendall MJ et al. Cardiovascular and biochemical responses to nebulised salbutamol in normal subjects. Br J Clin Pharmacol. 1984; 18:641-4. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1463610&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/6487508?dopt=AbstractPlus

113. Ebden P, Farrow PR, Shaw D et al. 75 Deaths in asthmatics prescribed home nebulisers. BMJ. 1987; 294:972. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1246026&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/2953403?dopt=AbstractPlus

114. Schering Corporation. Proventil (albuterol sulfate) 0.5% solution for inhalation prescribing information. Kenilworth, NJ, 1999 May

115. Glaxo Wellcome. Ventolin (albuterol sulfate) solution for inhalation prescribing information. Research Triangle Park, NC; 1998 Aug.

116. Osborne JP, Cocksedge S. Children with asthma: will nebulised salbutamol reduce hospital admissions? Br Med J. 1985; 290:1076-7. Letter.

117. Pearce JL, Wesley HMM. Children with asthma: will nebulised salbutamol reduce hospital admissions? Br Med J. 1985; 290:595-7.

118. Beck R, Robertson C, Galdès-Sebaldt M et al. Combined salbutamol and ipratropium bromide by inhalation in the treatment of severe acute asthma. J Pediatr. 1985; 107:605-8. http://www.ncbi.nlm.nih.gov/pubmed/2931507?dopt=AbstractPlus

119. Wilkie RA, Bryan MH. Effect of bronchodilators on airway resistance in ventilator-dependent neonates with chronic lung disease. J Pediatr. 1987; 111:278-82. http://www.ncbi.nlm.nih.gov/pubmed/2956405?dopt=AbstractPlus

120. Cocksedge SH, Jackson MB, Williamson L et al. Acute asthma in childhood and the role of nebulisers. Practitioner. 1985; 229:860,863. http://www.ncbi.nlm.nih.gov/pubmed/4059166?dopt=AbstractPlus

121. Newhouse MT, Dolovich MB. Control of asthma by aerosols. N Engl J Med. 1986; 315:870-4. http://www.ncbi.nlm.nih.gov/pubmed/2875391?dopt=AbstractPlus

122. Reed CE. Aerosols in chronic airway obstruction. N Engl J Med. 1986; 315:888-9. http://www.ncbi.nlm.nih.gov/pubmed/3748105?dopt=AbstractPlus

123. Lenney W, Evans NAP. Nebulized salbutamol and ipratropium bromide in asthmatic children. Br J Dis Chest. 1986; 80:59-65. http://www.ncbi.nlm.nih.gov/pubmed/2936370?dopt=AbstractPlus

124. Turpeinen M, Kuokkanen J, Backman A. Adrenaline and nebulized salbutamol in acute asthma. Arch Dis Child. 1984; 59:666-8. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1628976&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/6465938?dopt=AbstractPlus

125. Stokes GM, Milner AD, Hodges IGC et al. Nebulised therapy in acute severe bronchiolitis in infancy. Arch Dis Child. 1983; 58:279-82. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1627964&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/6221700?dopt=AbstractPlus

126. Greenough A, Loftus BG, Pool J et al. Response to bronchodilators assessed by lung mechanics. Arch Dis Child. 1986; 61:1020-3. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1777965&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/3535685?dopt=AbstractPlus

127. Storr J, Lenney W. Nebulised ipratropium and salbutamol in asthma. Arch Dis Child. 1986; 61:602-3. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1777847&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/2942116?dopt=AbstractPlus

128. Tal A, Bavilski C, Yohai D et al. Dexamethasone and salbutamol in the treatment of acute wheezing in infants. Pediatrics. 1983; 71:13-8. http://www.ncbi.nlm.nih.gov/pubmed/6129609?dopt=AbstractPlus

129. Ventolin. In: Krogh CME, ed. Compendium of pharmaceuticals and specialties 1986. 21st ed. Ottawa, ON, Canada: Canadian Pharmaceutical Association; 1986:819-20.

130. Respolin. In: Wilkinson LL, ed. Mims annual 1987: Australian edition. 11th ed. Crows Nest, NSW, Australia: IMS Publishing; 1987:687-9.

131. Glaxo Inc, Research Triangle Park, NC: Personal communication.

132. Glaxo Wellcome. Ventolin Rotacaps (albuterol sulfate) for inhalation prescribing information. Research Triangle Park, NC; 1998 Nov.

133. Glaxo Inc. Product information form for American Hospital Formulary Service: Ventolin Rotacaps. Research Triangle Park, NC; 1989 Jan.

134. Bronsky E, Bucholtz GA, Busse WW et al. Comparison of inhaled albuterol powder and aerosol in asthma. J Allergy Clin Immunol. 1987; 79:741-7. http://www.ncbi.nlm.nih.gov/pubmed/3553277?dopt=AbstractPlus

135. McFadden ER Jr, Mills R. Inhaled albuterol powder for the prevention of exercise-induced bronchospasm. Immunol Allergy Pract. 1986; 8:199-203.

136. Towns SJ, Sharota E, Simpson SJ et al. Bronchodilator effects of salbutamol powder administered via Rotahaler and of terbutaline aerosol administered via Misthaler. Med J Aust. 1983; 1:633-6. http://www.ncbi.nlm.nih.gov/pubmed/6343815?dopt=AbstractPlus

137. Tarlo SM, Broder I, Corey P et al. A one-year study of salbutamol inhaled powder administered by a breath-activated device in asthmatics. Curr Ther Res. 1984; 35:566-74.

138. Sovijarvi ARA, Lahdensuo A, Muittari A. Bronchodilating effect of salbutamol aerosol after metacholine-induced bronchoconstriction. Curr Ther Res. 1982; 32:566-72.

139. Glaxo Wellcome. Ventolin (albuterol sulfate) tablets prescribing information (dated 1998 May). In: Physicians’ desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:1250-2.

140. Duncan D, Paterson IC, Harris D et al. Comparison of the bronchodilator effects of salbutamol inhaled as a dry powder and by conventional pressurized aerosol. Br J Clin Pharmacol. 1977; 4:669-71. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1429172&blobtype=pdf

141. Hartley JPR, Nogrady SG, Gibby OM et al. Bronchodilator effects of dry salbutamol powder administered by Rotahaler. Br J Clin Pharmacol. 1977; 4:673-5. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1429184&blobtype=pdf

142. Hetzel MR, Clark TJH. Comparison of salbutamol Rotahaler with conventional pressurized aerosol. Clin Allergy. 1977; 7:563-8. http://www.ncbi.nlm.nih.gov/pubmed/589786?dopt=AbstractPlus

143. Latimer KM, Roberts R, Dolovich J et al. Salbutamol: comparison of bronchodilating effect of inhaled powder and aerosol in asthmatic subjects. Can Med Assoc J. 1982; 127:857-9. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1862216&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/7139504?dopt=AbstractPlus

144. Hartley JPR, Nogrady SG, Seaton A. Long-term comparison of salbutamol powder with salbutamol aerosol in asthmatic outpatients. Br J Dis Chest. 1979; 73:271-6. http://www.ncbi.nlm.nih.gov/pubmed/399858?dopt=AbstractPlus

145. Schering. Proventil (albuterol) inhalation aerosol prescribing information. Kenilworth, NJ: 2004 May

146. GlaxoSmithKline. Ventolin (albuterol) inhalation aerosol prescribing information. Research Triangle Park, NC: 2001 Aug.

147. Hampson NB, Mueller MP. Cooling of metered-dose inhalers decreases pressure output from canisters. New Engl J Med. 1989; 320:321. http://www.ncbi.nlm.nih.gov/pubmed/2563147?dopt=AbstractPlus

148. Lourenco RV, Cotromanes E. Clinical aerosols: I. Characterization of aerosols and their diagnostic uses. Arch Intern Med. 1982; 142:2163-72. http://www.ncbi.nlm.nih.gov/pubmed/6753780?dopt=AbstractPlus

149. Watson Laboratories. Albuterol sulfate syrup prescribing information. Corona, CA; 1993 Jan.

150. The United States Pharmacopeia, 22nd rev, and The national formulary, 17th ed. Albuterol. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1990:31.

151. The United States Pharmacopeia, 22nd rev, and The national formulary, 17th ed. Albuterol sulfate. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1990:31-2.

152. Allen & Hanburys. Ventolin (albuterol sulfate) prescribing information. In: Physicians’ desk reference. 47th ed. Montvale, NJ: Medical Economics Company Inc; 1993:582-5.

153. Glaxo Wellcome. Ventolin nebules (albuterol sulfate) inhalation solution 0.083% prescribing information. Research Triangle Park, NC; 1998 May.

154. Muro Pharmaceutical, Inc. Volmax (albuterol sulfate) extended-release tablets prescribing information. Tewksbury, MA; 2001 Dec.

155. CibaGeneva. Brethine (terbutaline sulfate) tablets prescribing information. In: Physicians’ desk reference. 50th ed. Montvale, NJ: Medical Economics Company Inc; 1997:831.2.

156. Meyer JM, Wenzel CL, Kradjan WA. Salmeterol: a novel, long-acting beta 2-agonist. Ann Pharmacother. 1993; 27:1478-87. http://www.ncbi.nlm.nih.gov/pubmed/7905757?dopt=AbstractPlus

157. Brogden RN, Faulds D. Salmeterol xinafoate: a review of its pharmacological properties and therapeutic potential in reversible obstructive airways disease. Drugs. 1991; 42:895-912. http://www.ncbi.nlm.nih.gov/pubmed/1723379?dopt=AbstractPlus

158. Kelly HW. Issues and advances in the pharmacotherapy of asthma. J Clin Pharm Ther. 1992; 17:271-81. http://www.ncbi.nlm.nih.gov/pubmed/1361192?dopt=AbstractPlus

159. Lipworth BJ. Risks versus benefits of inhaled β2-agonists in the management of asthma. Drug Safety. 1992; 7:54-70. http://www.ncbi.nlm.nih.gov/pubmed/1346963?dopt=AbstractPlus

160. Sears MR, Taylor DR, Print CG et al. Regular inhaled beta-agonist treatment in bronchial asthma. Lancet. 1990; 336:1391-6. http://www.ncbi.nlm.nih.gov/pubmed/1978871?dopt=AbstractPlus

161. Anon. Warnings from the CSM. Int Pharm J. 1991; 5:247-8.

162. Spitzer WO, Sussa S, Ernst P et al. The use of β-agonists and the risk of death and near death from asthma. N Engl J Med. 1992; 326:501-6. http://www.ncbi.nlm.nih.gov/pubmed/1346340?dopt=AbstractPlus

163. Palmer JBD, Jenkins MM. β2-agonists in asthma. Lancet. 1991; 337:43. http://www.ncbi.nlm.nih.gov/pubmed/1670660?dopt=AbstractPlus

164. Dahl R. β2-agonists in asthma. Lancet. 1991; 337:43. http://www.ncbi.nlm.nih.gov/pubmed/1670660?dopt=AbstractPlus

165. Löfdahl CG, Svedmyr N. Beta agonists—friends or foes? Eur Respir J. 1991; 4:1161-5. Editorial.

166. Kamada AK, Spahn JD, Blake KV. Salmeterol: its place in asthma management. Ann Pharmacother. 1994; 28:1100-2. http://www.ncbi.nlm.nih.gov/pubmed/7803888?dopt=AbstractPlus

167. Wanner A. Is the routine use of inhaled β-adrenergic agonists appropriate in asthma treatment? Yes. Am J Respir Crit Care Med. 1995; 151:597-9. http://www.ncbi.nlm.nih.gov/pubmed/7881643?dopt=AbstractPlus

168. Sears MR. Is the routine use of inhaled β-adrenergic agonists appropriate in asthma treatment? No. Am J Respir Crit Care Med. 1995; 151:600-1. http://www.ncbi.nlm.nih.gov/pubmed/7881644?dopt=AbstractPlus

169. Lai CKW, Twentyman OP, Holgate ST. The effect of an increase in inhaled allergen dose after rimiterol hydrobromide on the occurrence and magnitude of the late asthmatic response and the associated change in nonspecific bronchial responsiveness. Am Rev Respir Dis. 1989; 140:917-23. http://www.ncbi.nlm.nih.gov/pubmed/2572192?dopt=AbstractPlus

170. Suissa S, Ernst P, Boivin JF et al. A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists. Am J Respir Crit Care Med. 1994; 149(3 Part 1):604-10. http://www.ncbi.nlm.nih.gov/pubmed/8118625?dopt=AbstractPlus

171. O’Connor BJ, Aikman SL, Barnes PJ. Tolerance to the nonbronchodilator effects of inhaled beta 2-agonists in asthma. N Engl J Med. 1992; 327:1204-8. http://www.ncbi.nlm.nih.gov/pubmed/1357551?dopt=AbstractPlus

172. Cockcroft DW, McParland CP, Britto SA et al. Regular inhaled salbutamol and airway responsiveness to allergen. Lancet. 1993; 342:833-7. http://www.ncbi.nlm.nih.gov/pubmed/8104272?dopt=AbstractPlus

173. Mullen ML, Mullen B, Carey M. The association between β-agonist use and death from asthma: a meta-analytic integration of case-control studies. JAMA. 1993; 270:1842-5. http://www.ncbi.nlm.nih.gov/pubmed/8105113?dopt=AbstractPlus

174. Reviewers’ comments (personal observations) on Salmeterol 12:12.

175. National Institutes of Health, National Heart, Lung, and Blood Institute. Global Initiative for asthma: global strategy for asthma management and prevention NHLBI/WHO Workshop Report. Bethesda, MD: National Institutes of Health. 1995 Jan:77-100. NIH/NHLBI Publication No. 95-3659.

176. Devoy MAB, Fuller RW, Palmer JBD. Are there any detrimental effects of the use of inhaled long-acting β2-agonists in the treatment of asthma? Chest. 1995; 107:1116-24.

177. McFadden ER Jr. Perspectives in β2-agonist therapy: vox clamantis in deserto vel lux in tenebris? J Allergy Clin Immunol. 1995; 95:641-51.

178. Crane J, Burgess C, Pearce N et al. Asthma deaths in New Zealand. BMJ. 1992; 304:1307. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1881872&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/1606438?dopt=AbstractPlus

179. Crane J, Pearce N, Flatt A et al. Prescribed fenoterol and death from asthma in New Zealand, 1981-83: case-control study. Lancet. 1989; 1:917-22. http://www.ncbi.nlm.nih.gov/pubmed/2565417?dopt=AbstractPlus

180. [ohw2]

181. Key Pharmaceuticals. Proventil HFA (albuterol sulfate) inhalation aerosol for oral inhalation prescribing information. Kenilworth, NJ; 2001 Oct.

182. Wilkinson JRW, Roberts JA, Bradding P et al. Paradoxical bronchoconstriction in asthmatic patients after salmeterol by metered dose inhaler. Br Med J. 1992; 305:931-2.

183. Shepherd GL, Jenkins WJ, Alexander J. Asthma exacerbations in patients taking regular salmeterol, or salbutamol for symptoms. Lancet. 1991; 337:1424. (IDIS 281722)

184. Keighley JF. Iatrogenic asthma associated with adrenergic aerosols. Ann Intern Med. 1966; 65:985-95.

185. Allen & Hanburys. Serevent (salmeterol xinafoate) inhalation aerosol product monograph. Research Triangle Park, NC; 1994 Mar.

186. Bryant DH, Rogers P. Effects of ipratropium bromide nebulizer solution with and without preservatives in the treatment of acute and stable asthma. Chest. 1992; 102:742-7.

187. Kleerup EC, Tashkin DP, Cline AC et al. Cumulative dose-response study of non-CFC propellant HFA 134a salbutamol sulfate metered-dose inhaler in patients with asthma. Chest. 1996; 109: 702-7. http://www.ncbi.nlm.nih.gov/pubmed/8617079?dopt=AbstractPlus

188. National Asthma Education and Prevention Program. Expert panel report II: guidelines for the diagnosis and management of asthma. 1997 Feb.

189. National Asthma Education Program. Executive summary: guidelines for the diagnosis and management of asthma. NIH Publ. No.94-3042A. Washington, DC: US Government Printing Office; 1994 Jul.

190. National Institutes of Health, National Heart, Lung, and Blood Institute. Global Initiative for asthma: global strategy for asthma management and prevention NHLBI/WHO Workshop Report. Bethesda, MD: National Institutes of Health. 1995 Jan:77-100. NIH/NHLBI Publication No. 95-3659.

191. British Thoracic Society. Guidelines on the management of asthma. Thorax. 1993; 48(2 Suppl):S1-24.

192. Allen & Hanburys. Serevent (salmeterol xinafoate) inhalation aerosol prescribing information. Research Triangle Park, NC; 1994 Dec.

193. Allen & Hanburys. Serevent (salmeterol xinafoate) inhalation aerosol patient instructions. Research Triangle Park, NC; 1994 Feb.

194. Bone RC. Another word of caution regarding a new long-acting bronchodilator. JAMA. 1995; 273:967-8. http://www.ncbi.nlm.nih.gov/pubmed/7884959?dopt=AbstractPlus

195. Reviewers’ comments (personal observations) on salmeterol.

196. Anon. Warnings from the CSM. Int Pharm J. 1991; 5:247-8.

197. Smyth ET, Pavord ID, Wong CS et al. Interaction and dose equivalence of salbutamol and salmeterol in patients with asthma. BMJ. 1993; 306:543-5. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1677185&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/8096416?dopt=AbstractPlus

198. Löfdahl CG, Svedmyr N. Beta agonists—friends or foes? Eur Respir J. 1991; 4:1161-5. Editorial.

199. Sterling Pharmaceuticals. Nuprel (isoproterenol hydrochloride) injection. In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:2209-12.

200. Anon. Adverse effects and complications of treatment with beta-adrenergic agonist. J Allergy Clin Immunol. 1985; 75:443-9. http://www.ncbi.nlm.nih.gov/pubmed/2858503?dopt=AbstractPlus

201. Ahlquist RP. Pharmacology of pressor agents on the systemic circulation. Seminars Drug Treat. 1973; 3:231-6.

202. Maguire JF, O’Rourke PP, Colan SD et al. Cardiotoxicity during treatment of severe childhood asthma. Pediatrics. 1991; 88:1180-6. http://www.ncbi.nlm.nih.gov/pubmed/1956735?dopt=AbstractPlus

203. Allen & Hanburys, Research Triangle Park, NC: Personal communication on salmeterol 12:12.

204. Anon. Sympathomimetics. In: Reynolds JEF, ed. Martindale: the extra pharmacopoeia. 30Rev. ed. London: The Pharmaceutical Press; 1993:1236.

205. Kamada AK, Spahn JD, Blake KV. Salmeterol: its place in asthma management. Ann Pharmacother. 1994; 28:1100-2. http://www.ncbi.nlm.nih.gov/pubmed/7803888?dopt=AbstractPlus

206. American Thoracic Society. Standards for the diagnosis and care of patients with chronicpobstructive pulmonary disease. Am J Respir Crit Care Med. 1995; 152: s77-120.

207. Siafakas NM, Vermeire P, Pride NB et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). Eur Respir J. 1995: 8; 1398-1420.

208. Glaxo Wellcome. Ventolin (albuterol sulfate) syrup prescribing information. Research Triangle Park, NC; 1997 Jun.

209. Boehringer Ingelheim. Atrovent (ipratropium bromide) inhalation aerosol prescribing information. Ridgefield, CT; 1993 June.

210. GlaxoSmithKline. Ventolin (albuterol) inhalation aerosol patient instructions. Research Triangle Park, NC; 2001 Aug.

211. Glaxo Wellcome. Ventolin (albuterol sulfate) inhalation solution 0.5% patient instructions. Research Triangle Park, NC; 1998 May.

212. GlaxoWellcome. Ventolin (albuterol sulfate) solution for inhalation 0.5% prescribing information. Research Triangle Park, NC; 1998 Sep.

213. Glaxo Wellcome. Ventolin Nebules (albuterol sulfate) inhalation solution, 0.083% patient instructions. Research Triangle Park, NC; 1998 May.

214. Glaxo Wellcome. Ventolin Rotacaps (albuterol sulfate) for inhalation patient instructions. Research Triangle Park, NC; 1998 Jun.

215. Key Pharmaceuticals. Proventil HFA (albuterol sulfate) inhalation aerosol for oral inhalation patient instructions. Kenilworth, NJ; 1997 Jun.

217. Prior C, Leonard MB, McCullough JR. Effects of the enantiomers of R,S-salbutamol on incompletely fused tetanic contractions of slow- and fast-twitch skeletal muscles of the guinea-pig. Br J Pharmacol. 1998; 123:558-64. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1565188&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/9504397?dopt=AbstractPlus

218. Cockcroft DW, Swystun VA. Effect of single doses of S-salbutamol, R-salbutamol, racemic salbutamol, and placebo on the airway response to methacholine. Thorax. 1997; 52:845-8. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1758422&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/9404369?dopt=AbstractPlus

220. Zhang XY, Zhu FX, Olszewski MA et al. Effects of enantiomers of beta 2-agonists on ACh release and smooth muscle contraction in the trachea. Am J Physiol. 1998; 274:L32-8. http://www.ncbi.nlm.nih.gov/pubmed/9458798?dopt=AbstractPlus

223. Mitra S, Ugur M, Ugur O et al. (S)-albuterol increases intracellular free calcium by muscarinic receptor activation and a phospholipase C-dependent mechanism in airway smooth muscle. Mol Pharmacol. 1998; 53:347-54. http://www.ncbi.nlm.nih.gov/pubmed/9495798?dopt=AbstractPlus

224. Handley DA, McCullough JR, Crowther SD et al. Sympathomimetic enantiomers and asthma. Chirality. 1998; 10:262-72. http://www.ncbi.nlm.nih.gov/pubmed/9499574?dopt=AbstractPlus

225. Mazzoni L, Naef R, Chapman ID et al. Hyperresponsiveness of the airways following exposure of guinea-pigs to racemic mixtures and distomers of beta 2-selective sympathomimetics. Pulm Pharmacol. 1994; 7:367-76. http://www.ncbi.nlm.nih.gov/pubmed/7549224?dopt=AbstractPlus

227. Medeva Pharmaceuticals. Airet(albuterol sulfate) inhalation solution 0.083% prescribing information(dated 1996 Nov). In: Physicians’ desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:1692-3.

228. Anon. Interactions between methyl xanthines and beta adrenergic agonists. FDA Drug Bull. 1981; 11:19-20. http://www.ncbi.nlm.nih.gov/pubmed/6119269?dopt=AbstractPlus

229. Boulton DW, Fawcett JP. Pharmacokinetics and pharmacodynamics of single oral doses of albuterol and its enantiomers in humans. Clin Pharmacol Ther. 1997; 62:138-44. http://www.ncbi.nlm.nih.gov/pubmed/9284849?dopt=AbstractPlus

230. Handley D. The Asthma-like pharmacology and toxicology of (S)-isomers of beta agonists. J Allergy Clin Immunol. 1999; 104:69-76.

231. Boulton DW, Fawcett JP. Enantioselective disposition of salbutamol in man following oral and intravenous administration. Br J Clin Pharmaco. 1996; 41:35-40.

232. Gumbhir-Shah K, Kellerman DJ, DeGraw S et al. Pharmacokinetics and pharmacodynamics of cumulative single doses of inhaled salbutamol enantiomers in asthmatic subjects. Pulm Pharmacol Ther. 1999; 12:353-62. http://www.ncbi.nlm.nih.gov/pubmed/10587476?dopt=AbstractPlus

233. Boehringer Ingelheim Pharmaceuticals. Combivent (ipratropium bromide and albuterol sulfate) inhalation aerosol prescribing information. Ridgefield, CT; 2005 Oct 11 .

234. Ikeda A, Nishimura K, Koyama H et al. Bronchodilating effects of combined therapy with clinical dosages of ipratropium bromide and salbutamol for stable COPD. Chest. 1995; 107:401-5. http://www.ncbi.nlm.nih.gov/pubmed/7842768?dopt=AbstractPlus

235. Combivent Inhalation Aerosol Study Group. In chronic obstructive pulmonary disease, a combination of ipratropium and albuterol is more effective than either agent alone; an 85-day multicenter trial. Chest. 1994; 105: 1411-9.

236. Boehringer Ingelheim Pharmaceuticals. Combivent (ipratropium bromide and albuterol sulfate) inhalation aerosol prescribing information. In: Physicians’ desk reference. 51th ed. Montvale, NJ: Medical Economics Company Inc; 1997(Suppl A):A14-6.

237. GlaxoWellcome. Ventolin HFA (albuterol sulfate HFA) inhalation aerosol prescribing information. 2005 Dec.

238. Lumry W, Noveck R, Weinstein S et al. Switching from ventolin CFC to ventolin HFA is well tolerated and effective in patients with asthma. Ann Allergy Asthma Immunol. 2001; 86:297-303. http://www.ncbi.nlm.nih.gov/pubmed/11289328?dopt=AbstractPlus

239. Shapiro G, Bronsky E, Murray A et al. Clinical comparability of ventolin formulated with hydrofluoroalkane or conventional chlorofluorocarbon propellants in children with asthma. Arch Pediatr Adolesc Med. 2000; 154:1219-25. http://www.ncbi.nlm.nih.gov/pubmed/11115306?dopt=AbstractPlus

240. Burgraaf J, Westendorp RG, Veen JC et al. Cardiovascular side effects of inhaled salbutamol in hypoxic asthmatic patients. Thorax. 2001; 56:567-9. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1746095&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/11413357?dopt=AbstractPlus

241. Schering Corporation. Proventil (albuterol sulfate) 0.083% inhalation solution prescribing information. Kenilworth, NJ; 2004 Jun.

242. Roxane Laboratories. Albuterol sulfate 0.083% inhalation solution. Columbus, OH; 2000 Mar.

243. Dey Laboratories. DuoNeb (ipratropium bromide/albuterol sulfate) inhalation solution prescribing information. Napa, CA; 2006 Jan.

244. Warrick Pharmaceuticals Corporation. Albuterol sulfate inhalation solution 0.5% prescribing information. Reno, NV; 1999 May.

245. Dey. DuoNeb (albuterol sulfate/ipratropium bromide) inhalation solution patient instructions. Napa, CA: 2001 May.

246. Roxane Laboratories. Albuterol sulfate inhalation solution 0.083% patient instructions. Columbus, OH; (undated).

247. Gross N, Tashkin D, Miller R et al. Inhalation by neulization of albuterol-ipratropium combination (Dey combination) is superior to either agent alone in the treatment of chronic obstructive pulmonary disease. Respiration. 1998; 65:354-62. http://www.ncbi.nlm.nih.gov/pubmed/9782217?dopt=AbstractPlus

248. GlaxoSmith Kline. Ventolin HFA (albuterol sulfate) inhalation aerosol patient instructions. Research Triangle Park, NC; 2000 Dec. 22.

249. National Institutes of Health, National Heart, Lung, and Blood Institute. Global Initiative for asthma: global strategy for asthma management and prevention. Bethesda, MD: National Institutes of Health. 2009 Dec. Available from website. Accessed 2010 Sep 23. http://www.ginasthma.com

250. National Heart, Lung, and Blood Institute/World Health Organization. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Bethesda, MD: National Heart, Lung, and Blood Institute, Global Initiative for Chronic Obstructive Lung Disease, World Health Organization; 2001. Available from website. Accessed Sep. 26, 2002. http://www.goldcopd.com

251. Veterans’ Health Administration Department of Veteran Affairs. The pharmacologic management of chronic obstructive pulmonary disease. Washington, DC: Veterans’ Health Administration; 1999 June. Pharmacy Benefits Management No. 99-0012. Available from website. Accessed Sep. 30, 2002. https://www.pbm.va.gov

252. Veterans’ Health Administration, Department of Veterans’ Affairs. VHA/DOD clinical practice guideline for the management of chronic obstructive pulmonary disease: complete summary. Washington, DC: Veterans’ Health Administration; 1999 Aug.

253. Snow V, Lascher S, Mottur-Pilson C for the Joint Expert Panel of Chronic Obstructive Pulmonary Disease of the American College of Chest Physicians and the American College of Physicians-American Society of Internal Medicine. Evidence base for management of acute exacerbations of chronic obstructive pulmonary disease. Clinical Practice Guideline, pt.1. Ann Intern Med. 2001; 134:595-9. http://www.ncbi.nlm.nih.gov/pubmed/11281744?dopt=AbstractPlus

255. Dey Laboratories. AccuNeb (albuterol sulfate) inhalation solution. Napa, CA; 2005 Jun.

256. Dey Laboratories. Accuneb (albuterol sulfate) inhalation solution patient information. Napa, CA; 2001 Sep.

257. Schering Laboratories. Proventil (albuterol sulfate) inhalation solution 0.5% patient instructions. Kenilworth, NJ; 1999 May.

258. Dey Laboratories. Albuterol sulfate inhalation solution 0.083% prescribing information. Napa, CA; 2006 Jan.

259. National Asthma Education Program Expert Panel Report. Executive summary: guidelines for the diagnosis and management of asthma—update on selected topics 2002. NIH Publication No. 02-5075. Bethesda, MD: National Institutes of Health, National Heart, Lung, and Blood Institute; 2002 Jun.

261. Schering . Proventil (albuterol sulfate) inhalation aerosol patient instructions. Kenilworth, NJ; 2004 May.

262. Schering. Proventil (albuterol) syrup prescribing information. Kenilworth, NJ: 1997 May.

263. Dey Laboratories. Albuterol sulfate inhalation solution 0.083% patient instructions. Napa, CA; 2000 Jan.

264. Ferguson GT, Cherniack RM. Management of chronic obstructive pulmonary disease. N Engl J Med. 1993; 328:1017-22. http://www.ncbi.nlm.nih.gov/pubmed/8450855?dopt=AbstractPlus

265. American Thoracic Society. ATS Statement: Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1995;152(Suppl):S78-120.

266. National Heart, Lung, and Blood Institute/World Health Organization. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Bethesda, MD: National Heart, Lung, and Blood Institute, Global Initiative for Chronic Obstructive Lung Disease, World Health Organization; 2005 Sep. Available from website. Accessed Oct. 5, 2005. http://www.goldcopd.com

267. ATS/ERS Standards for the diagnosis and management of patients with COPD. New York, NY: American Thoracic Society, European Respiratory Society; 2004. Available from website. Accessed Dec. 8, 2004. http://www.thoracic.org/clinical/copd-guidelines/index.php

268. O’Donnell DE, Aaron S, Bourbeau J et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease-2003. Can Respir J. 2003; 10 (Suppl. A):11A-65A.

269. Celli BR, Macnee W. Standard for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004; 23:932-46. http://www.ncbi.nlm.nih.gov/pubmed/15219010?dopt=AbstractPlus

270. Teva Pharmaceuticals. Albuterol sulfate syrup prescribing information. Sellersville, PA; 2003 Jun.

271. Dava Pharmaceuticals. VoSpire ER (albuterol sulfate) extended-release tablets prescribing information. Fort Lee, NJ; 2006.

272. Nephron Pharmaceuticals. Albuterol sulfate 0.5% inhalation solution prescribing information. Orlando, FL; 2001 Apr 24.

273. Nephron Pharmaceuticals. Albuterol sulfate 0.5% inhalation solution patient information. Orlando, FL; 2001 Apr 24.

276. Sepracor. Xopenox (levalbuterol tartrate) inhalation aerosol prescribing information. Northridge, CA; 2005 Sep.

277. Sepracor. Xopenox (levalbuterol tartrate) inhalation aerosol patient instructions for use. Northridge, CA; 2005 Sep.

278. Boulton DW, Fawvett JP. The pharmacokinetics of levosalbutamol: what are the clinical implications? Clin Pharmacokinet. 2001; 40:23-40

279. Price AH, Clissold SP. Salbutamol in the 1980s: a reappraisal of its clinical efficacy. Drugs. 1989; 38:77-122. http://www.ncbi.nlm.nih.gov/pubmed/2670512?dopt=AbstractPlus

280. Mylan Pharmaceuticals. Albuterol tablets prescribing information. Morgantown, WV; 2006 Mar 3.

281. Hi-Tech Pharmacal. Albuterol sulfate syrup prescribing information. Amityville, NY; 2006 Apr.

282. IVAX Laboratories. ProAir HFA (albuterol sulfate) inhalation aerosol prescribing information. Miami, FL; 2006 Feb

283. Schering. Proventil (albuterol sulfate) 0.083% inhalation solution patient’s instructions for use. Kenilworth, NJ; 2004 Jun.

287. GlaxoSmithKline. Serevent Diskus (salmeterol xinafoate) inhalation powder prescribing information. Research Triangle Park, NC; 2010 Jun.

292. National Institutes of Health, National Heart, Lung and Blood Institute. Global initiative for asthma: global strategy for asthma management and prevention NHLBI/WHO Workshop Report. Bethesda, MD: National Institutes of Health. 2002. Available from website. Accessed 2010 Oct 27. http://www.ginasthma.com

293. Schering Plough. Proventil HFA (albuterol sulfate) inhalation aerosol prescribing information. Kenilworth, NJ; 2009 Feb.

294. GlaxoSmithKline. Ventolin HFA (albuterol sulfate) inhalation aerosol prescribing information. Research Triangle Park, NC; 2009 Jun.

295. Teva. ProAir HFA (albuterol sulfate) inhalation aerosol prescribing information. Horsham, PA; 2010 Jul.

j. AHFS drug information 2007. McEvoy GK, ed. Albuterol. Bethesda, MD: American Society of Health-System Pharmacists; 2007:1306-18.

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