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Composition for 1 bottle/1 dose:

Active ingredient: salbutamol - 12.2 mg/100 mcg;
excipients: cetyl oleate - 24.4 mg/0.2 mg, fluorotrichloromethane (freon-11) - 6000 mg/49.2 mg, difluorodichloromethane (freon-12) - 10800 mg/88.5 mg.

Description: The contents of a metal cylinder with a dosing valve is a suspension under pressure and forms a white spot when sprayed onto a glass slide.

Pharmacodynamics. Salbutamol is a selective beta2-adrenergic receptor agonist. In therapeutic doses, it acts on beta2-adrenergic receptors of the smooth muscles of the bronchi, providing a pronounced bronchodilator effect, prevents and relieves bronchospasm, and increases the vital capacity of the lungs. Prevents the release of histamine, a slow-reacting substance from mast cells and neutrophil chemotaxis factors. Causes a slight positive chrono- and inotropic effect on the myocardium, dilation of the coronary arteries, and practically does not reduce blood pressure. It has a tocolytic effect: it reduces the tone and contractile activity of the myometrium. The effect of the drug begins 5 minutes after inhalation administration and lasts for 4-6 hours.
It has a number of metabolic effects: it reduces the K+ content in plasma, has a hyperglycemic (especially in patients with bronchial asthma) and lipolytic effect, and increases the risk of developing acidosis.

Pharmacokinetics. After inhalation administration, 10 to 20% of the dose enters the respiratory tract. The rest is retained in the device or settles in the oropharynx and is then swallowed. Part of the dose that remains in the respiratory tract is absorbed by lung tissue without being metabolized in the lungs and enters the bloodstream. When it enters the systemic circulation, it can be metabolized in the liver and is excreted primarily unchanged in the urine.
Part of the dose entering the gastrointestinal tract is absorbed and undergoes intensive metabolism during the first passage through the liver.
The unchanged drug and conjugate are excreted primarily in the urine.
Most of the dose of salbutamol is eliminated within 72 hours. The degree of binding of salbutamol to plasma proteins is 10%.
The maximum concentration in blood plasma is 30 ng/ml.
The half-life is 3.7-5 hours.

Inhalation.
Adults and children over 12 years of age: 100-200 mcg of salbutamol (1-2 inhalations)
to relieve asthma attacks.
If there is no effect after 5 minutes, repeated inhalation is possible. Subsequent inhalation can be carried out no earlier than 2 hours later.
To control the course of mild asthma - 1-2 doses 1-4 times a day and moderate severity of the disease - in the same dosage in combination with other anti-asthmatic drugs.
To prevent asthma from physical exertion - 20-30 minutes before exercise, 1-2 doses per dose.
Children from 2 to 12 years old: with the development of an attack of bronchial asthma, as well as to prevent attacks of bronchial asthma associated with exposure to an allergen or caused by physical activity, the recommended dose is 100-200 mcg (1-2 inhalations).
The daily dose of salbutamol should not exceed 1200 mcg (12 inhalations).

When using a metered aerosol, the following instructions must be strictly followed:
1. Shake the can thoroughly before use.
2. Place the sprayer on the bottle and remove the cap from the sprayer.
3. Take a deep breath.
4. Turn the balloon upside down, wrap your lips around the mouthpiece, take a strong breath and at the same time press the bottom of the balloon. In this case, a strong release of aerosol occurs. Hold your breath for a few seconds and, moving the mouthpiece away from your mouth, exhale slowly.
5. After use, close the mouthpiece with a lid to prevent contamination.

For patients (including young children) who find it difficult to
correctly breathing maneuver, it is recommended to use a special device (spacer) for inhalation of the drug, which increases the tidal volume and smoothes out the inaccuracies of asynchronous inspiration.

In patients with severe or unstable disease, the use of bronchodilators should not be the main or only method of therapy.
If the effect of the usual dose of salbutamol becomes less effective or less durable (the effect of the drug should last at least 3 hours), the patient should consult a doctor.
Frequent use of salbutamol can lead to increased bronchospasm and sudden death, and therefore it is necessary to take breaks of several hours between doses of the drug.
An increased need for the use of inhaled beta2-adrenergic agonists with a short duration of action to control the symptoms of bronchial asthma indicates an exacerbation of the disease. In such cases, the patient's treatment plan should be reviewed and the issue of prescribing or increasing the dose of inhaled or systemic glucocorticosteroids should be decided.
Therapy with beta2-adrenergic agonists may lead to hypokalemia. Particular caution is recommended when treating severe attacks of bronchial asthma, since in these cases it can intensify as a result of the simultaneous use of xanthine derivatives, glucocorticosteroids, diuretics, as well as due to hypoxia. In such situations, it is necessary to monitor the level of potassium in the blood serum.

By frequency, side effects can be divided into the following categories: very common (≥ 1/10), common (≥ 1/100 and< 1/10), нечастые (≥ 1/1000 и < 1/100), редкие (≥ 1/10 000 и < 1/100), очень редкие (< 1/10 000).
From the immune system: very rarely - hypersensitivity reactions, including angioedema, urticaria, erythema, nasal congestion, bronchospasm.
From the side of metabolic processes: rarely - hypokalemia, as well as reversible metabolic disorders, for example, an increase in the concentration of glucose in the blood.
From the central nervous system: often - , ; infrequently - ; very rarely - increased excitability, anxiety, sleep disturbance, insomnia, fatigue.
From the cardiovascular system: rarely - a slight compensatory increase in heart rate, increased blood pressure; very rarely - including atrial fibrillation, supraventricular tachycardia and extrasystole, and; rarely - expansion of peripheral vessels (facial skin hyperemia).
From the respiratory system: very rarely - paradoxical bronchospasm.
From the digestive system: not often - changes in taste sensations; rarely - dryness or irritation of the mucous membrane of the mouth and pharynx (pharyngitis), .
From the musculoskeletal system: rarely - muscular.

Theophylline and other xanthines, when used simultaneously with salbutamol, increase the likelihood of developing tachyarrhythmias; agents for inhalation anesthesia, levodopa - severe ventricular arrhythmias.
It is not recommended to simultaneously use salbutamol and non-selective beta-adrenergic blockers, such as propranolol.
Monoamine oxidase inhibitors and tricyclic antidepressants enhance the effect of salbutamol and can lead to a sharp decrease in blood pressure.
Salbutamol enhances the effect of stimulants of the central nervous system, the side effect of thyroid hormones on the heart.
Increases the likelihood of developing glycoside intoxication. Reduces the effectiveness of antihypertensive drugs and nitrates.
Hypokalemia may increase as a result of the simultaneous use of xanthine derivatives, glucocorticosteroids, and diuretics.
Simultaneous administration with anticholinergic drugs (including inhalation drugs) may increase intraocular pressure.

Symptoms: nausea, vomiting, increased excitability, tachycardia, ventricular flutter, dilatation of peripheral vessels, decreased blood pressure, hypoxemia, acidosis, hypokalemia, muscle tremor, headache.
Treatment: drug withdrawal, cardioselective beta-blockers; symptomatic therapy.
If an overdose is suspected, the level of potassium in the blood serum should be monitored.

Ireland

They stimulate β2-adrenergic receptors, which are located in the membranes of smooth muscle cells of the bronchi, uterus, gastrointestinal tract, bladder detrusor, blood vessels (vessels of skeletal muscles, lungs, coronary vessels). In this case, the smooth muscles of the bronchi relax, the tone and contractile activity of the myometrium, bladder, gallbladder and bile ducts decrease, motility and tone of the stomach and intestines decrease, and blood vessels dilate.

Relaxation of smooth muscles upon stimulation of β2-adrenergic receptors coupled to Gs proteins that stimulate adenylate cyclase is associated with an increase in cAMP levels and activation of cAMP-dependent protein kinase in smooth muscle cells. cAMP-dependent protein kinase A inhibits the kinase of myosin light chains, as a result of which their phosphorylation is disrupted and interaction with actin does not occur. cAMP-dependent protein kinase A inhibits phospholamban (Ca2+-ATPase inhibitor), as a result, in smooth muscle cells the activity of Ca2+-ATPase, which transports Ca2+ from the cytoplasm to the sarcoplasmic reticulum, increases, and the concentration of cytoplasmic Ca2+ decreases. All this leads to a decrease in the tone and contractile activity of smooth muscles. An increase in blood glucose levels is possible, since β2-adrenergic receptors control the process of glycogenolysis in the liver and skeletal muscles and insulin secretion in the pancreas, and when they are stimulated, phosphorylase is activated and glycogen breakdown increases, resulting in an increase in blood glucose levels.

Insulin secretion increases when β2-adrenergic receptors are stimulated.

When taken orally, 80-85% is absorbed. After inhalation administration, 10-20% of the dose of salbutamol reaches the lower respiratory tract. The rest of the dose remains in the inhaler, settles on the mucous membrane of the oropharynx and is then swallowed. The fraction deposited on the mucous membrane of the respiratory tract is absorbed into the lung tissue and blood, but is not metabolized in the lungs.

The degree of binding of salbutamol to plasma proteins is about 10%.

Salbutamol is metabolized in the liver and excreted primarily in the urine unchanged in the form of phenolic sulfate. The ingested portion of the inhalation dose is absorbed from the gastrointestinal tract and undergoes active first-pass metabolism through the liver, turning into phenolic sulfate. Unchanged and conjugate are excreted mainly in the urine.

The half-life of salbutamol is 4-6 hours. It is excreted by the kidneys partly unchanged and partly in the form of an inactive metabolite 4"-O-sulfate (phenolic sulfate). A small part is excreted in bile (4%) and in feces. Most of the dose of salbutamol is excreted within 72 hours

Prevention and reliefbronchospastic syndrome, bronchial asthma;symptomatic treatment chronic obstructive pulmonary disease (oral, inhalation).

X.J40-J47.J42 Chronic bronchitis, unspecified

X.J40-J47.J43 Emphysema

X.J40-J47.J46 Asthmatic status

X.J40-J47.J45.9 Asthma, unspecified

X.J40-J47.J45.8 Mixed asthma

X.J40-J47.J45.1 Non-allergic asthma

X.J40-J47.J45.0 Asthma with a predominance of an allergic component

X.J40-J47.J45 Asthma

X.J40-J47.J44.9 Chronic obstructive pulmonary disease, unspecified

X.J40-J47.J44.8 Other specified chronic obstructive pulmonary disease

X.J40-J47.J44.1 Chronic obstructive pulmonary disease with exacerbation, unspecified

X.J40-J47.J44.0 Chronic obstructive pulmonary disease with acute respiratory infection of the lower respiratory tract

X.J40-J47.J44 Other chronic obstructive pulmonary disease

XV.O60-O75.O60 Premature birth

In this article you can read the instructions for use of the drug Salbutamol. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Salbutamol in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Salbutamol in the presence of existing structural analogues. Use for the treatment of bronchial asthma and relief of bronchospasm in adults, children, as well as during pregnancy and lactation. Composition of the drug.

Salbutamol- is a selective beta2-adrenergic receptor antagonist. In therapeutic doses, it acts on beta2-adrenergic receptors of the smooth muscles of the bronchi, providing a pronounced bronchodilator effect, prevents and relieves bronchospasm, and increases the vital capacity of the lungs. Prevents the release of histamine, a slow-reacting substance from mast cells and neutrophil chemotaxis factors. Causes a slight positive chrono- and inotropic effect, dilates the coronary arteries and practically does not reduce blood pressure. It has a tocolytic effect: it reduces the tone and contractile activity of the myometrium.

It has a number of metabolic effects: it reduces the potassium content in plasma, affects glycogenolysis and insulin secretion, has a hyperglycemic (especially in patients with bronchial asthma) and lipolytic effect, and increases the risk of developing acidosis.

The effect of the drug begins 5 minutes after inhalation administration and lasts for 4-6 hours.

Compound

Salbutamol sulfate + excipients.

Pharmacokinetics

After inhalation administration, 10 to 20% of the dose enters the respiratory tract. The rest is retained in the device or settles in the oropharynx and is then swallowed. Part of the dose that remains in the respiratory tract is absorbed by lung tissue without being metabolized in the lungs and enters the bloodstream. Once in the systemic circulation, it can be metabolized in the liver and excreted primarily in the urine unchanged or in the form of phenolic sulfate. The degree of binding of salbutamol to plasma proteins is 10%. Part of the dose delivered to the gastrointestinal tract is absorbed and undergoes intensive metabolism during the “first pass” through the liver, turning into phenolic sulfate. The unchanged drug and conjugate are excreted primarily in the urine. Most of the dose of salbutamol administered intravenously, orally or by inhalation is eliminated within 72 hours.

Indications

• prevention and relief of bronchospasm in bronchial asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema.

Release forms

Aerosol for inhalation dosed 100 mcg (sometimes mistakenly called spray).

Tablets 2 mg and 4 mg.

Instructions for use and dosage

Adults and children over 12 years of age: 100-200 mcg (1-2 inhalation doses) to relieve asthma attacks. To control the course of mild asthma - 1-2 doses 1-4 times a day and moderate severity of the disease - in the same dosage in combination with other anti-asthmatic drugs. To prevent asthma from physical exertion - 20-30 minutes before exercise, 1-2 doses per dose.

The daily dose should not exceed 800 mcg (8 inhalations).

Instructions for using the inhaler

Check the operation of the inhaler before using it for the first time, and also if you have not used it for some time.

1. Remove the cap from the inhaler. Make sure there is no dust or dirt in the outlet tube.
2. Hold the balloon in an upright position with your thumb on the bottom and your index finger on the top of the balloon.
3. Shake the can vigorously up and down.
4. Exhale as deeply as possible (without straining). Pinch the outlet tube of the can tightly with your lips.
5. Take a slow, deep breath. As you inhale, press your index finger on the valve of the canister, releasing a dose of medication. Continue to inhale slowly.
6. Remove the inhaler tube from your mouth and hold your breath for 10 seconds or as long as you can without straining. Exhale slowly.

If more than one dose of medication is needed, wait about a minute and then repeat from step 2. Replace the cap on the inhaler.

Take your time when performing steps 3 and 4. When releasing a dose of medication, it is important to inhale as slowly as possible. First, practice in front of a mirror. If you notice steam coming out of the top of the can or from the corners of your mouth, start again from step 2.

Cleaning the inhaler

The inhaler should be cleaned at least once a week. Remove the metal can from the plastic case and rinse the case and cap with warm water. Do not use hot water. Dry thoroughly, but do not use heating devices. Place the canister back into the case and put on the cap. Do not immerse the metal canister in water.

Side effect

• tremor of fingers;
• headache;
• dizziness;
• increased excitability;
• anxiety;
• sleep disturbance;
• insomnia;
• dilation of peripheral blood vessels (facial skin hyperemia);
• the appearance of chest pain;
• arthralgia;
• angioedema;
• hives;
• nasal congestion;
• bronchospasm;
• muscle cramps;
• nausea, vomiting;
• dyspepsia;
• cough;
• excitement and increased motor activity in children;
• the appearance of arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystole).

Contraindications

• rhythm disturbances (paroxysmal tachycardia, polytopic ventricular extrasystole);
• myocarditis;
• heart defects;
• aortic stenosis;
• cardiac ischemia;
• tachyarrhythmia;
• thyrotoxicosis;
• decompensated diabetes mellitus;
• glaucoma;
• epileptic seizures;
• pyloroduodenal narrowing;
• renal or liver failure;
• simultaneous use of non-selective beta-blockers;
• pregnancy;
• children under 2 years of age;
• hypersensitivity to any component of the drug.

Use during pregnancy and breastfeeding

Contraindicated during pregnancy.

During lactation it is prescribed only in cases where the expected benefit to the mother exceeds any possible risk to the child.

Use in children

Children from 2 to 12 years: with the development of an attack of bronchial asthma, as well as to prevent attacks of bronchial asthma associated with exposure to an allergen or caused by physical activity, the recommended dose is 100-200 mcg (1 or 2 inhalations).

special instructions

In patients with severe or unstable asthma, the use of bronchodilators should not be the main or only method of therapy. If the effect of the usual dose of Salamol Eco becomes less effective or shorter lasting (the effect of the drug should last for at least 3 hours), the patient should consult a doctor.

Frequent use of salbutamol can lead to increased bronchospasm and sudden death, and therefore it is necessary to take breaks of several hours between doses of the drug.

An increased need for the use of inhaled beta2-adrenergic agonists with a short duration of action to control the symptoms of bronchial asthma indicates an exacerbation of the disease. In such cases, the patient's treatment plan should be reviewed and the issue of prescribing or increasing the dose of inhaled or systemic glucocorticosteroids (GCS) should be decided.

Therapy with beta2-adrenergic agonists may lead to hypokalemia. Particular caution is recommended when treating severe attacks of bronchial asthma, since in these cases hypokalemia may increase as a result of the simultaneous use of xanthine derivatives, corticosteroids, diuretics, as well as due to hypoxia. In such situations, it is necessary to monitor the level of potassium in the blood serum.

The salbutamol cylinder must not be punctured, disassembled or thrown into fire, even if it is empty. Like most other inhalation aerosol products, salbutamol may be less effective at low temperatures. When cooling the cylinder, it is recommended to remove it from the plastic case and warm it with your hands for a few minutes.

To determine the reversibility of bronchial obstruction and assess the effectiveness of therapy, tests with bronchodilators (bronchodilators), such as Salbutamol, are used.

This medicine contains ethanol (alcohol). This fact must be taken into account when driving a vehicle.

Drug interactions

Theophylline and other xanthines, when used simultaneously with salbutamol, increase the likelihood of developing tachyarrhythmias; agents for inhalation anesthesia, levodopa - severe ventricular arrhythmias.

MAO inhibitors and tricyclic antidepressants enhance the effect of salbutamol and can lead to a sharp decrease in blood pressure.

Salbutamol enhances the effect of central nervous system stimulants, the side effects of thyroid hormones, cardiac glycosides.

Reduces the effectiveness of antihypertensive drugs and nitrates.

Hypokalemia may increase as a result of the simultaneous use of xanthine derivatives, corticosteroids, and diuretics.

Simultaneous administration with anticholinergic drugs (including inhaled ones) may increase intraocular pressure.

Analogues of the drug Salbutamol

Structural analogues of the active substance:

• Aloprol;
• Astalin;
• Ventolin;
• Ventolin Nebula;
• Volmax;
• Salamol;
• Salamol Eco;
• Salmo;
• Salben;
• Salbuvent;
• Salbutamol Teva;
• Salbutamol hemisuccinate;
• Salbutamol sulfate;
• Salgim;
• Saltos;
• Sterineb Salamol;
• Cibutol Cyclocaps.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Salbutamol is a bronchodilator (promotes dilation of the bronchi) drug.

Release form and composition

Dosage forms of Salbutamol:

• tablets (in blisters of 15 pieces, 2 blisters in a cardboard box; 30 pieces in bottles, 1 bottle in a cardboard box; in packages of 100, 500 or 1000 pieces);
• metered aerosol for inhalation: a suspension of almost white or white color, which is under pressure, when exiting the cylinder, it is sprayed in the form of an aerosol stream (in aluminum cylinders with a metering valve and an inhaler nozzle with a protective cap, 1 cylinder in a cardboard box).

Active ingredient in 1 tablet: salbutamol sulfate – 2 or 4 mg.

Aerosol composition (1 dose/1 12 ml container):

• active substance: salbutamol – 0.1/24 mg (in terms of 100% substance; salbutamol sulfate – 0.1208/29 mg);
• auxiliary components: oleyl alcohol – 0.0625/15 mg; propellant R 134a (1,1,1,2-tetrafluoroethane, HFA 134a) – 56.91/13659 mg; ethanol (rectified ethyl alcohol) – 2.02/485 mg.

The drug does not contain chlorofluorocarbon propellants.

Indications for use

Pills

• bronchospasm (relief/prevention) in all forms of bronchial asthma;
• broncho-obstructive syndrome in children;
• chronic bronchitis, emphysema, asthmatic bronchitis;
• uncomplicated preterm birth (management).

Aerosol

• bronchial asthma – to relieve attacks of bronchial asthma, including severe exacerbations, to prevent an attack of bronchospasm associated with exposure to an allergen or physical activity, and also as an additional component during long-term maintenance treatment;
• Chronical bronchitis;
• chronic obstructive pulmonary disease (COPD) in combination with reversible airway obstruction.

Contraindications

• age up to 2 years;
• hypersensitivity to the components of the drug.

Salbutamol is prescribed with caution in the presence of the following diseases/conditions (relative contraindications):

• thyrotoxicosis;
• combined use with non-selective β-blockers.

Additional relative contraindications for tablets:

• high arterial hypertension;
• paroxysmal tachycardia;
• acute heart failure;
• I trimester of pregnancy;
• I–II trimester of pregnancy with a threat of miscarriage due to bleeding and toxemia.

Additional relative contraindications for the aerosol:

• severe chronic heart failure;
• complicated history of tachyarrhythmia;
• cardiac ischemia;
• myocarditis;
• aortic stenosis;
• liver/renal failure;
• heart defects;
• arterial hypertension;
• decompensated diabetes mellitus;
• pheochromocytoma;
• seizures;
• glaucoma;
• pregnancy and breastfeeding period.

Directions for use and dosage

Pills

• adults and children over 12 years of age: 3-4 times a day, 2-4 mg, possibly increasing the single dose to 8 mg; maximum – 32 mg per day;
• children 6–12 years old: 3-4 times a day, 2 mg; maximum – 24 mg per day;
• children 2–7 years old: 3 times a day, 1–2 mg.

As a rule, the effect of Salbutamol develops 5–15 minutes after taking a single dose, the maximum effect is after 3 hours, the average duration of action is from 6 hours.

Aerosol

Salbutamol is administered by inhalation.

You cannot change the dosage regimen without consulting your doctor.

Directions for use (adults, including elderly patients, and children):

• long-term use for COPD and bronchial asthma as part of complex treatment: 4 times a day, 0.2 mg;
• bronchospasm (relief of attack): 0.1-0.2 mg;
• preventing the development of an attack of bronchospasm associated with exposure to an allergen or physical activity: 0.1-0.2 mg (children) or 0.2 mg (adults) over 10–15 minutes.

Before using Salbutamol for the first time, you must remove the protective cap from the inhaler nozzle, then shake the canister vigorously with vertical movements, turn it 180° (with the inhaler nozzle down) and spray several times into the air, which will ensure that the valve is working properly. If the drug has not been used for several days, after thoroughly shaking the container, you need to spray one spray into the air.

To use the drug, you should perform the following sequential steps:

• remove the protective cap from the inhaler nozzle, making sure that its outer and inner surfaces are clean;
• shake the container with vigorous vertical movements;
• turn the cylinder 180°;
• exhale as deeply as possible;
• place the inhaler nozzle between the teeth, covering it with your lips, without biting;
• begin to inhale slowly and deeply through your mouth, while simultaneously pressing on the top of the balloon;
• hold your breath as much as possible;
• remove the inhaler nozzle from your mouth.

If it is necessary to carry out 2 inhalations, the second one is performed after 30 seconds.

When cleaning the inhaler nozzle (at least once every 7 days), do not place the cylinder in water.

Side effects

Pills

As a rule, if the dosage regimen is followed, side effects rarely develop.

The most significant disorders (in case of increasing single/daily doses, in the presence of hypersensitivity to beta-2-adrenergic receptor stimulants): tension, tremor of the hands, internal tremors. If therapeutic doses are exceeded significantly (or with special sensitivity), the development of such adverse reactions as dizziness, headache, transient dilatation of peripheral vessels, muscle cramps, moderate tachycardia, nausea, vomiting is possible. In rare cases, the development of bronchospasm, angioedema, allergic reactions in the form of skin rash, urticaria, collapse, and hypotension is observed.

Aerosol

Possible adverse reactions (>10% - very common; >1% and<10% – часто; >0.1% and<1% – нечасто; >0.01% and<0,1% – редко; <0,01% – очень редко):

• immune system: rarely – dermatitis; very rarely - skin rash, hypersensitivity reactions, including angioedema;
• musculoskeletal system: rarely – convulsions;
• digestive system: rarely - irritation and/or dryness of the mucous membrane of the mouth and pharynx, changes in taste, nausea, vomiting;
• nervous system: often – headache, tremor, anxiety; rarely - drowsiness, dizziness, fatigue; very rarely - hyperactivity;
• respiratory system: rarely - respiratory tract irritation, cough; very rarely - bronchospasm (caused by hypersensitivity to the components of the drug or paradoxical);
• cardiovascular system: often – palpitations, tachycardia; rarely - dilatation of peripheral vessels with skin hyperemia, pain or discomfort in the chest; very rarely - arrhythmia, including supraventricular tachycardia, atrial fibrillation, extrasystole, collapse, decreased blood pressure;
• metabolic processes: rarely – hypokalemia.

special instructions

Pills

If you have cardiac dysfunction, hypertension, or diabetes, Salbutamol should be taken with caution.

Frequent use of Salbutamol can lead to increased bronchospasm and, in some cases, sudden death. Between single doses of the drug you need to take breaks (usually 6 hours). Reducing intervals is permissible only in exceptional cases.

Muscle tremors in the hands most often occur after oral administration of the drug.

Aerosol

To ensure that Salbutamol enters the bronchi, you must follow the instructions. At the beginning of treatment, the drug must be used under the supervision of medical personnel and after training in front of a mirror.

When the balloon cools, the therapeutic effect may decrease. In this regard, before use, the container with Salbutamol must be warmed in your hands to room temperature (other methods of heating are unacceptable).

If after inhalation there is discomfort in the mouth and a sore throat, at the end of the procedure the mouth should be rinsed with water.

Salbutamol should not be the main/only component of the treatment of bronchial asthma in severe or unstable cases.

If the effect of the usual single dose of the drug becomes shorter (up to 3 hours) and effective, you should consult your doctor. Changing the dosage regimen should be carried out under his control, reducing the intervals between doses should be strictly justified and possible only in exceptional cases.

In the treatment of bronchial asthma, an increase in the need for the drug may be a symptom of an exacerbation of the disease. In such cases, the treatment plan is usually revised.

High doses of Salbutamol during exacerbation of bronchial asthma can cause rebound syndrome (increasing the intensity of each subsequent attack). In case of severe asthma attacks, the break between inhalations should be at least 20 minutes. The likelihood of complications increases both with a significant duration of therapy and in case of abrupt withdrawal of Salbutamol. The drug should be used long-term in combination with anti-inflammatory drugs for basic therapy.

Progressive or sudden worsening of bronchial asthma can be life-threatening for the patient. In this regard, it is urgent to decide whether to prescribe glucocorticosteroids or increase their dose, as well as conduct daily monitoring of peak expiratory flow.

Particular caution is required when treating severe attacks of bronchial asthma, since in such patients hypokalemia may increase due to combined use with xanthine derivatives, glucocorticosteroids, diuretics, or hypoxia (monitoring of serum potassium concentration in the blood is required).

The use of Salbutamol can lead to the development of adverse reactions such as convulsions and dizziness, therefore, at the beginning of therapy, it is recommended to exercise extreme caution or refrain from driving vehicles or performing other potentially dangerous work.

Drug interactions

When using Salbutamol in combination with certain drugs/substances, the following effects may develop:

• monoamine oxidase inhibitors and tricyclic antidepressants: increased effect of salbutamol, increased likelihood of a sharp decrease in blood pressure;
• non-selective β-adrenergic receptor blockers (propranolol): antagonism of action (the combination is contraindicated);
• glucocorticosteroids, diuretics: increased hypokalemic effect of salbutamol;
• drugs that stimulate the action of the central nervous system: enhancing their effect;
• theophylline and other xanthines: increased risk of tachyarrhythmias;
• levodopa, drugs for inhalation anesthesia: increased risk of developing severe ventricular arrhythmias;
• m-anticholinergics (including inhaled): increased risk of increased intraocular pressure.

Possible combined use with monoamine oxidase inhibitors.

Terms and conditions of storage

Store in a dry, dark place, out of reach of children, at temperatures up to 25 °C. Do not freeze the aerosol container and protect it from impacts and falls.

Best before date:

• tablets – 4 years;
• aerosol – 3 years.

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