Salbutamol inhaler

1. About salbutamol inhalers

Salbutamol is used to relieve symptoms of asthma and chronic obstructive pulmonary disease (COPD) such as coughing, wheezing and feeling breathless. It works by relaxing the muscles of the airways into the lungs, which makes it easier to breathe.

Salbutamol comes in an inhaler (puffer). Salbutamol inhalers are usually blue.

Salbutamol is sometimes given as tablets, capsules or syrup for people who cannot use an inhaler very well.

It can also be given using a nebuliser, but this is usually only if you have severe asthma or COPD. A nebuliser is a machine that helps you breathe in your medicine as a mist, using a mask or a mouthpiece. You can use a nebuliser in hospital or you may be given one to manage your condition at home.

This medicine is only available on prescription.

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3. Key facts

• Salbutamol inhalers are safe and effective with few side effects if you use them as advised by your doctor, pharmacist or nurse.
• Salbutamol inhalers are called "reliever" inhalers because they give you quick relief from breathing problems when you need it. You'll usually be given another "preventer" inhaler to help stop (prevent) symptoms and you will use this every day.
• If you need to use your salbutamol inhaler more than 3 times a week, it could be a sign that your condition is not well controlled. Talk to your doctor, pharmacist or nurse.
• Salbutamol is safe to use in pregnancy and while breastfeeding.

4. Who can and cannot use salbutamol inhalers

Most adults and children of all ages can use salbutamol inhalers.

Most adults can use salbutamol in a nebuliser.

Children aged under 18 years old can use salbutamol in a nebuliser only if it's with advice from a specialist doctor. This is because children need to be monitored to make sure their condition is not getting worse.

Salbutamol is not suitable for some people. To make sure it's safe for you, check with your doctor before starting salbutamol if you have ever had an allergic reaction to salbutamol or any other medicine.

5. How and when to use your inhaler

Only use your salbutamol inhaler when you need it. This may be when you notice symptoms, such as coughing, wheezing, shortness of breath and tightness in the chest, or when you know that you are going to do an activity that can make you breathless, for example climbing stairs or sport.

You should feel a difference to your breathing within a few minutes.

Dosage

The normal way to use your inhaler (both adults and children) is:

• 1 or 2 puffs of salbutamol when you need it
• up to a maximum of 4 times in 24 hours (regardless of whether you have 1 puff or 2 puffs at a time)

Salbutamol is sometimes used to prevent breathing symptoms happening in the first place. This could be before a trigger such as exercise or exposure to pets. In this situation, the normal dose is still 1 or 2 puffs at a time.

If you need to use your inhaler more than 4 times in 24 hours:

• it may mean that your condition is getting worse and that you need different treatment
• you are more likely to get side effects such as increased heart rate, jitteriness, nervousness and headaches

In a sudden asthma attack you can use your inhaler more and take up to 10 puffs. Wait 30 seconds and always shake the inhaler between each puff.

For treating severe asthma attacks, salbutamol can be given through a nebuliser. A nebuliser is a machine that delivers the medicine as a mist inhaled through a face mask. This will probably be given to you by your doctor.

Your salbutamol inhaler works quickly to make your breathing easier.

Inhalers can be difficult to use and mistakes in the technique can mean very little of the medicine gets into your lungs where you need it.

There are different types of salbutamol inhaler. Before using your inhaler, read the manufacturer's printed information leaflet from inside the pack. This leaflet gives you information and diagrams to show you how to use the inhaler, how to keep it clean, and how long to use it before getting a replacement.

It's very important that you use your inhaler properly. This is so you get the right amount of salbutamol into your lungs and the most benefit from it.

If you're not sure how to use your inhaler, or you have not had your technique checked for a year, ask your doctor, pharmacist or nurse to watch you use it.

If you or your child find it difficult to use an inhaler, your doctor may give you a spacer to use with it.

A spacer is a large metal or plastic container with a mouthpiece and a hole for the inhaler. When used with the inhaler it makes it easier to get the right amount of salbutamol into the lungs.

Spacers are especially useful for giving salbutamol to young children.

Your doctor, pharmacist or nurse can show you how to use a spacer with the inhaler.

If you use too much

If you use your inhaler too much, you may notice that your heart beats more quickly than normal and that you feel shaky.

These side effects are not dangerous, as long as you do not also have chest pain. They usually go away within 30 minutes or a few hours at most.

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Search for your inhaler, and watch a short video on the Asthma + Lung UK website on how to use your inhaler.

7. Side effects

Salbutamol is a safe and very effective medicine if you use it properly. It has very few side effects.

Common side effects

More than 1 in 100 people have these side effects after taking 1 or 2 puffs of their inhaler.

Contact your doctor or pharmacist if these or any other side effects bother you or do not go away:

• feeling shaky
• faster heartbeat for a short while (but no chest pain)
• headaches

These side effects are not dangerous and they should gradually improve as your body gets used to salbutamol.

Serious side effects

It happens rarely, but some people may have very serious side effects when taking salbutamol.

Call a doctor or call 111 straight away if you get:

• muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal – this can be a sign of low potassium levels
• very bad dizziness or you pass out

It is possible to have a serious allergic reaction (anaphylaxis) to salbutamol.

These are not all the side effects of salbutamol. For a full list see the leaflet inside your medicines packet.

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9. How to cope with side effects of salbutamol inhalers

What to do about:

• feeling shaky – see if your asthma or COPD symptoms get better with just 1 puff of your inhaler rather than 2. If you find you need 2 puffs for symptom relief, be reassured that the shakiness will wear off after a short time.
• faster heartbeat for a short while – make sure you are not taking more than the prescribed dose. If this happens regularly, talk to your doctor or nurse as you may need your treatment reviewed so that you do not need to use your salbutamol as often.
• headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking salbutamol. Talk to your doctor if they last longer than a week or are severe.

10. Pregnancy and breastfeeding

Salbutamol is safe to use in pregnancy. It's important that your asthma is well treated, so do not hesitate to use your inhaler if you need it.

Since salbutamol is inhaled and works in the lungs, very little of it gets into your blood and even less of it gets to your baby. Even if your baby is exposed to salbutamol, it will not cause them any harm.

If you have asthma, your doctor will recommend that you continue to use your salbutamol inhaler. They will be able to give you advice on how to manage your asthma during pregnancy.

If your asthma gets worse, let your midwife or doctor know, as your treatment may need to be increased.

Salbutamol and breastfeeding

It's OK to use salbutamol while breastfeeding and you can use your salbutamol inhaler as normal. It's important that you continue to treat your asthma while breastfeeding to keep you well.

It's not known how much salbutamol gets into breast milk, but it's likely to be a very small amount. It has been used for many years in breastfeeding women without side effects in their babies.

If your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife.

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For more information about how salbutamol can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.

12. Cautions with other medicines

Some medicines can affect the way salbutamol works.

If you're taking other prescribed medicines that do not mix well with salbutamol such as a beta blocker like bisoprolol, your doctor will decide whether the benefits of taking both medicines outweigh the risks.

Mixing salbutamol with herbal remedies or supplements

There's very little information about taking herbal remedies and supplements with salbutamol. These remedies are not tested in the same way as medicines.

13. Common questions about salbutamol inhalers