Chemical formula: C₁₃H₂₁NO₃ Molecular mass: 239.311 g/mol PubChem compound: 2083
Salbutamol interacts in the following cases:
The effects of salbutamol may be altered by monoamine oxidase inhibitors.
Salbutamol nebuliser solutions should be used with care in patients known to have received large doses of other sympathomimetic medicinal products.
Owing to the hypokalaemic effect of beta-agonists, concurrent administration of serum potassium depleting agents known to exacerbate the risk of hypokalaemia, such as corticosteroids, should be administered cautiously after careful evaluation of the benefits and risks with special regard to the increased risk of cardiac arrhythmias arising as a result of hypokalaemia.
The effects of salbutamol may be altered by tricyclic antidepressants.
Patients with underlying severe heart disease (e.g. severe heart failure) who are receiving salbutamol should be warned to seek medical advice if they experience chest pain or other symptoms of worsening heart disease. Attention should be paid to assessment of symptoms such as dyspnoea and chest pain, as they may be of either respiratory or cardiac origin.
The administration of beta-agonists is associated with a rise of blood glucose, which can be interpreted as an attenuation of anti-diabetic therapy; therefore individual anti-diabetic therapy may need to be adjusted.
Owing to the hypokalaemic effect of beta-agonists, concurrent administration of serum potassium depleting agents known to exacerbate the risk of hypokalaemia, such as diuretics, should be administered cautiously after careful evaluation of the benefits and risks with special regard to the increased risk of cardiac arrhythmias arising as a result of hypokalaemia.
Owing to the additional antihypertensive effect, there is increased uterine inertia with risk of haemorrhage; in addition, serious ventricular rhythm disorders due to increased cardiac reactivity, have been reported on interaction with halogenated anaesthetics. Treatment should be discontinued, whenever possible, at least 6 hours before any scheduled anaesthesia with halogenated anaesthetics.
Owing to the hypokalaemic effect of beta-agonists, concurrent administration of serum potassium depleting agents known to exacerbate the risk of hypokalaemia, such as xanthines, should be administered cautiously after careful evaluation of the benefits and risks with special regard to the increased risk of cardiac arrhythmias arising as a result of hypokalaemia.
Owing to the hypokalaemic effect of beta-agonists, concurrent administration of serum potassium depleting agents known to exacerbate the risk of hypokalaemia, such as digoxin, should be administered cautiously after careful evaluation of the benefits and risks with special regard to the increased risk of cardiac arrhythmias arising as a result of hypokalaemia.
The effects of salbutamol may be altered by guanethidine.
Co-administration of salbutamol with isocarboxazid causes an increase in blood pressure.
The effects of salbutamol may be altered by methyldopa.
Co-administration of salbutamol with midodrine causes an increase in blood pressure.
Co-administration of salbutamol with phenelzine results in an increase in blood pressure.
Co-administration of salbutamol with rasagiline results in an increase in blood pressure.
The effects of salbutamol may be altered by reserpine.
There is an increased risk of hypokalaemia if high doses of theophylline are given with higher doses of salbutamol.
As with other inhalation therapy, paradoxical bronchospasm may occur with an immediate increase in wheezing after dosing. This should be treated immediately with an alternative presentation or a different fast-acting inhaled bronchodilator. Salbutamol nebuliser solutions should be discontinued, and if necessary a different fast-acting bronchodilator instituted for on-going use.
Patients with underlying severe heart disease (e.g. ischaemic heart disease) who are receiving salbutamol should be warned to seek medical advice if they experience chest pain or other symptoms of worsening heart disease. Attention should be paid to assessment of symptoms such as dyspnoea and chest pain, as they may be of either respiratory or cardiac origin.
Patients with underlying severe heart disease (e.g. arrhythmia) who are receiving salbutamol should be warned to seek medical advice if they experience chest pain or other symptoms of worsening heart disease. Attention should be paid to assessment of symptoms such as dyspnoea and chest pain, as they may be of either respiratory or cardiac origin.
Administration of beta agonists is associated with a rise of blood glucose. Therefore blood glucose and lactate levels should be monitored in diabetics and diabetic treatment adjusted accordingly to meet the needs of the diabetic during tocolysis. Diabetic patients may be unable to compensate for the increase in blood glucose and the development of ketoacidosis has been reported.
Salbutamol should only be administered cautiously to patients suffering from thyrotoxicosis after careful evaluation of the benefits and risks of treatment.
Administration of medicinal products during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the fetus.
As with the majority of medicinal products, there is little published evidence of the safety of salbutamol in the early stages of human pregnancy, but in animal studies there was evidence of some harmful effects on the fetus at very high dose levels.
Salbutamol should only be used during pregnancy if it is considered essential by the physician.
As salbutamol is probably secreted in breast milk its use in nursing mothers requires careful consideration.
It is not known whether salbutamol has a harmful effect on the neonate, and so its use should be restricted to situations where it is felt that the expected benefit to the mother is likely to outweigh any potential risk to the neonate.
There is no information on the effects of salbutamol on human fertility. There were no adverse effects on fertility in animals.
None known.
The frequencies of adverse reactions are ranked according to the following MedDRA convention: Common (≥1/100 to <1/10); Uncommon (≥1/1,000 to <1/100); Rare (≥1/10,000 to <1/1,000); Very rare (<1/10,000); Not known (cannot be estimated from the available data).
Very rare: Hypersensitivity reactions including angioedema, urticaria, bronchospasm, hypotension and collapse
Not known: Lactic acidosis, Hypokalaemia
Not known: Headaches, Myoclonus
Not known: Peripheral vasodilation and compensatory increase in heart rate*, Cardiac arrhythmias, Myocardial ischemia**
Not known: Pulmonary oedema
Not known: Skeletal muscle tremor***, Tense feeling****
* With doses of salbutamol higher than those recommended or in patients who are unusually sensitive to beta-adrenergic stimulants.
** There have been spontaneously reports of myocardial ischemia in post-marketing experience (frequency unknown).
*** A fine tremor, which occurs in some patients, usually the hands and the effects are dose related.
**** Due to the effects on skeletal muscle and not to direct CNS stimulation.
Adverse events are listed below by system organ class and frequency. Frequencies are defined as: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000) and not known (cannot be estimated from the available data). Very common and common events were generally determined from clinical trial data. Rare, very rare and unknown events were generally determined from spontaneous data.
Very rare: Hypersensitivity reactions including angioedema, urticaria, bronchospasm, hypotension and collapse.
Rare: Hypokalaemia
Potentially serious hypokalaemia may result from beta2 agonist therapy
Not known: Lactic acidosis.
Common: Tremor, headache.
Very rare: Hyperactivity.
Common: Tachycardia.
Uncommon: Palpitations.
Very rare: Cardiac arrhythmias including atrial fibrillation, supraventricular tachycardia and extrasystoles.
Not known: Myocardial ischaemia*.
Rare: Peripheral vasodilatation.
Very rare: Paradoxical bronchospasm.
Uncommon: Mouth and throat irritation.
Uncommon: Muscle cramps.
* reported spontaneously in post-marketing data therefore frequency regarded as unknown
Adverse events are listed below by system organ class and frequency. Frequencies are defined as: very common (≥1/10), common (≥1/100 and <1/10), uncommon (≥1/1000 and <1/100), rare (≥1/10,000 and <1/1000) and very rare (<1/10,000). Very common and common events were generally determined from clinical trial data. Rare, very rare and unknown events were generally determined from spontaneous data.
Very rare: Hypersensitivity reactions including angioedema, urticaria, bronchospasm, hypotension and collapse.
Rare: Hypokalaemia.
Potentially serious hypokalaemia may result from beta-agonist therapy.
Unknown: Lactic acidosis
Very common: Tremor.
Common: Headache.
Very rare: Hyperactivity.
Very common: Tachycardia.
Common: Palpitations.
Rare: Cardiac arrhythmias including atrial fibrillation, supraventricular tachycardia and extrasystoles.
Unknown: Myocardial ischaemia*
Rare: Peripheral vasodilatation.
Uncommon: Pulmonary oedema.
In the management of pre-term labour, Ventolin Injection has uncommonly been associated with pulmonary oedema. Patients with predisposing factors including multiple pregnancies, fluid overload, maternal infection and pre-eclampsia may have an increased risk of developing pulmonary oedema.
Unknown: Nausea, vomiting*.
Common: Muscle cramps.
Unknown: Slight pain or stinging on intramuscular use of undiluted injection*.
* reported spontaneously in post-marketing data therefore frequency regarded as unknown.
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