Ventolin HFA (Albuterol Sulfate, Salbutamol)

Ventolin is a pharmaceutical drug designed to alleviate episodes of bronchial asthma and other conditions associated with reversible bronchial obstruction. The active ingredient in Ventolin is salbutamol, which is categorized as a 2-selective adrenoreceptor agonist. In therapeutic doses, it takes impact on beta2-adrenergic receptors of bronchial smooth muscle cells slightly influencing and causing no impact on beta1-adrenergic receptors.

Content:

First Things to Know about This Bronchodilator

Ventolin is a perfect remedy for treatment of:

Bronchial asthma

It blocks episodes of bronchial asthma including the cases of severe progression of bronchial asthma;
It prevents from bronchospasm attacks connected with allergen impact or caused by physical exertion;
It can be applied in capacity of one of the components for long-term supporting therapy of bronchial asthma.

Chronic obstructive lung disease accompanied by reversible obstruction of respiratory tract, such as chronic bronchitis and pulmonary emphysema.

Posology and Application of Ventolin Inhaler

Ventolin dosed aerosol is designed for inhalation only. The issue about increase of dose and frequency of Ventolin application may be decided by a doctor only. Ventolin inhaler is not recommended to use oftener that 4 times a day. Demand for frequent application of Ventolin maximal doses or for sudden dose increase testifies about aggravation of disease progression.

Adults (including aged patients):

Blockage of bronchospasm: recommended dose is 100-200 mcg (1-2 inhalations).

Blockage of bronchospasm attacks connected with allergen influence or caused by physical exhaustion: recommended dose is 200 mcg (2 inhalations) 10-15 minutes prior to impact of initiating agent.

Long-term supporting therapy: recommended dose is up to 200 mcg (2 inhalations) 4 times a day.

Children:

Blockage of bronchospasm: recommended dose is 100-200 mcg (1-2 inhalations).
Blockage of bronchospasm attacks connected with allergen influence or caused by physical exhaustion: recommended dose is 100-200 mcg (1-2 inhalations) 10-15 minutes prior to impact of initiating agent.
Long-term supporting therapy: recommended dose is up to 200 mcg (2 inhalations) 4 times a day.

Ventolin solution for inhalation is not for injections. Ventolin nebula is to be taken under control of specialists by means of special inhaler (nebulizer) with masque, T-shaped tube or endotracheal tube. Sometimes artificial ventilation with intermittent positive pressure is applied. In case of risk for development of hypoxia due to hyperventilation the inhaled air may be enriched with oxygen. Ventolin nebula is designed for application in undiluted form. But in case of long-term introduction of salbutamol (longer than 10 minutes), the medicine may be diluted with sterile physiological solution. The solution remained unused on nebulizer camera should be drunk. Since a lot of nebulizers act only in case of constant air stream, it is not excluded that dispersed medications would get in environment. Given Ventolin nebula is to be taken in a well-ventilated room, this recommendation should be more strictly observed at hospital where nebulizer may be used by several patients at a time. Most patients experience therapeutic action of salbutamol from four to six hours.

Adults and children:

Average initial dose of salbutamol introduced by means of inhalation via nebulizer is equal to 2,5 mg, but it may be increased to 5mg. Inhalations may be repeated four times a day. For treatment of severe obstruction of respiratory tracts, adults may take higher doses – up to 40mg per day under strict medical control at hospital. Clinical efficiency of salbutamol introduction via nebulizer by children under 18 months is not stated. Since, they may have transient hypoxemia, the possibility of oxygen-therapy should be considered.

Active Substance and Its Characteristics

Salbutamol highly selectively stimulates 2- selective adrenoreceptor agonists and activates endocellular adenylyl cyclase. Broncholytic effect is explained by relaxation of bronchial smooth muscle cells. Salbutamol is not destroyed by pulmonary catechol-O-methyl transferase; and therefore, it has a long-term action. In case of inhalation, its 10-20% reaches bronchial tubes and gets absorbed gradually and the part of the dose after swallowing gets absorbed from gastro-intestinal tract. Salbutamol reaches its maximal peak of action (relieve of bronchospamodic episode) via inhalation. Bronchodilation occurs on 4-5^th minute and grows by 20^th minute reaching its maximum in 40-60 minutes. The duration of effect is 4-5 hours. The most pronounced result is achieved after inhalation of 2 doses; further dose increase doesn’t lead to a bigger bronchial passability, but enhances the risk of possible side-effects. Salbutamol is good for mucociliary clearance (chronic bronchitis increases it by 36%), it stimulates mucus secretion and activates functions of ciliated epithelium. Salbutamol is applied for prophylaxis and blockage of bronchospasm in case of bronchial asthma, symptomatic therapy of broncho-obstructive syndrome (including chronic bronchitis, chronic obstructive pulmonary disease, emphysema), nocturnal asthma (prolonged tableted forms), preterm delivery threat.

How Does Ventolin Function?

After inhaling 10-20 percent of Ventolin, salbutamol doses achieve lower divisions of respiratory tracts. The rest part of the dose remains in inhaler or gets deposited in oropharyngeal cavity and then is swallowed. The fraction accumulated in respiratory tract gets absorbed in pulmonary tissues and blood but is not metabolized in lungs. The swallowed part of inhalation dose gets absorbed from gastro-intestinal tract and undergoes intensive metabolism during the first passage through liver turning into inactive phenol sulphate. Connection of Ventolin with plasma proteins is 10 per cent. It is partially cleared by kidneys in unchanged form or partially in the form of inactive phenol sulphate which is also mainly cleared with urine. Only insignificant part of cleared salbutamol dose is excreted with feces. The major part of salbutamol dose introduced in organism intravenously, perorally or via inhalation gets cleared within 72 hours.

11 Quick Facts

Ventolin is a medicinal product the action of which is aimed at blockage of episodes of bronchial asthma and other diseases connected with bronchial obstruction.

Salbutamol is active substance.

Ventolin is issued in various presentation forms, such as:

Double-layer tablets of Ventolin containing 8mg of salbutamol; a pack contains 20 and 50 pcs;
Ventolin syrup with active substance concentration 2mg per 1ml, flasks contain 150ml of the drug;
Ventolin in tablets containing 2 and 4 mg of active component (20, 50 and 100 pcs in a pack);
Ventolin for inhalations: dosed aerosol without ozone screen-destroying freons: 100 mcg of salbutamol in 1 dose, a flask contains 200 portions) and Ventolin nebula (aerosol with dosing device in plastic ampules; one nebula – 2,5 mg of the substance; the flask contains 200 doses).

Pharmaceutical action of Ventolin is aimed at beta-2receptors causing enlargement of bronchi in case of bronchospasms.

Ventolin takes insignificant action on heart beta1-adrenergic receptor agonists.

Antiallergenic characteristics of the drug are connected with inhibition of histamine and other mediators from granule cells production.

Around 10-20 per cent of Ventolin inhalation dose achieves the lower respiratory tract. The great deal of Ventolin settles in nasopharynx or dosing equipment.

Necessary quantity of medicinal product penetrates in system blood stream; and moreover, metabolism of the medication doesn’t occur in lungs.

Ventolin action starts in a couple of minutes after inhalation and lasts 4-6 hours.

Ventolin gets metabolized by liver and cleared with urine (90 per cent) in initial form and in the form of phenol sulphate composition. Also, the medicine comes out of organism with bile.

The major part of the medicine gets cleared within seventy-two hours.

The Most Popular Dosages

Solution for inhalation

Children above 12 years and adults should take the drug

in reconstituted form 0.5-1.0ml of Ventolin should be mixed with sodium chloride. The total volume should be 2.0-2.5ml. Then the solution is to be placed in nebulizer; a patient should inhale the solution until termination of aerosol formation.
unformulated Ventolin 2.0ml should be placed in nebulizer and the inhalation is to be performed. The procedure takes in average 5 minutes.

Children from 2 to 12 years are to take the medicine in reconstituted form (0.5ml)

Aerosol

Children above 12 years and adults:

100-200 mcg (1-2 sprays) in case of acute bronchospasm;
200 mcg (2 sprays) – prophylaxis of acute bronchospasm episodes due to allergen or physical exertion.
200 mcg (2 sprats) as a supporting treatment prescribed for long period of time.

Children from 2 to 12 years of age:

100 mcg (1 spray) in case of acute bronchospasm;
100 mcg (1 spray) – prophylaxis of acute bronchospasm episodes 15 minutes prior to provoking factor;
100 mcg (1 spray) as a supporting treatment prescribed for long period of time.

Correct Application Methods

Inhaler examination

Before the first usage of inhaler or in case the inhaler was used a week ago or earlier, remove a cap from actuator by slightly pressing a cap from both sides. Shake the inhaler and push the cap of aerosol for releasing of one inhalation dose in air in order to make sure of inhaler’s operable condition.

Inhaler Usage

Remove the cap from actuator by slightly pressing the cap from both sides.
Examine actuator from inside and outside in order to make sure it is clean.
Shake an inhaler.
Hold inhaler between thumb and finger vertically bottom-upwards; the thumb should be placed on the base under actuator.
Make a slow and deep breath; seize the actuator with lips without pressing it with teeth.
While making a maximally deep inhale, press the upper part of the inhaler simultaneously to release 1 inhaling dose of salbutamol.
Hold your breath for a couple of seconds, take the actuator out of your mouth and exhale slowly.
In order to get the 2^nd dose, wait for 30 seconds holding the inhaler vertically and repeat the stages 3-7.
Shut the actuator tightly with a safety cap.

Inhaler cleaning

Inhaler is to be cleaned not rarer than once a week.

Take the metallic cartridge from plastic case and remove the actuator cover.
Wash the plastic case and actuator cover thoroughly under warm water stream.
Dry plastic case and actuator cover either from both: inside and outside. Do not admit overheating.
Place the metallic cartridge back in plastic case and put the actuator cover.

Do not plunge the metallic cartridge into water.

First Aid in Case of Ventolin Overdose

Overdose symptoms: most often: hypoglycemia, arterial blood pressure drop, tachycardia, muscular tremor, nausea, vomit; less frequent: anxiety, hyperglycemia, respiratory alkalosis, hypoxaemia, headache; rare: hallucinations, cramps, tachy-arrhythmia, rapid ventricular tachycardia, enlargement of peripheral vessels.

In case of overdose with salbutamol, the best antidotes are considered to be cardioselective beta-adrenergic blocking agents. Nevertheless, these agents are to be taken cautiously by patients suffering from bronchospasm episodes in the past medical history. Application of large Ventolin doses may cause hypokalemia; therefore, in case of overdose symptoms, it is essential to control the level of potassium in blood serum.

Safety Note

Contraindications:

Hypersensitivity to any Ventolin ingredients;
Age under 2 years;
Threatened miscarriage or preterm delivery.

Ventolin is prescribed with caution in case of:

abnormality of heart;
myocarditis;
tachyarrhythmia;
ischemic heart disease;
aortic stenosis;
arterial hypertension;
thyrotoxicosis;
glaucoma;
diabetes at decompensation stage;
renal or hepatic failure;
epilepsy;
phaeochromocytoma;
pregnancy and lactation.

Drug Interactions

Ventolin is not to be combined with non-selective beta-receptors blockers, such as propranolol. Salbutamol is not counter-indicative to patients who take monoaminooxidase inhibitors. Persons suffering from thyrotoxicosis may experience enhanced action of CNS stimulators and tachycardia. Theophylline and other xanthines may increase the possibility of tachyarrhythmia development in case of co-administration. The remedies for inhalation anesthesia may provoke severe ventricular arrhythmia. Simultaneous prescription of Ventolin with anticholinergic agents (including inhalation ones) may cause the increase of intraocular pressure. Diuretics and glucocorticosteroids enhance hypokalaemic action of salbutamol.

Possible Side-Effects

Ventolin side-effects may be divided into frequent, not frequent, rare and very rare.

Frequent: headache, vertigo, tachycardia, and tremor of skeletal muscles.
Not frequent: convulsion, heartbeats, throat choke and mouth mucous membrane irritation.
Rare: hypokalemia and enlargement of peripheral blood vessels.
Very rare: arrhythmia, hyperactivity, extrasystole, lactic acidosis, superventricular tachycardia, as well as some allergic reactions, such as collapse or arterial blood pressure drop, urticarial fever, edema, or bronchospasm.

Full List of Components

Solution for nebulizer – 5mg/ml. 1ml of Ventolin solution contains 5mg of active substance, salbutamol (in the form of salbutamol sulphate). Auxiliary substance: solution of benzalkonium chloride, sulfuric acid reconstituted, distilled water.
Aerosol – 1 dose: micronized salbutamol sulphate 120,5 mcg (1 inhaler 28,92mg); auxiliary agent: propellent (1,1,1,2- tetrafluoroethane) in 1 dose – up to 75mg and in 1 inhaler – up to 18g.

Storage Requirements

Keep in original pack, do not store above 30 degrees; keep away from direct sunlight. Ventolin should not be frozen. Expiration period is two years. Nebula is to be stored not longer than three months after opening of aluminum foil. Solution in nebulizer which was not used is not to be stored.

What Is It All about?

According to patients’ reviews, Ventolin is well tolerated and is quite effective for bronchospasm, In case of correct application, side-effects occur very rarely. Only an insignificant part of testimonials reported about such adverse effects as convulsions, headache and tachycardia. Patients also noted the “affordable” and “favorable” price of Ventolin.

Key Alternatives to Ventolin

The list of analogues of Ventolin containing the same active substance (salbutamol) is as follows:

Aloprol;
Astalin;
Volmax;
Salamol;
Salmo;
Salben;
Salbuvent;
Salbutamol;
Salgim;
Saltos;
Cyclopacs.

FAQs

Can I take Ventolin nebulizer unformulated?

For nebulizer the volume of liquid is very important. It should be not less than 2ml. In case a person is prescribed 2ml of Pulmicort, it may not be diluted. It is also very important to study the instruction to the drug thoroughly.

Can I take Ventolin during lactation?

Ventolin nebula, tablets, syrup and aerosol are prescribed very carefully during lactation, since the question of its safety for babies is not studied enough.

I am pregnant. Can I take Ventolin?

Pregnant women are prescribed Ventolin only in case, when potential benefit to the mother outweighs any potential risk to the fetus. During post-authorization examination, the rare cases of various developmental anomalies in children were detected, such as formation of cleft palate and dysmelia on the setting of salbutamol intake. In some cases, mothers took several accompanying medicinal products. Thus, cause and effect relationship between Ventolin administration and these abnormalities is not confirmed.

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