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.
2. 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.
3. 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.
4. 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
Non-urgent advice: Contact your doctor, pharmacist or nurse if you need to use your inhaler:
- more than 4 times in 24 hours
- more than 2 days of each week
- in the middle of the night at least once a week
Dosage during an asthma attack
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.
Immediate action required: Call 999 or go to A&E now if you or your child:
- are struggling to breathe
- have asthma symptoms that are not getting better
- do not feel better after 10 puffs of your salbutamol inhaler – you can take another dose of up to 10 puffs 10 minutes later if the ambulance has not yet arrived and your symptoms are not improving
Asthma attacks can get worse very quickly.
How to use your inhaler
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.
Important: Checking your technique
To get the most from your inhaler, have your technique checked regularly by a doctor, pharmacist or nurse.
Using a spacer with your inhaler
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.
Watch a video
Search for your inhaler, and watch a short video on the Asthma + Lung UK website on how to use your inhaler.
5. 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
Immediate action required: Call 999 or go to A&E now if:
- you have chest pain, especially if you also have a fast heartbeat or your heartbeat does not feel normal
Serious allergic reaction
It is possible to have a serious allergic reaction (anaphylaxis) to salbutamol.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Other side effects
These are not all the side effects of salbutamol. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect using the Yellow Card safety scheme.
6. 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.
7. Pregnancy and breastfeeding
Salbutamol and pregnancy
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.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
- pregnant
- breastfeeding
For more information about how salbutamol can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.
8. 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.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions about salbutamol inhalers
How does salbutamol work?
Salbutamol is a type of medicine called a bronchodilator. It works by relaxing the muscles of the airways into the lungs, which makes it easier to breathe.
How long does salbutamol take to work?
When you have a puff of your salbutamol inhaler it works almost straight away to make your breathing easier. It carries on working for about 5 hours.
How long will I need to use my salbutamol inhaler for?
Most people will use salbutamol for many years. Once your breathing is better, it may be possible for you or your child to use salbutamol less often. But it's important to always have your salbutamol inhaler with you so you can use it as soon as you have breathing problems.
Do not stop using salbutamol unless your doctor tells you to. If you stop using salbutamol your breathing problems could get worse. Even if you only have to use salbutamol occasionally, keep your inhaler with you all the time in case you have a sudden attack.
Are there other inhalers?
Salbutamol is a type of medicine called a bronchodilator.
Almost everyone who has asthma or COPD is prescribed a bronchodilator inhaler or "reliever" inhaler to help their breathing.
There are 2 main bronchodilators:
- salbutamol
- terbutaline
Salbutamol and terbutaline work as well as each other. However, the inhalers may look different.
If you have difficulty using a salbutamol inhaler talk to your doctor. Switching to a terbutaline inhaler may be an option for you.
In most cases, you will also be given a "preventer" inhaler to help stop you getting symptoms. Use this every day.
Is it safe to use a salbutamol inhaler for a long time?
Salbutamol is a very safe medicine. There's no evidence that it does any lasting damage to your body even if you use it for many years.
Do I need to keep a salbutamol diary?
It's a good idea to keep a diary of how often you need to use your salbutamol inhaler. That way you can discuss how it's helping your asthma or COPD with your doctor or nurse.
Keeping a diary will also help you know when to order a replacement inhaler. Some inhalers contain a fixed number of 200 doses and it's not always obvious when they are empty.
Will it affect my fertility?
There's no evidence to suggest that taking salbutamol will reduce fertility in either men or women.
Will it affect my contraception?
Salbutamol does not affect any type of contraception including the combined pill and emergency contraception.
Can I drink alcohol with it?
Yes, you can drink alcohol with salbutamol.
Can I smoke if I use a salbutamol inhaler?
Try to quit smoking. Smoking irritates the lungs and will make your breathing problem worse. Speak to your doctor, nurse or pharmacist if you're finding it hard to stop smoking. There is help available on the NHS.
Can I drive or ride a bike?
Salbutamol can make you feel dizzy or shaky. If this happens, do not drive, cycle or use tools or machinery until you feel better.
Do salbutamol inhalers cause global warming?
Metered dose inhalers (MDIs), also known as pump inhalers, contain hydrofluorocarbon propellants which act as powerful greenhouse gases that are a lot more damaging than carbon dioxide.
Dry powder inhalers (DPI) do not use propellants and so are less likely to contribute to global warming.
One way to reduce your carbon footprint is to reduce the use of MDIs. You might be asked if you would consider switching your inhaler to one that is less damaging to the environment if your doctor or asthma nurse think that is safe for you.
If you do change your device, always make sure you can use it properly by checking with your nurse or pharmacist.