1. About inhaled salbutamol
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. In most cases, you will be given another inhaler to "prevent" your symptoms and you should use this regularly every day.
- If you need to use your salbutamol inhaler more than 3 times a week, it could be a sign that your breathing problem 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
Salbutamol can be used by adults and children of all ages.
Salbutamol is not suitable for people with certain health problems.
Check with your doctor before starting salbutamol if you:
- have had an allergic reaction to salbutamol or any other medicines in the past
- take other medicines including ones you buy from a pharmacy, herbal remedies or supplements
- have a rare inherited digestive disorder of galactose intolerance, the Lapp lactase deficiency or glucose-galactase malabsorption. This is because many salbutamol products contain lactose. Do not have lactose if you have these conditions
If you have a lactose intolerance, however, the amount of lactose in salbutamol products is too small to cause you any problems.
4. How and when to use your inhaler
Only use your salbutamol when you need it. This may be when you notice symptoms, such as coughing, wheezing, shortness of breath and tightness in the chest or 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.
The normal way for adults and children to use their inhaler 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 prescribed 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 health problem 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
Make an appointment to see 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
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 doses. You can repeat this dose 10 minutes later.
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
Asthma attacks can get worse very quickly.
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.
What if I 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.
5. 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. 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.
To get the most from your inhaler, you should have your technique checked regularly.
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.
Using a spacer with the 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.
Watch a video
Search for your inhaler, and watch a short video on the Asthma UK website on how to use your inhaler.
6. 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:
- feeling shaky
- faster heartbeat for a short while (but no chest pain)
- muscle cramps
These side effects are not dangerous and they should gradually improve as your body gets used to salbutamol.
Contact your doctor or pharmacist if these or any other side effects bother you or do not go away.
Serious side effects
It happens rarely, but some people may have very serious side effects when taking salbutamol.
Call a doctor 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
- chest pain, especially if you also have a fast heartbeat or your heartbeat does not feel normal
- a very bad headache
Serious allergic reaction
It is possible to have a serious allergic reaction (anaphylaxis) to salbutamol.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
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.
7. 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.
- muscle cramps – if you get unusual muscle ache, which is not from exercise or hard work, talk to your doctor.
8. Pregnancy and breastfeeding
Salbutamol and pregnancy
Salbutamol is generally considered safe to use in pregnancy and while breastfeeding. Some women find that their asthma gets better during pregnancy, some see no change at all, and for others it will be worse.
Always tell your health professional if you are pregnant.
If you have asthma, your doctor will most likely recommend that you continue to use your salbutamol inhaler during pregnancy. They will be able to give you advice on how to manage your asthma during pregnancy.
The risks of having serious asthma attacks during pregnancy are much worse than the risks of using salbutamol. Asthma attacks in pregnancy can prevent your baby from getting enough oxygen.
Salbutamol and breastfeeding
Salbutamol may pass into breast milk in very small amounts.
In general though, you can use your salbutamol inhaler as normal while you're breastfeeding. The amount of medicine that passes into breast milk is so small that it's unlikely to harm the baby.
For safety, tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.
9. Cautions with other medicines
Some medicines can interfere with the way salbutamol works.
If you're taking other prescribed medicines that do not mix well with salbutamol your doctor will decide whether the benefits of taking both medicines outweighs the risks.
Mixing salbutamol with herbal remedies or supplements
There are no known problems with taking herbal remedies and supplements with salbutamol.
For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
10. 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 you should always have your salbutamol inhaler with you so you can use it as soon as you have breathing problems.
Do not stop taking salbutamol unless your doctor tells you to. If you stop taking 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 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 another inhaler to "prevent" your symptoms and you should use this regularly 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 firm evidence to suggest that taking salbutamol will reduce fertility in either men or women.
Can I drink alcohol with it?
Yes, you can drink alcohol with salbutamol.
Can I smoke if I use a salbutamol inhaler?
Try not to smoke. 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.