Methazolamide: (Moderate) Albuterol may cause additive hypokalemia when coadministered with carbonic anhydrase inhibitors. The net result of beta2-receptor agonism in the lungs is relaxation of bronchial and tracheal smooth muscles, which in turn relieves bronchospasm, reduces airway resistance, facilitates mucous drainage, and increases vital capacity.Albuterol can also inhibit the degranulation and subsequent release of inflammatory autocoids from mast cells. If you find that treatment with albuterol sulfate inhalation solution becomes less effective for symptomatic relief, your symptoms become worse, and/or you need to use the product more frequently than usual, you should seek medical attention immediately. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Max: 2.5 mg/dose 3 to 4 times daily; do not exceed 4 doses/day. Chlorpheniramine; Hydrocodone; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. Thyroid hormones: (Moderate) Based on the cardiovascular stimulatory effects of beta-agonists and other sympathomimetics, concomitant use with thyroid hormones might enhance the effects on the cardiovascular system. Amoxicillin; Clarithromycin; Lansoprazole: (Minor) The coadministration of beta-agonists with clarithromycin may increase the risk for adverse effects, including prolongation of the QT interval. Most Use cautiously with drugs that prolong the QT interval such as beta-agonists. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Lefamulin has a concentration dependent QTc prolongation effect. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with flecainide include the beta-agonists. Risperidone: (Minor) Use risperidone and short-acting beta-agonists together with caution due to the potential for additive QT prolongation and risk of torsade de pointes (TdP). Disopyramide: (Minor) Beta-agonists should be used cautiously and with close monitoring with disopyramide. Thioridazine: (Severe) Thioridazine is associated with a well-established risk of QT prolongation and torsades de pointes (TdP). Tranylcypromine: (Major) Beta-agonists should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors (MAOIs) due to their sympathomimetic effects. Quinolones have been associated with a risk of QT prolongation and TdP. Safety and efficacy have not been established. A higher concentration product (0.083% or 0.5% solution for inhalation) may be more appropriate for treatment of acute asthma exacerbations. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. The Global Initiative for Asthma (GINA) guidelines recommend 2 to 6 puffs every 20 minutes for the first hour, then 2 to 3 puffs every hour as needed for acute exacerbations. Additive side effects may occur between caffeine and beta-agonists. Theophylline, Aminophylline: (Moderate) Beta-agonists are commonly used in conjunction with aminophylline or theophylline therapy. Pharmacokinetics In a single-dose bioavailability study which enrolled six healthy, male volunteers, transient low albuterol levels (close to the lower limit of quantitation) were observed after administration of two puffs from both Albuterol Sulfate Inhalation Aerosol and a CFC 11/12 propelled albuterol inhaler. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Sensitive patients might experience tremor, sleep difficulties, or mild increases in heart rate. Register Now. Beta agonists infrequently produce cardiovascular adverse effects, mostly with high doses or in the setting of beta-agonist-induced hypokalemia. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. The patient should hold breath as long as they can, up to 10 seconds, then breathe normally. Increased cyclic AMP leads to activation of protein kinase A, which inhibits phosphorylation of myosin and lowers intracellular ionic calcium concentrations, resulting in relaxation. Beta-agonists should be administered with extreme caution to patients being treated with drugs known to prolong the QT interval because the action of beta-agonists on the cardiovascular system may be potentiated. The action of beta-agonists on the cardiovascular system may be potentiated by a halogenated anesthetic. The patient should breathe in deeply through the mouth until their lungs feel completely full of air. For those who use a short-acting beta-agonist on a daily basis, a controller agent (e.g., inhaled corticosteroid, leukotriene receptor antagonist) should be considered if albuterol tolerance develops. The effects of these beta-agonists on the cardiovascular system may be potentiated. A mobile app is required for data transmission but is not required for the administration of albuterol to the patient.Throw away the inhaler 13 months after removing it from the foil pouch for the first time, when the dose counter displays "0", or after the expiration date on the package, whichever comes first. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. In general, the National Asthma Education and Prevention Program (NAEPP) Expert Panel recommends albuterol 0.63 to 2.5 mg via oral inhalation every 4 to 6 hours as needed for symptoms of bronchospasm. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. -If a previously effecti… Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Drugs with a possible risk for QT prolongation that should be used cautiously with vemurafenib include the beta-agonists. Max: 2.5 mg/dose 3 to 4 times daily. The action of beta-agonists on the cardiovascular system may be potentiated by clarithromycin. Monitor the patients lung and cardiovascular status closely. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. All rights reserved. If pazopanib and the other drug must be continued, closely monitor the patient for QT interval prolongation. Contact the applicable plan Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Additive side effects may occur between caffeine and beta-agonists. Patients using prescription beta-agonists for the treatment of asthma should generally avoid the concurrent use of racepinephrine inhalation since additive cardiovascular and nervous system adverse effects are possible, some which may be undesirable. Perphenazine: (Minor) Perphenazine, a phenothiazine, is associated with a possible risk for QT prolongation. Carbetapentane; Chlorpheniramine; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Acetaminophen; Dichloralphenazone; Isometheptene: (Major) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Because of the potential for TdP, use of other drugs that might increase the QT interval is contraindicated with cisapride. Onset of action begins within 30 minutes, peak levels are reached in 2 to 3 hours, and duration of action is 4 to 6 hours for the conventional-release tablets and 8 to 12 hours for the sustained-release product. A dose of 400 mcg every 2 hours was effective in lowering serum potassium concentrations to less than 5 mmol/L in mechanically ventilated newborns weighing less than 2,000 grams. The global Albuterol Sulfate Metered Dose Inhalers market is valued at million US$ in 2019 and will reach million US$ by the end of 2027, growing at a CAGR of during 2020-2027. Bismuth Subcitrate Potassium; Metronidazole; Tetracycline: (Minor) Potential QT prolongation has been reported in limited case reports with metronidazole. Sertraline: (Minor) Use caution and monitor patients for QT prolongation when administering short-acting beta-agonists with sertraline. The Global Initiative for Asthma (GINA) guidelines recommend 2 to 6 puffs using a valved holding chamber (VHC) with mouthpiece and/or facemask every 20 minutes for the first hour, then 2 to 3 puffs every hour as needed for acute exacerbations. Max: 32 mg/day PO. Adjuvant or alternative therapy is warranted for patients experiencing electrocardiographic (ECG) changes or significantly elevated serum potassium concentrations. Concurrent use may increase the severity of metabolic acidosis. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. Monitor the patients lung and cardiovascular status closely. Weigh the risks of co-use, and where possible, allow a washout period after discontinuation of the MAOI before instituring beta-agonist treatment or vice-versa. The effects of beta-agonists can be reduced with concurrent use of sotalol, which is a non-selective beta-blocker. Chlorpromazine: (Minor) Phenothiazines have been associated with a risk of QT prolongation and/or torsade de pointes (TdP). For acute asthma exacerbations, NAEPP recommends 0.15 mg/kg/dose (Min: 2.5 mg/dose) every 20 minutes for 3 doses, then 0.15 to 0.3 mg/kg/dose (Max: 10 mg/dose) every 1 to 4 hours as needed or 0.5 mg/kg/hour by continuous nebulization. Albuterol Inhalation Aerosol prescription and dosage sizes information for physicians and healthcare professionals. Erythromycin: (Minor) Erythromycin administration is associated with QT prolongation and torsade de pointes (TdP). Therefore, linezolid has the potential for interaction with adrenergic agents, such as the beta-agonists. Carbetapentane; Guaifenesin; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. A cardiovascular examination, including an ECG, should be obtained in all patients prior to initiating anagrelide therapy. Siponimod therapy prolonged the QT interval at recommended doses in a clinical study. If present in breast milk, albuterol has low oral bioavailability in the infant. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Levobetaxolol: (Moderate) Use of a beta-1-selective (cardioselective) beta blocker is recommended whenever possible when this combination of drugs must be used together. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Caffeine is a CNS-stimulant and beta-agonists are sympathomimetic agents. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Post-marketing surveillance has identified very rare cases of ventricular arrhythmias including torsade de pointes (TdP), usually in patients with severe underlying proarrhythmic conditions. Monitor blood pressure and heart rate. QT prolongation has occurred with pasireotide at therapeutic and supra-therapeutic doses. Therefore, the manufacturer recommends avoiding trazodone in patients receiving other drugs that increase the QT interval. Initially, 0.1 mg/kg PO every 8 hours (Max: 6 mg/day PO). Administer with meals to minimize gastric irritation. For acute asthma exacerbations, NAEPP recommends 2.5 to 5 mg every 20 minutes for 3 doses, then 2.5 to 10 mg every 1 to 4 hours as needed or 10 to 15 mg/hour by continuous nebulization. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Each tablet also contains the following inactive ingredients: anhydrous lactose, magnesium stearate, pregelatinized (corn) starch, and sodium starch glycolate. Pazopanib: (Minor) Coadministration of pazopanib and other drugs that prolong the QT interval is not advised; pazopanib has been reported to prolong the QT interval. Norepinephrine: (Major) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. For those who use a short-acting beta-agonist on a daily basis, a controller agent (e.g., inhaled corticosteroid, leukotriene receptor antagonist) should be considered if albuterol tolerance develops. Arrhythmias, sinus bradycardia, and conduction disturbances have occurred during octreotide therapy. Beta-agonists and beta-blockers are pharmacologic opposites, and will counteract each other to some extent when given concomitantly, especially when non-cardioselective beta blockers are used. Monitor ECGs for QT prolongation and monitor electrolytes if coadministration is necessary; correct electrolyte abnormalities prior to administration of oxaliplatin. Take the cap off the mouthpiece. [31823] [43674] [44010] [49951] [59350] [64470] The National Asthma Education and Prevention Program (NAEPP) Asthma and Pregnancy Working Group include short-acting inhaled beta-2 agonists (SABAs) as first-line therapy for mild intermittent asthma during pregnancy, if treatment is required. Itraconazole: (Minor) Use itraconazole with caution in combination with beta-agonists as concurrent use may increase the risk of QT prolongation. Fluctuations in plasma concentrations are similar for albuterol extended-release tablets administered at 12-hour intervals and immediate-release tablets administered at 6-hour intervals. Degarelix: (Minor) Consider whether the benefits of androgen deprivation therapy outweigh the potential risks in patients receiving short-acting beta-agonists as concurrent use may increase the risk of QT prolongation. Dobutamine: (Major) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Dofetilide, a Class III antiarrhythmic agent, is associated with a well-established risk of QT prolongation and torsade de pointes (TdP). Caution is advised when loop diuretics are coadministered with high doses of beta agonists; potassium levels may need to be monitored. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. 5 mg/dose via oral inhalation was effective in a small study of pediatric patients (5 to 18 years of age) with end stage renal failure (n = 11). Granisetron: (Minor) Use granisetron with caution in combination with short-acting beta-agonists due to the risk of QT prolongation. Atenolol: (Moderate) Use of a beta-1-selective (cardioselective) beta blocker is recommended whenever possible when this combination of drugs must be used together. Available data from published epidemiological studies and postmarketing case reports of pregnancy outcomes following inhaled albuterol use do not consistently demonstrate a risk of major birth defects or miscarriage. Sensitive patients might experience tremor, sleep difficulties, or mild increases in heart rate. FDA-approved labeling for some buprenorphine products recommend avoiding use with Class 1A and Class III antiarrhythmic medications while other labels recommend avoiding use with any drug that has the potential to prolong the QT interval. Make sure a "click" sound is heard; if not, the inhaler may not be activated to give a dose of medicine.The cap should not be opened unless the patient is ready to take a dose; opening and closing the cap without inhaling a dose will waste the medicine and may damage the inhaler.The patient should breathe out through the mouth and push as much air from the lungs as they can. When administered orally, albuterol is well absorbed through the GI tract. Lisdexamfetamine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Disopyramide administration is associated with QT prolongation and torsade de pointes (TdP). This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. Put the mouthpiece in the mouth and have the patient close their lips around it. Pimozide: (Severe) Pimozide is associated with a well-established risk of QT prolongation and torsade de pointes (TdP) and should not be used with other drugs that might prolong the QT interval. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Serum potassium concentrations must be closely monitored during the treatment of DKA and albuterol may contribute to changes in serum potassium concentrations. Ezogabine has been associated with QT prolongation. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Doses should be delivered over 5 to 15 … Caffeine is a CNS-stimulant and beta-agonists are sympathomimetic agents. Rare case reports of QT prolongation have also been described when tamoxifen is used at lower doses. No significant differences in FEV-1 have been demonstrated between metered-dose inhalers (with or without a spacer) and nebulizers among short-acting bronchodilators in clinical trials; nebulizers may be more convenient for patients that are more acutely ill.[63765]. Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. This risk may be more clinically significant with long-acting beta-agonists (i.e., formoterol, arformoterol, indacaterol, olodaterol, salmeterol, umeclidinium; vilanterol) than with short-acting beta-agonists. Bedaquiline has been reported to prolong the QT interval. This risk may be more clinically significant with long-acting beta-agonists (i.e., formoterol, arformoterol, indacaterol, olodaterol, salmeterol, umeclidinium; vilanterol) than with short-acting beta-agonists. Articaine; Epinephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Geriatric patients should receive 2 mg PO every 6 to 8 hours initially. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with ciprofloxacin include the beta-agonists. Clinically significant improvement (defined as maintaining at least a 15% increase in FEV1 and a 20% increase in mid-expiratory flow rate over baseline) was recorded for up to 6 hours in a controlled clinical trial of 55 children. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Carbinoxamine; Hydrocodone; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Drugs with a possible risk for QT prolongation that should be used cautiously with venlafaxine include the beat-agonists. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval such as ribociclib. Albuterol 0.083% Inhalation Solutionis a bronchodilator used to treat or prevent the symptoms of asthma, … Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. Leuprolide: (Minor) Consider whether the benefits of androgen deprivation therapy (i.e., leuprolide) outweigh the potential risks of QT prolongation in patients receiving short-acting beta-agonists. Inotuzumab Ozogamicin: (Minor) Coadministration of inotuzumab ozogamicin with short-acting beta-agonists may increase the potential for additive QT prolongation and risk of torsade de pointes (TdP). 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Only need 1 inhalation ( albuterol-ipratropium bromide 100 mcg-20 mcg ) orally four times into the before...