Albuterol HFA alternatives: What can I take instead of albuterol HFA?

Compare albuterol HFA alternatives | Proventil HFA | ProAir RespiClick | Xopenex HFA | Albuterol nebulizer solution | Primatene Mist | Natural alternatives | How to switch meds

Albuterol HFA is a rescue inhaler used to prevent or treat bronchospasm in adults and children four years and older with asthma (also known as reversible obstructive airway disease). It can also prevent exercise-induced bronchospasm in adults and children four years and older. Bronchospasm is a tightening of the muscles in the lungs’ airways, which causes symptoms such as wheezing, coughing, and breathing problems like shortness of breath. 

Albuterol HFA is part of a class of drugs known as short-acting beta2 agonists or SABAs. It is also known as a bronchodilator. SABAs are typically used as rescue inhalers to relieve asthma symptoms quickly in asthmatic patients. They are not used to prevent asthma exacerbations or asthma attacks, except in the case of exercise-induced bronchospasm.

Albuterol HFA is known by several brand names, including ProAir HFA (which was discontinued as a brand-name drug in October 2022), Ventolin HFA, and Proventil HFA. Albuterol is also an ingredient in ProAir RespiClick and ProAir Digihaler. 

Common side effects of albuterol HFA may include:

• Throat irritation
• Upper respiratory infection symptoms
• Cough
• Altered taste
• Tremor
• Dizziness
• Nervousness
• Nausea, vomiting
• Headache
• Palpitations and fast heart rate
• Pain

Serious side effects may include:

• Paradoxical bronchospasm (this occurs when the airways constrict after using the inhaler rather than open up)
• Severe, worsening, or life-threatening allergic reactions
• Swelling 
• High blood pressure or low blood pressure
• Chest pain 
• Cardiac arrest
• Irregular heartbeat
• Low potassium levels (hypokalemia)
• High blood sugar levels

Sometimes, patients may want to change to an alternative to generic albuterol HFA. This could be due to several reasons, for example, cost, difficulty using the inhaler, or a manufacturer’s drug shortage.

RELATED: Albuterol side effects and how to avoid them 

What can I take in place of albuterol HFA?

Albuterol HFA is a rescue inhaler. Although it can prevent exercise-induced bronchospasm before physical activity, albuterol HFA is not used daily for the long-term control of asthma symptoms. Many prescription inhalation medications are available for the long-term management of symptoms of asthma and/or chronic obstructive pulmonary disease (COPD). Because albuterol HFA is used for short-term relief of symptoms, this article will focus on alternatives that can be used for the same purpose. Many of the alternatives are similar to albuterol HFA, with slight differences. For individuals looking for an alternative to albuterol HFA, another option may be more suitable. The table below highlights albuterol HFA as well as common alternatives.

Other alternatives to albuterol HFA

• Levalbuterol nebulizer solution: This prescription medication can be used in the nebulizer to treat or prevent bronchospasm in adults and pediatric patients six years and older with asthma.
• Asthmanefrin: This OTC medicine is an inhaled solution that is delivered via a handheld device called an atomizer. It contains racepinephrine and can be used in adults and children four years and older to temporarily relieve mild symptoms of asthma. Check with your healthcare provider before using. 
• Primatene tablet: This OTC medicine is an oral tablet that contains ephedrine and can be used in adults and adolescents 12 years and older to temporarily relieve mild symptoms of asthma. Check with your healthcare provider before using. 

Top 5 albuterol HFA alternatives

The following are some of the most common alternatives to albuterol HFA.

1. Another generic albuterol HFA, or brand-name Proventil HFA or Ventolin HFA

If you are using a generic albuterol HFA inhaler, you may want to try an albuterol HFA inhaler by a different manufacturer or a brand-name albuterol HFA inhaler such as Proventil HFA or Ventolin HFA. All of these are metered-dose inhalers (MDIs) that deliver a fine mist of spray and have the same uses, dosages, and side effects—but differ in size and number of puffs. However, some insurances may have a preferred form of albuterol HFA inhalers, such as a particular brand name or a generic made by a certain manufacturer. If you switch to a different type of albuterol HFA inhaler, check the priming and cleaning instructions. The number of puffs in each inhaler varies, so be sure to use the built-in dosing counter to track how much medication is left in the inhaler. 

2. ProAir RespiClick or ProAir Digihaler

ProAir RespiClick (albuterol) is a breath-activated, dry powder inhaler. It is a brand-name drug. People with a severe milk protein allergy should not use this medication because the inhaler contains a small amount of lactose. ProAir RespiClick can be used in adults and children four years and older to treat or prevent bronchospasm due to asthma or to prevent exercise-induced bronchospasm. The “click” in RespiClick means that when you open the mouthpiece, you will hear a clicking sound, which is the sound of the inhaler loading a dose of medication. When you hear the click, the medicine is ready to be inhaled. Unlike albuterol HFA inhalers, ProAir RespiClick is breath-activated and releases the medicine only when you breathe in. You do not need to press down on the top of the inhaler. The manufacturer lists the benefits of the RespiClick, which include: 

• No need to press and breathe at the same time
• No priming or shaking
• No washing
• A built-in dose counter to let you know when you need to refill your prescription

The ProAir Digihaler (albuterol) is also a dry powder inhaler and should not be used by people with a severe milk protein allergy. It has the same uses as the ProAir RespiClick but is a smart inhaler with an accompanying mobile app. It has built-in sensors to record when you use the inhaler (this occurs when you open the cap or inhale), and you can share data with your physician. This technology provides feedback on the strength of your inhalations, measures how often you use the inhaler, and analyzes data for patterns you can share with your doctor. 

Because ProAir RespiClick and ProAir Digihaler both contain the active ingredient albuterol, side effects will be the same as albuterol HFA inhalers.

3. Xopenex HFA inhaler (or generic levalbuterol HFA inhaler)

Xopenex HFA, and its generic, levalbuterol HFA, are metered-dose inhalers that are FDA-approved to treat or prevent bronchospasm in adults and children 4 years and older with asthma. While not approved by the Food and Drug Administration (FDA) to prevent exercise-induced bronchospasm, some healthcare professionals may prescribe it off-label for this use. Off-label prescribing is when a drug is prescribed for a use that is not FDA-approved. Levalbuterol is chemically related to albuterol, so its side effects are similar to those of albuterol. Common side effects of levalbuterol may include vomiting, upper respiratory infection symptoms, headache, nervousness, tremor, fast heart rate, palpitations, weakness, dizziness, flu-like symptoms, and chest pain. 

RELATED: Levalbuterol vs. Albuterol: Differences, similarities, and which is better for you

4. Albuterol nebulizer solution

Albuterol can also be delivered by a nebulizer machine. This form of albuterol comes in a solution placed into a nebulizer machine, which turns the liquid into a mist inhaled through a mouthpiece or mask. Albuterol nebulizer solution can be used in adults and children 2 years and older with asthma and acute bronchospasm. Side effects are the same as albuterol HFA. Using a nebulizer is not portable like an inhaler—and also requires more time to set up, deliver the dose (usually over 10 to 15 minutes), and clean—however, it may be easier to administer this medication to younger children who do not have the dexterity to manage an inhaler. 

5. Primatene Mist

Primatene Mist is an over-the-counter inhaler that contains the active ingredient epinephrine. It can be used in adults and adolescents 12 years and older. It should not be used in children younger than 12 years old. Like albuterol, Primatene Mist is a bronchodilator. It can temporarily relieve mild symptoms of intermittent asthma, such as wheezing, chest tightness, and shortness of breath. According to the FDA, Primatene Mist should only be used in people diagnosed with mild, intermittent asthma—not in individuals with more severe asthma. Primatene Mist is unsafe for everyone, so check with your healthcare provider before using this medication. 

Natural alternatives to albuterol HFA

The American Lung Association recommends that individuals with asthma avoid triggers that can exacerbate asthma symptoms. Some common asthma triggers include: 

• Air pollution
• Animal dander
• Dust mites
• Exercise
• Food allergies—such as nuts and shellfish
• Humidity/sudden or extreme temperature changes
• Medications—for example, aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs)
• Mold
• Respiratory infections 
• Smoke from cigarettes, fireplaces, or burning leaves
• Stress
• Strong odors such as those from perfumes and cleaning supplies
• Trees, grass, and pollen

Because there is no cure for asthma, it’s best to avoid any dietary supplements that claim to cure it; it’s best to avoid any dietary supplements that claim to cure asthma. Certain natural therapies can help improve asthma symptoms, such as breathing techniques like pursed lip breathing or belly breathing, yoga; or exercise (as approved by your healthcare professional). These should be used as a complement to the action plan from your doctor—not in place of prescription medication. You can discuss various asthma treatments with your healthcare professional. 

How to switch to an albuterol HFA alternative

If you are interested in switching to an alternative to albuterol HFA:

1. Consult your healthcare provider for medical advice. Only your healthcare provider can determine which medication is appropriate for you, considering your medical condition(s), symptoms, medical history, and potential drug interactions. Also, ask your healthcare provider to prescribe two inhalers (or add extra refills), so you can have an extra inhaler on hand. It may help to keep one at home, and one at work, for example.
2. If price is a concern, consult your health insurance plan. Some alternatives may be less expensive than others. You can share this information with your healthcare provider when deciding on an alternative. You can always use a free SingleCare card to save money on your prescriptions—and refills, too. 
3. When you get the new prescription, carefully read the prescription label so that you understand the directions. Also, read the information leaflet that comes with your prescription. Ask your pharmacist if you have any questions. If you are getting an inhaler, ask your pharmacist how to use it, and how to prime and clean it. If you are using a nebulizer solution, make sure you have a nebulizer as well as tubing and the correct-sized mask or mouthpiece. Your pharmacist can help you with this, too. 
4. Monitor how you feel with the new medication. Keep an asthma diary or log, or use an app to do so. Your doctor will provide you with an asthma treatment plan. You may be using a rescue inhaler alone, or in addition to other inhaled or oral medications. Ensure that you understand how and when to take all of your asthma medications. If you are taking medication(s) that must be taken every day, such as an inhaled corticosteroid (steroid), combination inhaler such as Advair, or an oral medicine like Singulair (montelukast), it is important to remember to take these every day—unlike albuterol HFA, which is used as needed as a rescue inhaler, or before exercise. For medications you have to take every day, you may want to have a system to make sure you remember to take your medications, such as a reminder on your phone, or a weekly pill organizer. You can ask your pharmacist for more suggestions, too.
5. Always call the pharmacy several days early when you need a refill, to allow time for processing, ordering, or any other unforeseen delays.