Albuterol interactions to avoid

Key takeaways | Drug interactions | Food interactions | Other interactions | Avoiding interactions | When to see a doctor

Albuterol (Ventolin HFA) is a quick-relief medication used to treat bronchospasm in people with asthma or chronic obstructive pulmonary disease (COPD). It is classified as a short-acting beta-agonist (SABA) or bronchodilator that relaxes and opens the airways. It is available in various forms, like inhalers and oral tablets, and it is marketed under brand names such as Ventolin and ProAir.

While albuterol is effective for treating immediate symptoms of shortness of breath, wheezing, and coughing, it may interact with other medications. Drug interactions may lead to decreased effectiveness of albuterol or increased side effects. Read on to learn more about albuterol interactions and when to consult a healthcare provider for guidance. 

Albuterol drug Interactions

Albuterol can interact with several types of drugs. Let’s review the main drug classes or drugs that interact with albuterol, such as beta blockers, non-potassium-sparing diuretics, and digoxin.

Beta blockers

Beta blockers, non-cardioselective ones, may need to be used cautiously in people with asthma or COPD. While albuterol helps open the airways, beta blockers can cause bronchoconstriction, narrowing the airways. As a result, this interaction may worsen respiratory symptoms. Examples of beta blockers include:

• Inderal (propranolol)
• Corgard (nadolol)
• Coreg (carvedilol)
• Betapace (sotalol)

Sometimes, a healthcare provider may recommend a selective beta-blocker, such as Tenormin (atenolol) or Lopressor (metoprolol), to reduce the risk of bronchospasm. 

Non-potassium-sparing diuretics 

Albuterol can also interact with non-potassium-sparing diuretics, medications that help the body eliminate excess fluid. As the name suggests, these drugs can lower the body’s potassium. Because albuterol can also lower potassium levels, taking albuterol with non-potassium-sparing diuretics may cause potassium levels to drop too low, a condition known as hypokalemia. Low potassium can cause heart rhythm problems and symptoms like muscle weakness and fatigue. Examples of non-potassium-sparing diuretics include:

• Lasix (furosemide)
• Hydrochlorothiazide
• Bumex (bumetanide)

Digoxin

Digoxin is a medication commonly used to treat heart failure and an irregular heartbeat. People who take albuterol with digoxin may experience decreased levels of digoxin in the body, which can lead to reduced digoxin effectiveness. Those who rely on digoxin may need regular blood tests to measure digoxin levels during treatment. Symptoms of decreased digoxin effectiveness may include worsening heart failure symptoms or changes in heart rhythm. 

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants, or TCAs, are a group of medications often used to treat depression and certain types of pain. Combining TCAs with albuterol may lead to increased side effects of albuterol, particularly those affecting the heart, such as a faster heart rate and higher blood pressure.

• Elavil (amitriptyline)
• Sinequan (doxepin)
• Tofranil (imipramine)
• Pamelor (nortriptyline)

Monoamine oxidase inhibitors (MAOIs)

Monoamine oxidase inhibitors, commonly referred to as MAOIs, are another class of antidepressants. MAOIs work by blocking the enzyme that breaks down mood-regulating neurotransmitters, which can improve symptoms of depression. Like with TCAs, taking MAOIs with albuterol can lead to increased side effects, particularly those related to the heart and blood pressure. More specifically, combining albuterol and MAOIs can cause a rapid heart rate and severe spikes in blood pressure. Examples of MAOIs include:

• Nardil (phenelzine)
• Parnate (tranylcypromine)
• Marplan (isocarboxazid)

Other short-acting beta-agonists 

Taking Xopenex (levalbuterol) in addition to albuterol may lead to overlapping side effects. Mixing albuterol with another SABA can intensify the cardiovascular effects, such as increased heart rate and blood pressure. Be mindful of the products that contain albuterol, such as:

• ProAir HFA (albuterol sulfate inhalation aerosol) 
• Ventolin HFA (albuterol sulfate inhalation aerosol) 
• Proventil HFA (albuterol sulfate inhalation aerosol) 
• AccuNeb (albuterol sulfate nebulizer solution)

Albuterol-food interactions

Albuterol metered-dose inhalers can generally be used with or without food. However, if you take albuterol tablets and experience an upset stomach, you can take them with food. Studies have shown that food has a minimal effect on the absorption of albuterol tablets. 

Albuterol and alcohol

Alcohol may have negative effects on lung function in people with asthma and COPD, which could counteract the benefits of albuterol. Studies have shown that people with alcohol use disorder, asthma, or COPD are at an increased risk of worsening breathing problems and poor outcomes. 

In addition, heavy alcohol use is also linked to negative effects on the cardiovascular system. These effects may be concerning since albuterol can cause adverse effects such as fast heart rate, palpitations, and blood pressure changes. Therefore, it’s recommended to limit or avoid drinking alcohol while using albuterol to decrease the risk of complications.

Albuterol and caffeine

While no significant interactions between albuterol and caffeine have been reported, some people may be more sensitive to the stimulant effects of both caffeine and albuterol. In such cases, limiting caffeine-containing beverages like coffee and tea may be recommended while taking albuterol.

Other albuterol interactions

Apart from its interactions with prescription drugs, albuterol may also interact with certain dietary supplements or over-the-counter herbal remedies. Consult a healthcare professional before starting any new supplement to ensure it’s safe for your medical condition.

Some potential albuterol interactions with dietary supplements and herbs include:

• Ephedra: Ephedra, also known as Ma Huang, is an herb used in traditional medicine to treat colds, fevers, and asthma. However, because it can stimulate the heart and lungs, combining ephedra and albuterol is not recommended. Combining them may lead to increased heart rate, higher blood pressure, and potentially severe heart problems. 
• Yohimbe: Yohimbe is an herbal supplement used for various purposes, including improving sexual performance and aiding weight loss. Like ephedra, yohimbe can also affect heart rate and blood pressure. When used with albuterol, there’s a risk of experiencing increased heart rate, blood pressure spikes, and other cardiovascular side effects. 

If considering herbal supplements like ephedra or yohimbe while using albuterol, consult a healthcare provider. They can offer medical advice on the potential safety risks.

Other considerations

Before using an albuterol inhaler, the following precautions should be considered:

• Hypersensitivity: If you have a known allergy to albuterol or its ingredients, avoid using the medication, as it may cause allergic reactions.
• High blood pressure or heart disease: Albuterol can cause increased heart rate and chest pain. Use it with caution if you have high blood pressure (hypertension) or a history of heart disease.
• Diabetes: Monitor blood sugar levels regularly while using albuterol, as the medication may cause changes in blood sugar.
• Hyperthyroidism: Albuterol may increase the effects of thyroid hormones, so use it with caution if you have an overactive thyroid.
• Seizures: If you have a history of seizures, use albuterol cautiously, as it may lower the seizure threshold.

If you have any medical conditions, you may need to take note of additional precautions. Tell your healthcare provider about any medical conditions before taking albuterol.

How to minimize albuterol interactions

Albuterol interactions are usually avoidable with adjustments in treatments. Here are some practical steps to reduce the risk of albuterol interactions.

Consult a healthcare professional

Before starting albuterol, consult a healthcare professional to see if it suits you. A healthcare provider can determine the best action based on your health and other medications and provide valuable drug information. 

Keep a detailed list of medications

You’ll want to write down a list of all your medications, especially if you take several. That way, you can easily share and update the list with your healthcare provider. The list should include:

• Prescription medications
• Over-the-counter drugs
• Vitamins 
• Herbal supplements

With this information, a healthcare professional can adjust dosages, discontinue medications, or recommend other medications if there’s a risk of drug interactions.

When to talk to a healthcare provider about albuterol interactions

Before starting albuterol, discuss potential interactions with a healthcare provider. If you’re already taking albuterol and experiencing signs or symptoms of an interaction, consult your healthcare provider or seek immediate medical attention if they’re severe. Your healthcare provider may recommend adjustments or close monitoring in most cases. 

Be aware of potential warning signs

If you know when to seek help for potential signs of interaction, you can take action and get prompt treatment. Some common warning signs of an interaction may include:

• Unusual side effects
• Worsening or new symptoms

Note: This is for informational purposes only and may not include a complete list of albuterol interactions. You should discuss your overall medical history, including medications, supplements, and medical conditions, with your healthcare provider before starting albuterol.