Albuterol dosage, forms, and strengths
Key takeaways
Albuterol is a prescription drug used to prevent and treat lung conditions that cause difficulty breathing, such as asthma and COPD.
Albuterol is available in various forms, including inhalers, nebulizer solutions, and oral forms. Your healthcare provider will determine which albuterol product is best for you or your child.
The dosage for albuterol varies by product, age, and the reason for use.
Common side effects of albuterol include headache, runny or stuffy nose, sore throat, cough, nausea and vomiting, dizziness, shaking, excitability or nervousness, palpitations, and fast heart rate.
Consult your healthcare provider for more information and medical advice about your condition and treatment.
Albuterol is a prescription drug that treats and prevents bronchospasm in adults and children. Bronchospasm happens when the airways in your lungs tighten, making it hard to breathe. Common causes of bronchospasm include lung conditions such as asthma and chronic obstructive pulmonary disease (COPD). Albuterol is classified as a bronchodilator and a beta-agonist. It is sold in a variety of formulations under the brand names ProAir HFA, ProAir Respiclick, Proventil HFA, and Ventolin HFA, as well as various generic products. Depending on the formulation and reason for use, albuterol may be scheduled regularly or used as needed for symptoms (i.e., as a rescue or quick-relief inhaler).
Albuterol forms and strengths
Albuterol is taken orally as a syrup, immediate-release, or extended-release tablet. It is also available as an aerosol inhaler, dry powder inhaler, or nebulizer solution for inhalation.
Immediate-release tablets: 2 mg, 4 mg
Extended-release tablets: 4 mg, 8 mg
Oral syrup: 2 mg/5 mL
Aerosol spray: 90 mcg/inhalation
Dry powder for inhalation: 90 mcg/inhalation
Nebulizer solution: 0.63 mg/3 mL (0.021%), 1.25 mg/3 mL (0.042%), 2.5 mg/3 mL (0.083%), 2.5 mg/0.5mL (0.5%)
Albuterol dosage for adults
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Albuterol dosage chart |
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|---|---|---|
| Indication | Inhaled dosage | Oral dosage |
| Bronchospasm | Inhaler: 2 puffs every 4-6 hours as needed Nebulizer: 2.5 mg three to four times daily as needed | Immediate release: 2 to 4 mg 3-4 times daily. May increase up to 8 mg 4 times daily. Extended-release tablets: 4 to 8 mg every 12 hours. May increase up to 16 mg every 12 hours. Older adults typically start at 4 mg every 12 hours and gradually increase if needed for symptom control. Syrup: 2 to 4 mg (5 to 10 mL) 3-4 times daily; the dose may be increased up to 8 mg (20 mL) per dose. |
| Acute bronchospasm | Inhaler: 4 to 10 puffs every 20 minutes for one hour, then 4 to 10 puffs every 3 to 4 hours or more often, as directed Nebulizer: 2.5-5 mg every 20 minutes for three doses (one hour), then 2.5-10 mg every 1-4 hours as needed Alternative: 10-15 mg/h continuous nebulization | Not indicated |
| Prevention of exercise-induced bronchospasm | Inhaler: 2 puffs 15 to 30 minutes before exercise | Not indicated |
Albuterol dosage for bronchospasm
A bronchospasm is a reflexive spasm of the smooth muscles that line bronchial tubes. When these muscles contract during a spasm, the airways become narrower. Breathing during bronchospasm requires more effort than normal breathing. This is a common symptom of reversible obstructive airway diseases such as asthma but may also occur during a flare-up of chronic obstructive pulmonary disease (COPD), which includes conditions like emphysema and chronic bronchitis. Albuterol causes bronchial muscles to relax, which opens the airways. Albuterol inhalation acts quickly and can be used as needed when bronchospasms occur.
Albuterol dosage for acute bronchospasm
Bronchospasms can cause breathing problems that range from mild to severe. While no single parameter has been identified to assess severity, acute bronchospasm typically includes using muscles not usually used for breathing (accessory muscles), chest wall retractions, and wheezing. If possible, patients should use a peak flow meter to measure lung function.
All patients with asthma should receive an asthma action plan from their doctor, outlining how much of their medication to take based on their symptoms and peak flow meter results. The typical dose for an albuterol inhaler is four to ten puffs every twenty minutes for one hour, followed by four to ten puffs every three to four hours as needed. The typical dose for a nebulizer is 2.5 to 5 mg every twenty minutes for three doses, then 2.5 to 10 mg every one to four hours as needed. Oral albuterol is not indicated for the treatment of acute bronchospasm due to its slower onset of action compared to inhaled dosage forms.
Albuterol dosage for prevention of exercise-induced bronchospasm
Albuterol inhalers are used to prevent bronchospasms caused by exercise. The dose is two puffs fifteen to thirty minutes before exercise. Oral albuterol is not indicated for preventing exercise-induced bronchospasm due to slower onset of action compared to inhaled dosage forms.
Albuterol dosage for children
The dose of albuterol for children depends on factors such as the reason for use and the child’s age and weight. The table below lists some common doses, although individual doses may vary. Consult your child’s health care provider for more information and medical advice.
Albuterol nebulizer pediatric dosages |
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|---|---|---|
| Indication | Dose | Max dosage |
| Bronchospasm (0-4 years) | 0.63 to 2.5 mg every 4-6 hours as needed | 2.5 mg every 4 hours as needed |
| Bronchospasm (5 years or older) | 1.25 to 5 mg every 4-8 hours as needed | 5 mg every 4 hours as needed |
| Acute bronchospasm (12 years or younger) | 2.5 mg every 20 minutes for 3 doses and then 0.15-0.3 mg/kg up to 10 mg every 1-4 hours as needed. | 0.15 mg/kg every 20 minutes for 3 doses, then 10 mg every hour as needed |
| Acute bronchospasm (older than 12 years) | 2.5-5 mg every 20 minutes for 3 doses, then 2.5-10 mg every 1-4 hours as needed. | 5mg every 20 minutes for 3 doses, then 10 mg every hour as needed |
Albuterol inhaler pediatric dosages |
||
|---|---|---|
| Indication | Dose | Max dosage |
| Prevention of exercise-induced bronchospasm | 2 puffs 15-30 minutes before exercise | 2 puffs per dose |
| Bronchospasm | 2 puffs every 4-6 hours as needed | 12 puffs per day |
| Acute bronchospasm (12 years or younger) | 4 to 8 puffs every 20 minutes for 3 doses, then every 1- 4 hours as needed. Use a spacer with a face mask for children less than 4 years old | 8 puffs every 20 minutes for 3 doses, then every hour as needed |
| Acute bronchospasm (12 years and older) | 4 to 8 puffs every 20 minutes for 3 doses, then every 1-4 hours as needed | 8 puffs every 20 minutes for 3 doses, then every hour as needed |
Albuterol oral pediatric dosage for asthma |
||
|---|---|---|
| Age range | Oral dose | Max dose |
| 2 to 5 yrs |
|
Syrup only: 4 mg three times daily |
| 6 to 12 yrs |
|
24 mg/day in divided doses |
| 12 to 14 yrs |
|
Syrup: 24 mg/day in divided doses Tablets: 32 mg/day in divided doses |
| 15 yrs and older |
|
Syrup: 32 mg/day (8 mg 4 times daily) Tablets: 32 mg/day in divided doses |
Albuterol warnings
Patients with a history of hypersensitivity (i.e., severe allergic reaction such as angioedema, rash, or anaphylaxis) to albuterol should not use any formulation of albuterol. A history of a hypersensitivity reaction to other components of oral albuterol, albuterol inhalers, or nebulizer solution is a contraindication to those products.
Before using albuterol, tell your healthcare provider about any medical conditions you have, including:
Hyperthyroidism (overactive thyroid gland)
Hypokalemia (low potassium levels)
Cardiovascular conditions such as coronary artery disease, angina (chest pain), cardiac arrhythmias (i.e., atrial fibrillation, tachycardia), QT prolongation, or high blood pressure
Seizures
Consult a healthcare provider for medical advice if you have any of the conditions listed above or concerns about possible adverse reactions.
Albuterol dosage FAQs
How do I use albuterol?
The directions for use will vary based on your albuterol product. Carefully read the instructions for use that come with your prescription, and ask your healthcare provider or pharmacist if you have any questions or would like more information before using albuterol.
How long does it take albuterol to work?
All forms of inhaled albuterol (powder, aerosol, nebulizer) have similar onset of action, which is approximately five to 15 minutes.
Oral albuterol takes longer to absorb and take effect. Oral albuterol starts to work in approximately thirty minutes. The maximum effect occurs within two to three hours for albuterol syrup and immediate-release tablets
and six hours for extended-release tablets. Additionally, food may decrease the absorption rate of albuterol extended-release tablets, which means it may take slightly longer to work.
How long does albuterol stay in your system?
In adults and children, albuterol aerosol inhalation continues to have an effect for around two to six hours. Albuterol may remain in the system after its effects are gone. Follow your healthcare provider’s instructions for how much albuterol to use and how often to use it. If you feel like you are still having difficulty breathing, or you need to use increasing amounts of albuterol, call your healthcare provider.
What happens if I miss a dose of albuterol?
Albuterol is generally taken as needed. For oral albuterol, if you forget to take a dose, simply take it as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra doses to make up for a missed dose.
What is the maximum dosage for albuterol?
The maximum dose of albuterol varies by product and age of the patient. The inhaled forms of albuterol are used as needed to control asthma symptoms, and patients should not exceed the doses outlined on their asthma medication action plan. In some cases, asthma attacks may be life-threatening. If asthma symptoms are severe and are not controlled after using your medicine as directed, seek emergency medical attention.
What interacts with albuterol?
Beta blockers such as carvedilol, labetalol, nadolol, timolol, and propranolol can trigger bronchospasms in patients with asthma or COPD by opposing the effects of albuterol on the airways. If a beta blocker is needed, cardioselective beta blockers (such as atenolol or metoprolol) is preferred, as they are less likely to affect the lungs.
Medications that prolong the QTc interval or decrease potassium levels may increase the risk of arrhythmias when used with albuterol. Risk is further increased with each additional medication carrying these side effects.
Phentermine, midodrine, linezolid, and procarbazine may increase the risk of hypertension and other cardiovascular adverse effects when combined with albuterol. Before taking albuterol, tell your healthcare provider about all the medications you take, including prescription drugs, OTC medicines, vitamins, and supplements.
Resources:
Albuterol
, StatPearls (2024)Asthma in cats
, International Cat Care (2018)Asthma action plan
, Asthma and Allergy Foundation of America (2015)Feline bronchial asthma: Treatment
, Compendium: Continuing Education for VeterinariansProAir RespiClick
, TevaVentolin HFA
, GlaxoSmithKlineVentolin tablets
, GlaxoSmithKline
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