Pharmacodynamics
Salbutamol is a selective β2-adrenergic receptor agonist. In therapeutic doses, it acts on β2-adrenergic receptors of bronchial smooth muscle, having little or no effect on β1-adrenergic receptors of the myocardium. It has a pronounced bronchodilator effect, preventing or relieving bronchospasm, and reduces resistance in the respiratory tract. Increases vital capacity of the lungs. Increases mucociliary clearance (in chronic bronchitis up to 36%), stimulates mucus secretion, activates the functions of the ciliated epithelium.
At recommended therapeutic doses it does not have a negative effect on the cardiovascular system and does not cause an increase in blood pressure. To a lesser extent, compared to drugs of this group, it has a positive chrono- and inotropic effect. Causes dilation of the coronary arteries.
It has a number of metabolic effects: it reduces the concentration of potassium in plasma, affects glycogenolysis and insulin secretion, has a hyperglycemic (especially in patients with bronchial asthma) and lipolytic effect, and increases the risk of developing acidosis.
After using inhalation forms, the action develops quickly, the onset of the effect is after 5 minutes, the maximum is after 30–90 minutes (75% of the maximum effect is achieved within 5 minutes), the duration is 4–6 hours.
Pharmacokinetics
After inhalation administration, 10–20% of the dose of salbutamol reaches the lower respiratory tract. The rest of the dose remains in the inhaler or is deposited in the oropharynx and is then swallowed. The fraction deposited in the respiratory tract is absorbed into the lung tissue and blood, but is not metabolized in the lungs.
The degree of binding of salbutamol to plasma proteins is about 10%.
Once in the blood, salbutamol is metabolized in the liver and excreted, mainly in the urine, unchanged or in the form of phenolic sulfate.
The ingested portion of the inhalation dose is absorbed from the gastrointestinal tract and undergoes active metabolism during the first passage through the liver, turning into phenolic sulfate. Unchanged salbutamol and the conjugate are excreted primarily in the urine.
Salbutamol administered intravenously has a T1/2 of 4–6 hours. It is excreted partly by the kidneys and partly as a result of metabolism to inactive 4′-O-sulfate (phenolic sulfate), which is also excreted mainly in the urine. Only a small part of the administered dose of salbutamol is excreted in feces. Most of the dose of salbutamol administered intravenously, orally or by inhalation is excreted within 72 hours.
Ventolin price, where to buy
The price of Ventolin for inhalation in dosages of 100 mcg is about 150 rubles. In the form of a solution, this product is more expensive.
The price of Ventolin Nebula is on average 300 rubles. Ventolin Easy Breathing costs approximately 150 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Ventolin aerosol for in.
dosage 100mcg/dose 200 dosesGlaxo Wellcome Production 144 RUR order
Pharmacy Dialogue
- Ventolin (aerial 100mcg 200doses)Glaxo-Wellcome
136 RUR order
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Pharmacy24
- Ventolin Evohaler 100 mcg 200 doses aerosol Glaxo Wellcome Production, France
72 UAH order
PaniPharmacy
- Ventolin liquid Ventolin Nebula d/ing solution. 2.5mg amp. 2.5ml No. 40 Germany, Aspen Bad Oldesloe
392 UAH. order
- Ventolin evohaler aerosol Ventolin evohaler aer. 100mcg/dose 200 doses Spain, Glaxo Wellcome
72 UAH order
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Indications for the drug Ventolin®
bronchial asthma:
— relief of attacks of bronchial asthma, incl. with exacerbation of severe bronchial asthma;
- prevention of bronchospasm attacks associated with exposure to an allergen or caused by physical activity;
- use as one of the components in long-term maintenance therapy of bronchial asthma;
COPD accompanied by reversible airway obstruction;
Chronical bronchitis.
Instructions for use of Ventolin (Method and dosage)
The instructions for use of Ventolin warn that the medicine must be used correctly, regardless of the form of release, otherwise the treatment process may go wrong.
In addition, the drug must be taken only after consultation with a doctor.
The instructions for Ventolin for inhalation in the form of an aerosol indicate that to use the drug it is necessary to use a nebulizer with a mask and an endotracheal tube .
Ventolin Nebula, which is sold in the form of an inhaler solution, is used without dilution. The duration of inhalation is about 10 minutes. The medicine can be diluted with a sterile sodium chloride solution (0.9%). It must be used in well-ventilated rooms, as some of the drug enters the environment.
The instructions for Ventolin Nebula for inhalation recommend a dose of 2.5 mg. If necessary, it can be increased to a maximum of 5 mg. Frequency of use – 3-4 times a day. For adult patients, if necessary, in a hospital setting, the dosage is increased to 40 mg per day.
The inhalation aerosol is designed for approximately 200 uses. It can be used by adult patients and children over 2 years of age after being prescribed by a specialist. For long-term maintenance therapy, adults are usually prescribed 200 mcg up to 4 times a day. To prevent bronchospasms in childhood, 100-200 mcg (1-2 inhalations) is used.
The syrup is prescribed to adult patients, 2 ml 3-4 times a day. If necessary, the dosage can be increased to 4 ml.
Contraindications
hypersensitivity to any component of the drug;
management of preterm birth;
threatened abortion;
children under 2 years of age.
With caution: tachyarrhythmia, myocarditis, heart defects, aortic stenosis, ischemic heart disease, severe chronic heart failure, arterial hypertension, thyrotoxicosis, pheochromocytoma, decompensated diabetes mellitus, glaucoma, seizures, renal or hepatic failure, simultaneous use of non-selective β-blockers, pregnancy, period lactation.
Use during pregnancy and breastfeeding
The drug is prescribed to pregnant women only when the expected benefit to the patient outweighs the potential risk to the fetus.
During post-registration surveillance, rare cases of various malformations in children, including the formation of a cleft palate and malformations of the limbs, were identified when mothers took salbutamol during pregnancy. In some of these cases, mothers took multiple concomitant medications during pregnancy. A cause-and-effect relationship with taking the drug has not been established.
Salbutamol is likely to pass into breast milk and is therefore not recommended for use in nursing women unless the expected benefit to the patient outweighs the potential risk to the baby. There is no evidence whether salbutamol present in breast milk is harmful to the newborn.
Side effects
Adverse reactions are listed depending on the anatomical and physiological classification and frequency of occurrence, which is defined as follows: very often (≥1/10), often (≥1/100 and <1/10), sometimes (≥1/1000 and <1 /100), rare (≥1/10,000 and <1/1000) and very rare (<1/10,000), including isolated cases.
From the immune system: very rarely - hypersensitivity reactions, including angioedema, urticaria, bronchospasm, hypotension and collapse.
Metabolic disorders: rarely - hypokalemia (therapy with β2-agonists can lead to significant hypokalemia); very rarely - lactic acidosis. Very rare cases of lactic acidosis have been reported in patients receiving IV salbutamol and Ventolin Nebula to treat exacerbations of asthma.
From the nervous system: often - tremor, headache; very rarely - hyperactivity.
From the cardiovascular system: often - tachycardia; sometimes - strong heartbeat (pulsation, palpitation); rarely - dilatation of peripheral vessels; very rarely - arrhythmia, including atrial fibrillation, supraventricular tachycardia and extrasystole.
From the respiratory system, chest and mediastinal organs: very rarely - paradoxical bronchospasm.
From the gastrointestinal tract: sometimes - irritation of the mucous membrane of the mouth and pharynx.
From the musculoskeletal system: sometimes - muscle cramps.
Analogs
Level 4 ATX code matches:
Onbrez Breezhaler
Formoterol Easyhaler
Fenoterol
Berotek
Foradil
Analogs of Ventolin, as well as Ventolin Nebula and Ventolin Easy Breathing in pharmacies can usually be obtained as follows:
- Ventilor;
- Nebutamol;
- Salamol Steri-Neb;
- Salamol-Eco;
- Salamol-Eco Easy Breathing;
- Salbutamol;
- Salbutamol-Inteli;
- Salbutamol-Neo.
They all have different prices. In many cases, analogues cost less than Ventolin itself.
Interaction
The simultaneous use of salbutamol and non-selective beta-adrenergic blockers such as propranolol is not recommended.
Salbutamol is not contraindicated in patients receiving MAO inhibitors.
In patients with thyrotoxicosis, it enhances the effect of central nervous system stimulants and tachycardia.
Theophylline and other xanthines, when used simultaneously, increase the likelihood of developing tachyarrhythmia; agents for inhalation anesthesia, levodopa - severe ventricular arrhythmia.
Simultaneous administration with anticholinergic drugs (including inhaled ones) may increase intraocular pressure.
Diuretics and corticosteroids enhance the hypokalemic effect of salbutamol.
Directions for use and doses
Inhalation. Only a doctor can decide whether to increase the dose or frequency of use of the drug. It is not recommended to use the Ventolin® inhaler more than 4 times a day. The need for frequent use of maximum doses of Ventolin® or a sudden increase in dose indicates a worsening of the disease.
Adults (including elderly patients)
Relieving an attack of bronchospasm: the recommended dose is 100–200 mcg (1–2 inhalations).
Prevention of bronchospasm attacks associated with exposure to an allergen or caused by physical activity: the recommended dose is 200 mcg (2 inhalations) 10–15 minutes before exposure to the provoking factor.
Long-term maintenance therapy: the recommended dose is up to 200 mcg (2 inhalations) 4 times a day.
Children
Relieving an attack of bronchospasm: the recommended dose is 100–200 mcg (1–2 inhalations).
Prevention of bronchospasm attacks associated with exposure to an allergen or caused by physical activity: the recommended dose is 100–200 mcg (1–2 inhalations) 10–15 minutes before exposure to the provoking factor.
Long-term maintenance therapy: the recommended dose is 200 mcg (2 inhalations) 4 times a day. Ventolin® can be administered through the Babyhaler spacer.
Instructions for use of the inhaler
Checking the inhaler: before using the inhaler for the first time or if the inhaler has not been used for a week or longer, remove the cap from the mouthpiece by lightly squeezing the cap on the sides, shake the inhaler well and press the aerosol valve to release 1 inhalation dose into the air to make sure the inhaler is working properly.
Using an inhaler
1. Remove the cap from the mouthpiece by lightly squeezing the sides of the cap.
2. Inspect the mouthpiece inside and out to make sure it is clean.
3. Shake the inhaler well.
4. Hold the inhaler between your index finger and thumb in a vertical position, bottom up, with your thumb resting on the base under the mouthpiece.
5. Exhale slowly, deeply, wrapping your lips around the mouthpiece without squeezing it with your teeth.
6. Inhaling as deeply as possible through your mouth, simultaneously press the top of the inhaler to release 1 inhalation dose of salbutamol.
7. Hold your breath for a few seconds, remove the mouthpiece from your mouth, then exhale slowly.
8. To receive the second dose, hold the inhaler in an upright position, wait about 30 seconds and then repeat steps 3–7.
9. Close the mouthpiece tightly with the protective cap.
Attention! When following steps 5, 6 and 7, you should not rush. You should begin inhaling as slowly as possible, just before pressing the inhaler valve. It is recommended to practice in front of a mirror the first few times. If “fog” is visible coming from the top of the inhaler or from the corners of the mouth, then you should start over from step 3.
If your doctor has given other instructions for using your inhaler, you should strictly follow them. You should contact your doctor if you have difficulty using your inhaler.
Cleaning the inhaler: the inhaler must be cleaned at least once a week.
1. Remove the metal can from the plastic case and remove the mouthpiece cover.
2. Rinse the plastic case and mouthpiece cover thoroughly under running warm water.
3. Dry the plastic case and mouthpiece cover completely, both outside and inside. Avoid overheating.
4. Place the metal can into the plastic case and put on the mouthpiece cap.
Do not immerse the metal can in water.
Ventolin aerosol for inhalation dosed 100 mcg/dose 200 doses 1 pc. in Moscow
Latin name
Ventolin®
International nonproprietary name
salbutamol (salbutamol)
Release form
Metered aerosol for inhalation.
Package
200 doses - aluminum inhalers (1) with a plastic dosing device with a protective cap - cardboard packs.
Description
Aerosol for inhalation dosed in the form of a suspension of white or almost white color.
pharmachologic effect
Selective agonist of β2-adrenergic receptors. In therapeutic doses, it acts on β2-adrenergic receptors of bronchial smooth muscle and has a short-term (4 to 6 hours) bronchodilatory effect on β2-adrenergic receptors with a rapid onset of action (within 5 minutes) with reversible airway obstruction. It has a pronounced bronchodilator effect, preventing or relieving bronchospasm, and reduces resistance in the respiratory tract. Increases vital capacity. Increases mucociliary clearance (in chronic bronchitis up to 36%), stimulates mucus secretion, activates the functions of the ciliated epithelium. In recommended therapeutic doses, it does not have a negative effect on the cardiovascular system and does not cause an increase in blood pressure. To a lesser extent, compared to drugs of this group, it has a positive chrono- and inotropic effect. Causes dilation of the coronary arteries. It has a number of metabolic effects: it reduces the concentration of potassium in plasma, affects glycogenolysis and insulin secretion, has a hyperglycemic (especially in patients with bronchial asthma) and lipolytic effect, and increases the risk of developing acidosis.
Indications
Bronchial asthma: - relief of symptoms of bronchial asthma when they occur; - prevention of bronchospasm attacks associated with exposure to an allergen or caused by physical activity; — use as one of the components in long-term maintenance therapy of bronchial asthma. Other chronic lung diseases accompanied by reversible airway obstruction, including chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema. Bronchodilators should not be the only or main component of the treatment of unstable or severe bronchial asthma. In the absence of a response to salbutamol in patients with severe bronchial asthma, it is recommended to treat with GCS in order to achieve and maintain control of the disease. Failure to respond to salbutamol therapy may indicate the need for urgent medical consultation or treatment.
Directions for use and doses
Ventolin is intended only for inhalation administration by inhalation through the mouth. An increased need for the use of beta2-adrenergic receptor agonists may be a sign of worsening bronchial asthma. In such a situation, it may be necessary to re-evaluate the patient's treatment regimen with consideration of the advisability of prescribing simultaneous therapy with GCS. Since an overdose may be accompanied by the development of undesirable reactions, the dose or frequency of use of the drug can be increased only on the recommendation of a doctor. The duration of action of salbutamol in most patients is 4 to 6 hours. In patients who have difficulty synchronizing inhalation with the use of a pressurized metered-dose aerosol inhaler, a spacer may be used. In children and infants receiving Ventolin, it is advisable to use a pediatric spacer device with a face mask. To relieve an attack of bronchospasms in adults, the recommended dose is 100 or 200 mcg; children - 100 mcg; if necessary, the dose can be increased to 200 mcg. It is not recommended to use the Ventolin inhaler more than 4 times a day. The need for such frequent use of additional doses of Ventolin or a sharp increase in dose indicates a worsening of asthma. To prevent attacks of bronchospasm associated with exposure to an allergen or caused by physical activity, adults - 200 mcg 10-15 minutes before exposure to a provoking factor or exercise; children - 100 mcg 10-15 minutes before exposure to a provoking factor or load; if necessary, the dose can be increased to 200 mcg. For long-term maintenance therapy for adults - up to 200 mcg 4 times a day; children - up to 200 mcg 4 times a day. Rules for using the inhaler Checking the inhaler Before using the inhaler for the first time or if the inhaler has not been used for a week or longer, you should remove the cap from the mouthpiece by lightly squeezing the cap on the sides, shake the inhaler well and spray twice into the air to ensure that it is working properly inhaler. Using the inhaler 1. Remove the cap from the mouthpiece by lightly squeezing the cap from the sides. 2. Inspect the mouthpiece inside and out to make sure it is clean. 3. Shake the inhaler well. 4. Hold the inhaler between your index finger and thumb in a vertical position, bottom up, with your thumb resting on the base under the mouthpiece. 5. Exhale slowly and deeply, wrap your lips around the mouthpiece without squeezing it with your teeth. 6. While inhaling as deeply as possible through your mouth, simultaneously press the top of the inhaler to release one inhalation dose of salbutamol. 7. Hold your breath for a few seconds, remove the mouthpiece from your mouth, then exhale slowly. 8. To receive the second dose, hold the inhaler in a vertical position, wait about 30 seconds and then repeat steps. 3-7. 9. Close the mouthpiece tightly with the protective cap. When performing stages 5, 6 and 7, you should not rush. You should begin inhaling as slowly as possible, just before pressing the inhaler valve. It is recommended to practice in front of a mirror the first few times. If visible
Compound
1 dose contains 120.5 mcg of micronized salbutamol sulfate. Excipients: propellant (1,1,1,2-tetrafluoroethane) in 1 dose - up to 75 mg, in 1 inhaler - up to 18 g. * to ensure the yield of 200 doses when using an inhaler , each inhaler contains an amount of suspension equivalent to 240 doses; ** 120.5 mcg salbutamol sulfate (micronized) is equivalent to 100 mcg salbutamol; ** depending on the equipment used in the production of the drug, up to 10% excess of the active substance may be included in the production formula.
Contraindications
- management of premature birth; - threatened abortion; - hypersensitivity to the components of the drug or any other component included in the drug. Salbutamol should be used with caution in patients with thyrotoxicosis, tachyarrhythmia, myocarditis, heart defects, aortic stenosis, coronary heart disease, severe chronic heart failure, arterial hypertension, pheochromocytoma, decompensated diabetes mellitus, glaucoma.
Use during pregnancy and breastfeeding
Fertility There are no data on the effects of salbutamol on human fertility. In preclinical studies, no undesirable effects on animal fertility were identified. Pregnancy During pregnancy, the drug should be prescribed only if the expected benefit of therapy for the mother outweighs the potential risk to the fetus. During post-registration surveillance, rare cases of various developmental defects in children were identified, including the formation
special instructions
Treatment of bronchial asthma is recommended to be carried out in stages, monitoring the patient's clinical response to treatment and lung function. Bronchodilators should not be the only or main component of the treatment of unstable or severe bronchial asthma. An increased need for the use of short-acting bronchodilators, in particular beta2-adrenergic agonists, to relieve the symptoms of bronchial asthma indicates a worsening of the disease. In such cases, the patient's treatment plan should be reconsidered. A sudden and progressive worsening of bronchial asthma may pose a potential threat to the patient's life, therefore, in such situations, the advisability of prescribing or increasing the dose of GCS should be considered. In patients at risk, daily monitoring of peak expiratory flow is recommended. Therapy with beta2-adrenergic agonists, especially when administered parenterally or via nebulizer, can lead to hypokalemia. Particular caution is recommended when treating severe attacks of bronchial asthma, since in these cases hypokalemia may increase as a result of the simultaneous use of xanthine derivatives, corticosteroids, diuretics, as well as due to hypoxia. In such situations, it is recommended to monitor the concentration of potassium in the blood serum. As with the use of other inhalation therapy agents, paradoxical bronchospasm may develop when taking salbutamol with increased wheezing immediately after using the drug. This condition requires immediate treatment using an alternative formulation of salbutamol or another short-acting inhaled bronchodilator. Ventolin should be discontinued immediately, the patient's condition assessed and, if necessary, another fast-acting bronchodilator prescribed to continue treatment. If there is no effect of using a previously effective dose of inhaled salbutamol for at least 3 hours, the patient should consult a doctor to determine whether any additional measures need to be taken. Patients should be instructed on the correct use of the Ventolin inhaler. Effect on the ability to drive vehicles and operate machinery No data.
Side effects
From the immune system: very rarely - hypersensitivity reactions, including angioedema, urticaria, bronchospasm, decreased blood pressure and collapse. Metabolism and nutrition: rarely - hypokalemia. Therapy with beta2-agonists may lead to clinically significant hypokalemia. From the nervous system: often - tremor, headache; very rarely - hyperactivity. From the heart: often - tachycardia; infrequently - palpitations; very rarely - arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystole). Vascular disorders: rarely - peripheral vasodilation. From the respiratory system, chest and mediastinal organs: very rarely - paradoxical bronchospasm. From the gastrointestinal tract: infrequently - irritation of the mucous membrane of the oral cavity and pharynx. From the musculoskeletal and connective tissue side: infrequently - muscle cramps.
Drug interactions
The simultaneous use of salbutamol and non-selective beta-adrenergic blockers such as propranolol is not recommended. Salbutamol is not contraindicated in patients receiving monoamine oxidase inhibitors (MAOIs). In patients with thyrotoxicosis, Ventolin enhances the effect of central nervous system stimulants and tachycardia. Theophylline and other xanthines, when used simultaneously with salbutamol, increase the likelihood of developing tachyarrhythmia. Simultaneous administration with anticholinergic drugs (including inhaled ones) may increase intraocular pressure. Diuretics and corticosteroids enhance the hypokalemic effect of salbutamol.
Storage conditions
Store at temperatures below 30C.
Overdose
Symptoms: more frequent - hypokalemia, decreased blood pressure, tachycardia, muscle tremors, nausea, vomiting; less frequent - agitation, hyperglycemia, respiratory alkalosis, hypoxemia, headache; rare - hallucinations, convulsions, tachyarrhythmia, ventricular flutter, dilatation of peripheral vessels.
Treatment: the best antidotes are cardioselective β-blockers. However, beta-adrenergic blockers should be used with caution in patients with a history of bronchospasm attacks. The use of large doses of salbutamol can cause hypokalemia, therefore, if overdose is suspected, serum potassium levels should be monitored.
For children
Inhalations for children can be used to relieve bronchospasm attacks at a dosage of 100-200 mcg (1-2 inhalations). Maintenance therapy with Ventolin – up to 200 mcg 4 times a day (2 inhalations). For prevention, 100-200 mcg is used 10-50 minutes before the provoking factor (1-2 inhalations).
For children, Babyhaler or Volumatic spacers are used.
The clinical effectiveness of this drug in children under 18 months using a nebulizer has not been studied.
special instructions
Patients should be instructed on the correct use of the Ventolin® inhaler.
Bronchodilators should not be the only or main component of the treatment of unstable or severe bronchial asthma.
If the effect of the usual dose of Ventolin® becomes less effective or shorter lasting (the effect of the drug should last at least 3 hours), the patient should consult a doctor.
An increased need for the use of inhaled β2-adrenergic agonists with a short duration of action to control the symptoms of bronchial asthma indicates an exacerbation of the disease. In such cases, the patient's treatment plan should be reconsidered. A sudden and progressive deterioration of bronchial asthma can pose a threat to the patient's life, therefore, in such situations, it is necessary to urgently decide on prescribing or increasing the dose of GCS. In such patients, daily monitoring of peak expiratory flow is recommended.
Salbutamol should be used with caution in patients with thyrotoxicosis.
Therapy with β2-adrenergic agonists, especially when administered parenterally or via nebulizer, can lead to hypokalemia. Particular caution is recommended when treating severe attacks of bronchial asthma, since in these cases hypokalemia may increase as a result of the simultaneous use of xanthine derivatives, corticosteroids, diuretics, as well as due to hypoxia. In such situations, it is necessary to monitor the level of potassium in the blood serum.
Impact on the ability to drive a car and/or other mechanisms. No data.
