Adult Dosing
Severe bronchospasm
- 250 mcg IV inj or IV infusion of a solution containing 5 mg in 500 ml at a rate of 3-20 mcg/min adjusted according to patient's need
- 500 mcg IM/SC, repeated q4 hrs if necessary
- Higher doses may be used in respiratory failure
Uncomplicated premature labour
- For arrest of preterm labor between 24 and 33 wks of gestation:
- Start 10 mcg/min using a dilute solution of 20 mcg/ml in glucose 5% (200 mcg/ml of salbutamol if using a syringe pump); titrate q10 mins to achieve diminution in strength and frequency of contractions
- Once contractions have ceased; maintain infusion rate at the same level for 1 hr; then reduce by 50% q6 hrs
- Usual dose: 10-45 mcg/min
- Avoid prolonged therapy
Pediatric Dosing
- Insufficient data is available to recommend a dosage regimen for routine use in the pediatric population
[Outline]
See Supplemental Patient Information
- Excessive chronic use likely increases asthma mortality. Therapy should be supported with regular medical assessments, including lung function testing, as patients are at risk of severe attacks and even death. Incorporation of inhaled or oral corticosteroids early in therapy is recommended
- If worsening of asthma occurs patient should be clinically assessed and consideration should be given to the need for increased anti-inflammatory therapy (e.g. higher doses of inhaled corticosteroid or a course of oral corticosteroid)
- In hypoxic patients concurrent administration of oxygen is recommended
- Salbutamol can induce reversible metabolic changes such as hypokalaemia and increased blood glucose levels; closely monitor blood glucose and potassium levels in diabetic patients. Concomitant treatment with xanthine derivatives, steroids and diuretics are risk factors
- Sympathomimetic drugs are known to have serious cardiovascular effects. Patients with a history of IHD, arrhythmia or severe heart failure should be warned to seek medical advice if they experience symptoms such as dyspnea and chest pain. Closely monitor cardiorespiratory function and ECG. Therapy should be discontinued if signs of myocardial ischaemia (such as chest pain or ECG changes) develop
- Higher doses of beta agonists may lead to development of lactic acidosis characterized by symptoms such as dyspnea and compensatory hyperventilation which could be misinterpreted as a sign of asthma treatment failure. Closely monitor patients for increase in serum lactate levels and development of metabolic acidosis
- Maternal pulmonary edema may occur in patients being treated for premature labour. Carefully monitor cardio-respiratory function and maintain adequate fluid balance. If signs of pulmonary edema develop, discontinue the therapy
- Before initiating therapy with IV infusion for treatment of premature labor, patients with known heart disease should be clinically assessed by a physician experienced in cardiology. Maternal blood pressure may fall slightly or heart rate may be increased during the infusion. Closely monitor maternal pulse rate
Cautions: Use cautiously in
- Thyrotoxicosis
- Tocolysis
- Arrhythmias
- Hyperthyroidism
- Hypertension
- DM
- Myocardial insufficiency
- Susceptibility to QT-interval prolongation
- Pregnancy
Supplemental Patient Information
- The patient should be instructed to seek medical advice if short-acting relief bronchodilator treatment becomes less effective, or more inhalations than usual are required
Pregnancy Category:C
Breastfeeding: Safety unknown; decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
