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Salbutamol

Sounds like 'sal-bew-ta-mol'

Key points about salbutamol

Salbutamol is used to quickly relieve breathing problems such as wheeze and cough caused by asthma and COPD.
Salbutamol is commonly called Ventolin®, SalAir® or Asthalin®.
For asthma, using salbutamol by itself – without an inhaled corticosteroid – is no longer recommended.
Find out more about salbutamol, how to use metered dose inhalers and possible side effects.

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Salbutamol is a medicine used to treat cough, wheeze and difficulty breathing caused by respiratory problems such as asthma and COPD. It works as a bronchodilator (to open your airways) and is often called a reliever (to relieve breathing problems).

Salbutamol relieves your breathing problems quickly. It starts to work within a few minutes and the effect will last 3 to 5 hours.

Although it relieves breathlessness, salbutamol doesn’t prevent the breathlessness from happening.

In Aotearoa New Zealand salbutamol is available as a metered dose inhaler (MDI) and a nebulising solution

Using salbutamol in an MDI helps the medicine go straight into your airways when you breathe in. This means that your airways and lungs are treated quickly and very little of the medicine gets into the rest of your body.
Using a spacer with your MDI allows better delivery of the medication to your bronchial tubes.
Inhalers are commonly called puffers, metered dose inhalers (MDIs) or aerosol inhalers because they contain hydrofluorocarbon propellant gases.
Nebulisers are not often used because, for most people, puffer inhalers used with a spacer are just as effective. Nebulisers are only used when inhalers aren’t suitable, such as for very young children, older adults or very sick people in hospital.
The information on this page is about salbutamol inhalers. Read more about nebulisers.

Salbutamol metered dose inhalers are available in different brands

In Aotearoa New Zealand salbutamol metered dose inhalers are available as Salair® and Ventolin®.

There's no difference in the amount of medicine between the different brands of inhaler but Ventolin doesn't contain any chlorofluorocarbons (CFCs) or alcohol in it.
SalAir is fully funded with a prescription. If you choose the Ventolin brand you’ll have to pay part of the cost for it.
From October 2023, the Respigen brand of salbutamol is no longer available in Aotearoa New Zealand. If you're still using a Respigen inhaler, you'll need to switch to a different brand.

If you have asthma, using salbutamol alone is no longer recommended because:

it doesn’t deal with the underlying cause of wheezing which is caused by an inflammation of the lining of your bronchial tubes
using salbutamol without an inhaled corticosteroid can make asthma worse by increasing inflammation and sensitivity to allergens
using salbutamol too often makes it less effective, so you need it more frequently
using 3 or more salbutamol inhalers a year is linked to a higher risk of needing emergency care or being hospitalized, no matter how severe your asthma is.

What is recommended?

The recommended treatment for people with asthma 12 years of age and over is a combination 2-in-1 inhaler containing the preventer medicine budesonide and the reliever medicine formoterol.

The brand names for these inhalers are Symbicort® or DuoResp Spiromax®. These inhalers can be used as either a reliever treatment alone (AIR), or as a regular preventer and reliever treatment (SMART).

Read more about AIR and SMART asthma therapy.

The usual dose of salbutamol inhaler is 1 or 2 puffs, preferably through a spacer device.

This dose can be repeated up to 4 times a day if you need it for shortness of breath or wheezing. If you don't get relief from your symptoms after using the salbutamol inhaler, you must contact your doctor for advice immediately or call 111.

If you’re needing to use your salbutamol inhaler more than 2 times a week, see your doctor to change your treatment, or increase the dose of your steroid inhaler, to help control your symptoms.

Before exercise: If you’re using salbutamol to prevent asthma brought on by exercise, the usual dose is 1 or 2 puffs inhaled 15 to 30 minutes before exercise.

To get the most benefit, it's important to use the correct technique. Ask your healthcare provider to show you how to use your MDI and spacer devices. Even if you’ve been shown before, ask your healthcare provider to explain how to use your inhaler if you still have any questions.

Here is some guidance on how to use a metered dose inhaler (MDI) without a spacer.

How to use an MDI (puffer)
	Take off the cap and hold the inhaler upright.
	Shake the inhaler to mix the medicine.
	Sit upright, tilt your head back slightly (as if you are sniffing) and breathe out gently.
	Hold the device upright, insert the inhaler into your mouth, ensuring that your lips firmly seal the mouthpiece. At the beginning of a slow, deep breath, breathe in through the mouthpiece as you press the inhaler to release one dose or 'puff'.
	Breathe in fully, remove the inhaler from your mouth and hold your breath for 10 seconds or as long as is comfortable. Breathe out gently through your nose.

Video: How to use a metered-dose inhaler (puffer)

The video below provides some guidance on how to use an MDI. Your MDI may be a different colour to the one in the video below. Read more about understanding your medicines(external link).

(National Asthma Council, Australia, 2014)

Here are some things to know when you're taking salbutamol. Other things may be important as well, so ask your healthcare provider what you should know about.

Other medicines: Salbutamol interacts with some medicines (eg, propranolol, herbal supplements and rongoā Māori) so check with your doctor or pharmacist before starting salbutamol and before starting any new products.
Some people with asthma might have trouble breathing after taking painkillers like ibuprofen (Nurofen®) or diclofenac (Voltaren®). If this happens, talk to your doctor.
Asthma action plan: Ask for a written asthma action plan from your asthma nurse or healthcare provider. This will tell you how many puffs to use for each dose, and what to do if your symptoms get worse. Read more about asthma action plans for adults(external link) and children(external link).
Keep your inhaler with you at all times: Make sure you have your inhaler with you at all times so you know where it is when you need it.
Holidays: Make sure you have enough salbutamol and any preventer steroid inhalers to last through weekends and holidays.
Storage: You can carry your inhaler in your pocket but it needs to be stored below 25ºC, so don't keep it in your car during summer.

Do you need a preventer?

If you need to use your salbutamol inhaler more than 2 times each week, talk to your doctor. To reduce your symptoms you may need a ‘preventer’ inhaler, or the dose of your preventer inhaler may need to be increased.

Preventers help reduce asthma symptoms and breathing problems. You’ll get better control of your symptoms with a 2-in-1 combination inhaler (reliever + preventer) instead of just salbutamol.

Like all medicines, salbutamol can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Feeling shaky Nervousness Tremor Changes in your heartbeat (faster) Headache	These are quite common when you first start using salbutamol and usually go away with time. Tell your doctor if they bother you.
Muscle cramps	This is not common. Tell your doctor if this bothers you.
Chest pain	This is rare. Tell your doctor or ring Healthline 0800 611 116.
Sudden worsening of breathing problems and you're using salbutamol very often	Tell your doctor immediately or ring Healthline 0800 611 116.

Spacers
Asthma in adults
Asthma in children | Mate huango tamariki
Asthma triggered by exercise
COPD | Mate ia tuku
COPD flare-ups

The following links provide further information on salbutamol.

SalAir(external link), Ventolin(external link) Medsafe Consumer Information Sheet, NZ
Salbutamol inhaler and nebules(external link) New Zealand Formulary Patient Information

Brochures

Salbutamol (for inhalation) New Zealand Formulary Patient Information te reo Māori(external link)
4 stage asthma action plan Asthma & Respiratory Foundation, NZ English(external link), Māori(external link), Samoan(external link)
5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)

Apps/tools

There are variety of mobile apps available for people with asthma. These can be a useful way to learn about and take control of your asthma, for example they can help you keep track of your symptoms, triggers, peak flow readings and medication. You can also create an asthma action plan together with your doctor or nurse. The New Zealand Health App Library has reviewed some asthma apps that you may like to consider. Read more about asthma apps.