Albuterol

VENTOLIN

What it isShort-acting beta-2 agonist; rescue bronchodilation in asthma and COPD.

Why this oneIt is the inexpensive racemic rescue standard; levalbuterol rarely offers a meaningful clinical advantage.

What limits itFrequent need signals inadequate asthma control. Tremor and tachycardia are common; repeated high use can lower potassium.

FDA-approved for

FDA dosing	Population	Start	Max
Bronchospasm (reversible obstructive airway disease)	Adults & children ≥12 yr	2-4 mg TID-QID	8 mg QID (32 mg/day)
Bronchospasm (reversible obstructive airway disease)	Children 6-12 yr	2 mg TID-QID	24 mg/day
Bronchospasm (reversible obstructive airway disease)	Elderly / beta-agonist-sensitive	2 mg TID-QID	8 mg TID-QID

Renal Undefined

Hepatic Undefined

Increase dose cautiously and stepwise only if the patient fails to respond
If a sympathomimetic reaction occurs, reduce dose temporarily then re-titrate up in small increments

Sympathomimetic effects: tachycardia, palpitations, tremor, nervousness; may cause hypertension and angina

Nervousness (~20%), tremor (~20%), headache (~7%)
Tachycardia (~5%), palpitations (~5%), muscle cramps (~3%), nausea (~2%), dizziness (~2%)

Pregnancy Pregnancy Category C. Teratogenic (cleft palate, limb defects) in animals; use only if potential benefit justifies risk.

Lactation Undefined

NO BOXED WARNINGS

Principal riskTachycardia and hypokalemia at high doses

Cost, est. cash$30–$500/month

Generic entry1989

Therapeutic safety burden1 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryC

Defining liabilityTremor, tachycardia or anticholinergic effects; excessive beta-agonist exposure can cause hypokalemia and arrhythmia.

Box: minimal PK interactions