BRONCHOVENT 5/MG NEBULIZER SOLUTION 20ML

Indications

Approved Uses

Treatment and prevention of bronchospasm in patients with reversible obstructive airway disease, including asthma and chronic obstructive pulmonary disease (COPD).

Off-Label Uses

Adjunct treatment of acute hyperkalemia (typically via inhaled/nebulized beta-2 agonist as part of emergency management).

Dosage & Administration

Dosing by Condition

Acute bronchospasm (asthma/COPD) via nebulizer: Adults and adolescents ≥12 years: 2.5 mg (0.5 mL of 5 mg/mL) diluted to 3 mL with sterile normal saline, 3-4 times daily; Children 2-12 years: 0.1-0.15 mg/kg/dose (max 2.5 mg) 3-4 times daily.

Initial Dose

2.5mg (0.5ml of 5mg/ml solution) diluted with normal saline, nebulised

Maintenance Dose

2.5 mg to 5 mg via nebulizer every 4 to 6 hours as needed.

Maximum Dose

Adults: typically 2.5-5 mg per nebulised dose up to 4 times daily (usual max 20 mg/day); higher doses (up to ~40 mg/day) may be used only in severe acute asthma under close medical supervision/monitoring.

Children's Dosage

Children 2-12 years: Initial 0.1-0.15 mg/kg/dose (approx 1.25-2.5 mg), not to exceed 2.5 mg 3-4 times daily by nebulization; <2 years: 0.2-0.6 mg/kg/day divided every 4-6 hours (use under specialist supervision).

Dose Adjustment Notes

Use the lowest effective dose; frequent need indicates poor control and requires reassessment; use caution in cardiovascular disease/arrhythmias, hyperthyroidism, and diabetes, and consider closer monitoring/starting lower in patients more sensitive to beta-agonist effects; monitor potassium (and glucose in diabetics) with high-dose or frequent use.

How to Take

For inhalation via a nebulizer (typically jet nebulizer) only; measure the prescribed dose and dilute with sterile 0.9% sodium chloride to an appropriate nebulizer fill volume (commonly ~2-4 mL per device instructions), then inhale the mist through a mouthpiece or mask until the nebulizer sputters/stops; do not swallow or inject; do not mix with other medicines in the nebulizer unless specifically directed.

How to Prepare

Measure the prescribed dose from the 5 mg/mL solution and dilute with sterile 0.9% sodium chloride to a nebulizer fill volume typically 2-4 mL (commonly ~2.5-3 mL); administer immediately and discard any unused prepared solution.

Side Effects

Common Side Effects

Tremor/shakiness, palpitations, tachycardia, headache, muscle cramps; hypokalemia can occur especially with high doses/frequent nebulization.

Side Effect Frequency

Common: tremor, headache, tachycardia/palpitations, muscle cramps; hypokalemia is a known dose-related effect that is typically listed as common/uncommon (not rare), while arrhythmias and paradoxical bronchospasm are rare.

Safety & Warnings

Contraindications

Hypersensitivity to albuterol or any component of the formulation.

Warnings & Precautions

Caution in cardiovascular disease/arrhythmias, hypertension, hyperthyroidism, diabetes, and in patients prone to hypokalemia; monitor potassium in severe asthma/high doses; stop immediately if paradoxical bronchospasm occurs; increasing SABA use signals worsening control and need for controller therapy review (not a substitute for inhaled corticosteroids in persistent asthma).

Age Restriction

No absolute minimum age; nebulised salbutamol can be used in infants and children, with dosing based on age/weight and clinical response under medical supervision (especially in infants).

Drug Interactions

Drug Interactions

Non-selective beta-blockers (e.g., propranolol) antagonize effect/bronchospasm risk; other sympathomimetics add CV effects; diuretics and xanthines (e.g., theophylline) increase hypokalemia risk; digoxin toxicity/arrhythmia risk may increase via hypokalemia; MAOIs/TCAs may potentiate cardiovascular effects.

Interaction Severity

MAJOR: Non-selective beta-blockers (e.g., propranolol) can antagonize bronchodilation and precipitate bronchospasm; MODERATE: Diuretics, systemic corticosteroids, and xanthines (e.g., theophylline) increase hypokalemia risk; TCAs/MAOIs may potentiate cardiovascular effects; digoxin-beta-agonist-induced hypokalemia may increase arrhythmia risk and lower digoxin levels.

Food Interaction

No restriction.

Special Populations

Pregnancy

Caution

Breastfeeding

Caution

Children

Children 2-12 years: Initial 0.1-0.15 mg/kg/dose (approx 1.25-2.5 mg), not to exceed 2.5 mg 3-4 times daily by nebulization; <2 years: 0.2-0.6 mg/kg/day divided every 4-6 hours (use under specialist supervision).

Kidney Impairment

No routine renal dose adjustment for inhaled/nebulised salbutamol; use clinical monitoring in severe renal impairment if high/frequent doses are required.

Liver Impairment

No adjustment needed.

Storage & Patient Advice

Preparation Instructions

Measure the prescribed dose from the 5 mg/mL solution and dilute with sterile 0.9% sodium chloride to a nebulizer fill volume typically 2-4 mL (commonly ~2.5-3 mL); administer immediately and discard any unused prepared solution.

Stopping the Medicine

May be stopped without taper; do not rely on frequent use-seek medical review if needing it more often or if symptoms worsen.

Overdose

Symptoms: tachycardia/palpitations, tremor, agitation, hypokalemia, hyperglycemia, lactic/metabolic acidosis, nausea/vomiting; severe: arrhythmias/ischemia and rarely seizures. Management: stop drug, supportive care, ECG and potassium/glucose monitoring and correction; consider a cardioselective beta-blocker cautiously for severe cardiovascular toxicity.

Patient Counseling

Rescue medicine for quick relief: use only by nebulizer for inhalation as prescribed; measure the dose accurately and dilute with normal saline to the nebulizer’s required volume; do not swallow or inject; if you need it more often than prescribed or it becomes less effective, seek medical review (poor control); expect possible tremor or fast heartbeat-seek urgent care for chest pain, severe palpitations, or worsening breathing; clean the nebulizer as instructed; store below 30°C.

Monitoring Requirements

Monitor symptom relief/need for repeat dosing and lung function (PEF/FEV1) when applicable; during high-dose/frequent nebulization monitor heart rate and blood pressure, and check serum potassium; monitor blood glucose in patients with diabetes or when using high doses.

Pharmacology

Mechanism of Action

Selective short-acting beta-2 adrenergic agonist that activates adenylate cyclase, increases intracellular cAMP, and relaxes bronchial smooth muscle to produce bronchodilation.

Onset of Action

Typically within about 5 minutes (often 3-5 minutes) after inhalation/nebulization, with peak effect around 30-60 minutes.

Duration of Effect

Approximately 3-6 hours.

Half-Life

Elimination half-life 5-6 hours after oral administration; plasma levels peak at 0.5 hours after nebulized dose.

Bioavailability

Systemic bioavailability after inhalation is limited; roughly ~10-20% of the inhaled dose reaches the lungs with the remainder swallowed, and systemic absorption occurs from both pulmonary and gastrointestinal routes (overall systemic exposure is generally low at usual inhaled doses).

Metabolism

Limited hepatic/extrahepatic metabolism mainly by conjugation to an inactive sulfate (salbutamol 4′-O-sulfate).

Excretion

Primarily renal: most of an absorbed dose is excreted in urine within 24 hours as unchanged salbutamol and as the inactive sulfate conjugate (commonly cited ~70% in urine; remainder mainly in feces).

Protein Binding

Low protein binding, about 10%.

Product Information

Available Dosage Forms

Nebuliser solution, metered-dose inhaler, dry powder inhaler, oral syrup, oral tablet, intravenous injection.

Composition per Dose

Each 1ml: 5mg salbutamol (as salbutamol sulfate)

Generic Availability

Yes

OTC Alternatives

No OTC alternative for nebulized salbutamol; this product is prescription-only per SFDA legal status.

Symptom Target

Bronchospasm, wheezing, shortness of breath

Sedating

No

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