VENTOLIN 100/MCG EVOHALER 200/DOSES

Indications

Approved Uses

Relief and prevention of bronchospasm in reversible obstructive airway disease (e.g., asthma) and in COPD; prevention of exercise-induced bronchospasm.

Dosage & Administration

Dosing by Condition

Acute bronchospasm/symptom relief (adults and adolescents): 1-2 puffs (100-200 mcg) as needed, typically every 4-6 hours; do not exceed label/clinician-directed maximum. Exercise-induced bronchospasm: 2 puffs (200 mcg) 15-30 minutes before exercise. COPD symptom relief: 1-2 puffs as needed up to 4 times daily (or per clinician).

Initial Dose

1-2 puffs (100-200 mcg) as needed for symptoms.

How to Take

Shake well before each puff. Remove cap. Breathe out gently away from the inhaler. Place mouthpiece between lips and seal. Start to breathe in slowly and press the canister once; continue slow deep inhalation. Hold breath ~10 seconds (or as long as comfortable), then breathe out slowly. If a second puff is needed, wait ~30-60 seconds, shake again, and repeat. Use a spacer if coordination is difficult; prime and clean per manufacturer instructions.

Side Effects

Common Side Effects

Tremor, headache, palpitations/tachycardia, nervousness, muscle cramps; hypokalemia can occur especially with high doses or interacting drugs.

Safety & Warnings

Contraindications

Contraindication: hypersensitivity to salbutamol (albuterol) or any excipients in the inhaler.

Age Restriction

Approved for relief of bronchospasm in adults and children; in practice, pMDI salbutamol 100 micrograms is commonly used from ≥4 years (with spacer), and use in children <4 years should be under physician supervision with age-appropriate delivery (spacer with mask).

Drug Interactions

Drug Interactions

Key interactions: non-selective beta-blockers (reduce bronchodilation/trigger bronchospasm); other sympathomimetics (additive CV effects); MAOIs/TCAs (potentiate CV effects); hypokalemia risk increased with diuretics, systemic corticosteroids, and xanthines; digoxin levels may decrease and arrhythmia risk may increase with hypokalemia.

Special Populations

Pregnancy

Category C

Breastfeeding

Safe

Liver Impairment

No adjustment needed.

Storage & Patient Advice

Missed Dose

If used as needed (usual for Ventolin), there is generally no missed dose; if prescribed on a regular schedule, take when remembered unless close to the next dose-do not double.

Patient Counseling

This is a quick-relief (rescue) inhaler for wheeze/shortness of breath. Use correct pMDI technique (shake, slow inhale with actuation, hold breath; spacer if needed). Seek medical review if needing it more than ~2 days/week (or increasing use), if poor response after recommended doses, or if symptoms worsen. Do not exceed prescribed maximum; report chest pain, significant palpitations, or tremor. Store below 30°C and protect from heat/sun; keep mouthpiece clean per instructions.

Pharmacology

Mechanism of Action

Selective beta2-adrenergic agonist that increases intracellular cAMP in airway smooth muscle, causing relaxation and bronchodilation.

Onset of Action

Typically within ~5 minutes (often 3-5 minutes), with peak effect around 30-60 minutes.

Duration of Effect

4-6 hours.

Bioavailability

After inhalation, only a minority of the metered dose reaches the lower airways (commonly ~10-20%); the remainder is deposited in the oropharynx and swallowed, so systemic exposure is generally low but can increase with high doses/frequent use.

Excretion

Primarily renal: most of the systemically absorbed salbutamol is excreted in urine as unchanged drug and as the sulfate conjugate; a smaller fraction is excreted in feces.

Protein Binding

Low protein binding, about 10%.

Product Information

Available Dosage Forms

Pressurised inhalation, solution (metered-dose inhaler/Evohaler).

Composition per Dose

Each actuation: 100 mcg salbutamol (as salbutamol sulfate)

Generic Availability

Yes

OTC Alternatives

No OTC alternative.

Symptom Target

Wheezing, Shortness of Breath, Cough

Sedating

No

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