Albuterol is a common rescue medication that people with COPD can use as an inhaler or nebulizer. Side effects are usually mild, but rare and serious cardiac side effects can occur.

Albuterol is a medication to treat symptoms of chronic obstructive pulmonary disease (COPD). It comes in an inhaler you take when it’s hard for you to breathe. Your COPD treatment plan should also include other medications for long-term management.

If you use an albuterol inhaler three times a week or more, you may want to speak with a doctor or healthcare professional about gaining better control of the condition.

Brand names for albuterol

Albuterol is also called salbutamol. It has the following brand names:

  • AccuNeb
  • ProAir HFA
  • ProAir RespiClick
  • Proventil HFA
  • Ventolin HFA
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Albuterol is a short-acting beta-agonist (SABA). SABAs work by stimulating the beta-2 adrenergic receptor on the surface of cells. This causes smooth muscles, such as those in your airways, to relax.

Relaxing the smooth muscles in your airways allows them to open up more. So, albuterol works by opening the passages to your lungs so you can breathe more easily.

Albuterol takes effect within a few minutes and can last for several hours. It can help people with COPD get quick control of their symptoms such as wheezing and chest tightness. It’s a “rescue” medication because it brings rapid symptom relief.

Albuterol comes in aerosol or powder form for use with an inhaler. You can also take albuterol through a nebulizer.

A nebulizer allows the medication to more easily reach your lungs. But most people use inhalers because they’re more convenient, portable, and less expensive.

A doctor is more likely to prescribe a nebulizer if you receive treatment for COPD in a hospital setting. But some people with severe COPD may find a nebulizer to be more effective. You may also prefer a nebulizer if you have trouble using an inhaler.

Speak with a doctor to determine which option is best for you.

The procedure for taking albuterol will depend on whether you use an inhaler or nebulizer. The steps to use an inhaler depend on whether you use an aerosol or powder.

You can usually take albuterol every 4 to 6 hours as needed to relieve your COPD symptoms. But it’s important to always follow a doctor’s directions.

Aerosol with inhaler

To take albuterol aerosol with an inhaler:

  1. Remove the dust cap from the mouthpiece.
  2. Ensure you fully insert the canister into the mouthpiece.
  3. Prime the inhaler by shaking it and releasing four pumps into the air.
  4. Shake the inhaler.
  5. Breathe out as much as you can from your mouth.
  6. Close your lips around the mouthpiece with the canister facing up.
  7. Breathe in slowly from the mouthpiece while pressing the canister once.
  8. Remove the inhaler.
  9. Hold your breath for 10 seconds.
  10. Breathe out slowly.

Powder with inhaler

To take albuterol powder with an inhaler:

  1. Hold the inhaler upright.
  2. Load the dose when you’re ready to take it. Open the dust cap at the mouthpiece until it clicks.
  3. Breathe out as much as possible through your mouth.
  4. Close your mouth around the mouthpiece, making a seal with your lips.
  5. Inhale through your mouth, trying to breathe in slowly and taking the inhalation into your lungs.
  6. Remove the inhaler.
  7. Hold your breath for 10 seconds.
  8. Breathe out slowly.
  9. Repeat all steps if you need to take another puff.

Nebulizer

There a several parts to a nebulizer:

  • a medicine cup to hold the liquid medication
  • a mask or mouthpiece to help you breathe in the medication
  • a cap to attach the cup to the mouthpiece
  • an air compressor
  • a plastic tube to connect the mouthpiece to the compressor

To take albuterol with a nebulizer:

  1. Ensure your hands are clean before setting up the nebulizer.
  2. Pour the vial into the medicine cup. Albuterol should appear clear in the vial. Don‘t use it if it appears cloudy or discolored in the vial.
  3. Securely attach the cap to the top of the cup and then connect it to the mask or mouthpiece.
  4. Use the plastic tube to connect the air compressor to the cup.
  5. Place the mask over your face. If you use a mouthpiece, place it in your mouth and keep your lips firmly around it.
  6. Turn on the compressor.
  7. Hold the nebulizer upright to avoid spills.
  8. Breathe regularly through your mouth until the cup is empty. It should take about 5 to 15 minutes. You can stop when you notice that no more mist forming in the nebulizer.
  9. Turn off the compressor when you’re finished.

Be sure to wash the cup and mouthpiece with water after each use.

The most common side effects of albuterol are tremors and nervousness. These occur in about 1 in 5 people who take albuterol. About 1 in 10 people may experience insomnia or nausea.

Less common side effects include:

When to contact a doctor

Contact a doctor if side effects are severe or don’t go away. Get medical assistance immediately if you have any of the following serious side effects:

  • irregular or rapid heart rate
  • pounding heartbeat
  • chest pain
  • rash, hives, or itching
  • swelling of the face, mouth, eyes, hands, feet, ankles, or legs
  • increased breathing difficulties
  • problems swallowing
  • hoarse voice

According to the Food and Drug Administration (FDA), you shouldn’t take albuterol if you’ve had a reaction to it in the past. You may be extra sensitive to albuterol if you experience hives, rashes, or swelling after taking it.

Talk with a doctor or pharmacist if you’re allergic to milk proteins and have a prescription for albuterol powder.

Other medications you take may interact with albuterol. Be sure to discuss all your medications and natural supplements with a doctor, especially:

You may also want to discuss your medical history with a doctor before taking albuterol. Tell a doctor if you have:

Also, talk with a doctor if you’re pregnant or are planning to become pregnant.

The chemical compound albuterol exists in two forms: left-handed and right-handed. The drug albuterol contains an equal mix of both forms. Levalbuterol contains only the right-handed form.

It’s the right-handed form that actually has most of the benefits. Some scientists may consider levalbuterol the “purer” form of the drug. But studies have shown no difference between albuterol and levalbuterol in either effectiveness or side effects.

Levalbuterol is also known as Xopenex HFA. It comes in an aerosol inhaler and solution for nebulization. There’s no powder form of levalbuterol.

DuoNeb is a combination medication. It contains albuterol and ipratropium. These medications are both bronchodilators that help open your airways.

Both are short-acting, but they have different mechanisms. While albuterol is a beta-agonist, ipratropium is an anticholinergic. Beta-agonists relax the airway muscles, and anticholinergics stop them from getting tight.

A doctor might prescribe DuoNeb if your COPD isn’t well-controlled with a single medication. It comes as a spray you use with an inhaler. You’d usually take it four times a day.

How often can you use albuterol for COPD?

The maximum you should use your inhaler is four times in 24 hours.

But if you find yourself using your albuterol rescue inhaler three times a week or more, your COPD may not be under control. You may want to speak to a doctor.

What should I do if I forget a dose of albuterol?

Although you’d normally take albuterol as needed, a doctor may prescribe it for you to take on a schedule. If you take albuterol on a regular schedule and you miss a dose, take the missed dose as soon as you can. If it’s close to the time of the next dose, skip the missed dose. Don’t double up on doses to make up for the missed dose.

Are there alternatives to albuterol to help manage COPD?

A doctor may prescribe a different bronchodilator as a rescue medication if albuterol doesn’t work for you. Levalbuterol is one such option. A combination product, such as DuoNeb, may also be an option.

Your COPD treatment plan should include medications for long-term management as well as for short-term exacerbations.

Albuterol is a medication you take through a rescue inhaler when you experience COPD symptoms. It comes in aerosol or powder form, and you may use it up to four times a day.

Another common form of the drug is levalbuterol. The two drugs work the same, and studies show little difference in their effectiveness or side effects. You might also take albuterol in combination with other medications to help relieve COPD symptoms.

Side effects are usually mild. Let a doctor know if you have heart disease because rare serious cardiac side effects may occur such as a rapid or irregular heart rate.

Albuterol can interact with other medications, so speak with a doctor about any other medications or supplements you take.