AccuNeb

Generic name: Albuterol sulfate
Brand names: VoSpire Extended-Release Tablets, Volmax Extended-Release Tablets, Ventolin HFA, Proventil HFA, AccuNeb, Proventil

Why is AccuNeb prescribed?

Drugs containing albuterol are prescribed for the prevention and relief of bronchial spasms that narrow the airway. This especially applies to the treatment of asthma. Some brands of AccuNeb are also used for the prevention of bronchial spasm due to exercise.

Most important fact about AccuNeb

Do not take albuterol more frequently than your doctor recommends. Increasing the number of doses can be dangerous and may actually make symptoms of asthma worse.

If the dose your doctor recommends does not provide relief of your symptoms, or if your symptoms become worse, consult your doctor immediately.

How should you take AccuNeb?

If you are taking extended-release tablets, swallow them whole with some liquid--never chew or crush them.

Shake the inhalation aerosol canister well before using and make sure it's firmly seated in the plastic mouthpiece. Before using it for the first time, prime the canister with 4 sprays into the air away from your face. Prime it with 2 sprays whenever it has not been used for at least 4 days. Use only the adapter that comes with the product; do not use this adapter with any other product. Wash the plastic mouthpiece with warm running water at least once a week to prevent medication buildup and blockage.

If you are using an inhalation solution, be sure to protect it from contamination. Keep the tip of the dropper away from the lip of the bottle or any other surface. Do not use the solution if it changes color or becomes cloudy.

--If you miss a dose...

Take the forgotten dose as soon as you remember; then take any remaining doses for that day at equally spaced intervals. Never take a double dose.

--Storage instructions...

AccuNeb, Proventil syrup, and Proventil solution for inhalation can be kept in the refrigerator or at room temperature. Proventil aerosol can be stored at temperatures as low as 60 degrees Fahrenheit, but should be at room temperature before use. Protect from excessive heat.

Ventolin nebules must be used within 2 weeks of being removed from the refrigerator.

Store VoSpire tablets at room temperature in a tight, light-resistant container.

Volmax tablets should be kept refrigerated.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking albuterol.

More common side effects may include:
Aggression, agitation, allergic reaction, anxiety, back pain, chest pain or discomfort, chills and fever, coordination problems, cough, decreased appetite, depression, difficulty speaking, diabetes, diarrhea, dizziness, drowsiness, dry mouth and throat, excitement, fluid retention and swelling, flushing, general bodily discomfort, headache, heart palpitations, heartburn, hives, increased appetite, increased blood pressure, increased difficulty breathing, indigestion, irritability, labored breathing, leg cramps, light-headedness, muscle cramps, muscle spasm, nasal inflammation, nausea, nervousness, nightmares, nosebleed, overactivity, rapid heartbeat, rash, respiratory infection or disorder, restlessness, ringing in the ears, shakiness, sleeplessness, slowed movement, stomachache, stuffy nose, sweating, swelling of mouth and throat, taste sensation on inhalation, throat irritation, tooth discoloration, tremors, unusual taste, urinary problems, vomiting, weakness, wheezing

Why should AccuNeb not be prescribed?

If you are sensitive to or have ever had an allergic reaction to albuterol or other bronchodilators, you should not take AccuNeb. Make sure that your doctor is aware of any drug reactions that you have experienced.

Special warnings about AccuNeb

When taking albuterol inhalation aerosol, you should not use other inhaled medications before checking with your doctor.

Make sure the doctor is aware of it if you have a heart condition, seizure disorder, high blood pressure, abnormal heartbeat, overactive thyroid gland, or diabetes. Call your doctor immediately if you notice any change in heartbeat or pulse while taking AccuNeb.

You may have an immediate, serious allergic reaction to the first dose of albuterol, causing symptoms such as hives, rash, and swelling of the mouth, throat, lips, and tongue. The drug has been known to cause life-threatening bronchial spasms, especially with the first dose from a new canister or vial. There have also been rare reports of skin reddening and peeling in children taking albuterol syrup.

Do not exceed your doctor's recommended dose of albuterol. If you need more than usual, check with your doctor. Your asthma may be getting unstable, and you may need another medication. Do not, however, change your medication without first consulting your doctor or pharmacist.

Possible food and drug interactions when taking AccuNeb

Use albuterol inhalation aerosol with other aerosol bronchodilators only if your doctor recommends it.

If albuterol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining albuterol with the following:

Antidepressants classified as MAO inhibitors, such as Nardil and Parnate, and tricyclic antidepressants such as Elavil, Norpramin, Pamelor, and Tofranil.
Beta blockers (heart and blood pressure drugs such as Inderal, Tenormin, and Sectral)
Digoxin (Lanoxin)
Drugs similar to albuterol, such as Alupent, Brethine, Isuprel, and epinephrine
Drugs that lower potassium levels (water pills such as Lasix or HydroDIURIL)

Special information if you are pregnant or breastfeeding

The effects of albuterol during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known whether albuterol appears in breast milk. If AccuNeb is essential to your health, your doctor may advise you to stop nursing your baby until your treatment is finished.

Recommended dosage

ADULTS

Inhalation Aerosol

If you are being treated for a sudden or severe bronchial spasm or the prevention of asthma symptoms, the usual dosage of albuterol inhalation aerosol is 2 inhalations repeated every 4 to 6 hours. More frequent use is not recommended. In some individuals, 1 inhalation every 4 hours may be sufficient.

To prevent exercise-induced bronchial spasm, the usual dosage is 2 inhalations, 15 minutes prior to exercise.

Tablets

The usual starting dose for adults and children 12 years of age and older is 2 or 4 milligrams 3 to 4 times a day. Dosage should not exceed 32 milligrams per day.

Syrup

The usual starting dose for adults and children over 12 years of age is 1 or 2 teaspoonfuls 3 or 4 times a day. Dosage should not exceed 4 teaspoonfuls 4 times a day.

Proventil Inhalation Solution

The usual dosage for adults and children 12 years of age and older is 2.5 milligrams administered 3 to 4 times daily by nebulization. Do not use more often or in higher doses. To administer 2.5 milligrams, use the entire contents of a unit-dose bottle of the 0.083% solution or dilute 0.5 milliliter of the 0.5 percent solution with 2.5 milliliters of sterile normal saline solution.

Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets

The usual recommended dosage for adults and children 12 years of age and older is 8 milligrams every 12 hours. In some people, 4 milligrams every 12 hours may be sufficient. If the desired effect is not achieved with the standard dosage, your doctor may increase doses to a maximum of 32 milligrams per day, divided into two 16-milligram doses spaced 12 hours apart. Those taking standard tablets or syrup can switch to extended-release tablets. One extended-release tablet every 12 hours is equivalent to one 2-milligram standard tablet every 6 hours.

CHILDREN

Inhalation Aerosol

The usual dose of albuterol inhalation aerosol for children aged 4 and over (12 and over for Proventil) is 2 inhalations every 4 to 6 hours. To prevent exercise-induced bronchial spasm, the dose is 2 inhalations 15 minutes prior to exercise.

Tablets

The usual starting dose for children 6 to 12 years of age is 2 milligrams 3 or 4 times a day. The dose can be increased with caution but should not exceed 24 milligrams per day. Safety and effectiveness in children under 6 have not been established.

Syrup

The usual starting dose for children 6 to 12 years of age is 1 teaspoonful 3 to 4 times a day. The dosage should not exceed 3 teaspoonfuls 4 times a day. For children 2 to 6 years of age, the starting dose is 0.1 milligram per 2.2 pounds of body weight, to a maximum of 4 milligrams, 3 times a day.

Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets

The usual starting dosage for children 6 to 12 years of age is 4 milligrams every 12 hours. The dosage can be increased with caution but should not exceed 24 milligrams per day.

AccuNeb Inhalation Solution

The usual starting dose for children 2 to 12 years of age is 0.63 or 1.25 milligrams 3 or 4 time daily by nebulization. To administer, use the entire contents of the prescribed unit-dose vial. The 1.25 milligram dosage may be more helpful for children 6 to 12 with more severe asthma, and for children 11 to 12.

OLDER ADULTS

Oral Dosage

The usual starting dose of tablets or syrup is 2 milligrams 3 or 4 times a day. If needed, the dosage may be increased gradually to as much as 8 milligrams 3 or 4 times a day.

Overdosage

Symptoms of albuterol overdose may include:
Dizziness, dry mouth, fatigue, general feeling of illness, headache, high or low blood pressure, insomnia, nausea, nervousness, radiating chest pain, rapid or irregular heartbeat, seizures, tremors

Heart attack and even death have been associated with abuse of albuterol inhalation. Exaggerated side effects may also be a sign of an overdose. If you suspect an overdose, seek medical attention immediately.