Albuterol rapidly dilates air passageways narrowed during asthma attacks. Originally available as Ventolin and later as ProAir and Proventil, generic albuterol remains the 10th most frequently prescribed drug in America. Due to the coronavirus pandemic, supplies of albuterol appear critically low.

Albuterol acts as a short acting bronchodilator with effects noticeable within 510 minutes and peak activity at 45 minutes. Unfortunately benefits fade after only 3 hours. Albuterol when inhaled 1530 minutes prior to physical activity may also prevent bronchospasm often associated with exercise.

Although albuterol continues as the most popular rescue inhaler for asthma, excessive use may accelerate deterioration of lung function. Guidelines regarding albuterol changed in 2019 when the Global Initiative for Asthma urged reliance on inhaled corticosteroids as the mainstay of asthma treatment. SABA – short acting bronchodilators including albuterol – should remain available for acute flares uncontrolled by inhaled steroids.

In the past, overreliance on albuterol provided a false sense of security. Although albuterol treated the symptoms of bronchospasm, relieved cough and improved shortness of breath, it failed to interrupt the underlying disease process. This led to a potentially devastating situation. Inhaled steroids alter the primary pulmonary abnormality.

Especially during the era of coronavirus, asthmatics prescribed albuterol should seek to maintain an adequate supply of the drug. Each canister contains sufficient albuterol for 200 activations.

Side effects typically include tremor, nervousness, headache and dizziness. Albuterol can decrease blood potassium, cause palpitations and in those with heart disease, may precipitate arrhythmias. Beta blockers counteract albuterol and typically should be avoided by asthmatics. Beta blockers treat high blood pressure and control heart rate and atrial fibrillation. Examples include propranolol, metoprolol, atenolol and carvedilol.

The HFA on the label refers to the inactive propellant – hydrofluoroalkane. It replaced the CFCs – chlorofluorocarbons when the Clean Air Act became effective in 2009.