Salbutamol inhalers

Salbutamol inhalers are not suitable for some people. For example, check with your doctor if you have heart problems or diabetes.

Salbutamol comes in an inhaler that you use only when you need it to relieve your symptoms. Follow the instructions that come with your medicine.

Common side effects of salbutamol include feeling shaky, a faster heartbeat and headaches. More serious side effects can happen in rare cases.

It can cause problems to use salbutamol with some other medicines, such as beta blockers, steroids or medicines to reduce build-up of fluid.

Most adults and children of all ages can use salbutamol inhalers.

Most adults can use salbutamol in a nebuliser.

Children and young people aged under 18 years old can use salbutamol in a nebuliser only if it's with advice from a specialist. This is because children who need to use a nebuliser at home should be monitored by a specialist to make sure their condition is not getting worse.

Salbutamol is not suitable for some people. To make sure it's safe for you, check with your doctor before starting to use salbutamol if you have:

• ever had an allergic reaction to salbutamol or any other medicine
• any heart problems
• an overactive thyroid
• low levels of potassium in your blood
• diabetes

The normal way to use your salbutamol inhaler (both adults and children) is 1 or 2 puffs when you need it. You can use it up to a maximum of 4 times in 24 hours, regardless of whether you have 1 puff or 2 puffs at a time.

Salbutamol is sometimes used to prevent breathing symptoms before they start. This could be before a trigger such as exercise or exposure to pets. To prevent symptoms, the normal dose is still 1 or 2 puffs at a time.

If you need to use your inhaler more than 4 times in 24 hours:

• it may mean that your condition is getting worse and that you need different treatment
• you're more likely to get side effects such as an increased heart rate, feeling shaky or nervous, and headaches

You need to use your salbutamol inhaler:

• more than 4 times in 24 hours
• 3 or more days each week
• in the middle of the night at least once a week

In a sudden asthma attack you can use your inhaler more and take up to 10 puffs. Wait 30 to 60 seconds between each puff and always shake the inhaler each time.

For treating severe asthma attacks, salbutamol can be given through a nebuliser. A nebuliser is a machine that delivers the medicine as a mist inhaled through a face mask. This will probably be given to you by your doctor.

More than 1 in 100 people have these side effects after taking 1 or 2 puffs of their salbutamol inhaler. There are things you can do to help cope with them:

See if your asthma or COPD symptoms get better with just 1 puff of your inhaler rather than 2. If you find you need 2 puffs for symptom relief, be reassured that the shakiness will wear off after a short time.

Make sure you're not taking more than the prescribed dose. If you get a faster heartbeat regularly, talk to your doctor or nurse as you may need your treatment reviewed so that you do not need to use your salbutamol as often.

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if the headaches do not go away or are severe.

These side effects should gradually improve as your body gets used to salbutamol. Speak to a doctor if the advice on how to cope does not help and a side effect still bothers you or does not go away.

Salbutamol can be used in pregnancy. It's important that your asthma is well treated, so do not hesitate to use your inhaler if you need it.

If you have asthma, your doctor will recommend that you continue to use your salbutamol inhaler. They will be able to give you advice on how to manage your asthma during pregnancy.

If your asthma gets worse, let your midwife or doctor know, as your treatment may need to be increased.

It's OK to use your salbutamol inhaler as normal while you're breastfeeding.

It's important that you continue to treat your asthma to keep you well. Breastfeeding will also benefit both you and your baby.

It's not known how much salbutamol gets into breast milk, but it's likely to be very low levels. For many years it has been widely used while breastfeeding without causing any side effects in breastfed babies.

It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicines while breastfeeding.

Contact your healthcare professional or call 111 as soon as possible if your baby is not feeding as well as usual.

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

Carry on taking the medicine and keep breastfeeding as usual until you've got advice about your baby's symptoms.

Salbutamol inhalers can be used with most other medicines. But some medicines may affect your inhaler or increase the chance of having side effects.

Check with a pharmacist or your doctor if you're taking any other medicines, including:

• a beta blocker like bisoprolol, as these can affect the way salbutamol works – your doctor will decide whether the benefits of taking both medicines outweigh the risks
• medicines to reduce build-up of fluid (diuretics), such as bendroflumethiazide or furosemide, as these may increase the risk of a low potassium level
• steroids, such as prednisolone, as these may increase the risk of a low potassium level
• other medicines to treat your breathing problem, such as theophylline or aminophylline, as these may increase the risk of a low potassium level
• medicines to treat depression

These are not all the medicines that may cause problems if you take them with salbutamol. For a full list, see the leaflet inside your medicine packet.