Albuterol Inhalers (Generic Ventolin & ProAir)

What is an albuterol inhaler?

An albuterol inhaler is a rescue, or reliever, inhaler. Albuterol (salbutamol) relaxes the tightened muscle around the airways, easing wheeze, cough, chest tightness and breathlessness from asthma or chronic obstructive pulmonary disease (COPD). In the US label's adult and teen studies, people who responded began to improve about 5 minutes after a dose on average, and the effect lasted about 4 hours (Ventolin HFA label on DailyMed).

US brands include Ventolin HFA and ProAir HFA. Asthalin (Cipla), Ventorlin (GlaxoSmithKline Pharmaceuticals, India) and Bonair (MidasCare Pharma) contain the same active ingredient and are made and licensed in India.

Is a 100 mcg inhaler the same as a 90 mcg inhaler?

In practice, yes: the numbers describe a similar puff measured at different points. The Ventolin HFA label states that each puff leaves the valve as 120 mcg of albuterol sulfate and delivers 108 mcg of albuterol sulfate, equal to 90 mcg of albuterol base, from the mouthpiece. ProAir HFA uses the same 90 mcg labeling.

Inhalers sold in India and the UK are named by the metered dose of albuterol base, 100 mcg, which is what 120 mcg of the sulfate salt works out to. So a 100 mcg Asthalin or Ventorlin puff is a close equivalent of a 90 mcg Ventolin HFA puff, and the number of puffs prescribed is normally the same. Confirm your dose with your doctor if you switch.

Which albuterol products are available here?

Rotacaps need a Rotahaler Inhalation Device (from $4), and respules need a nebulizer. Prices can change. Delivery to the USA takes about 6–15 days, so reorder before your last inhaler runs out.

How do you choose a device?

• Aerosol inhaler (Asthalin, Ventorlin, Bonair): the closest match to Ventolin HFA and ProAir HFA. A spacer helps children and anyone who struggles to press and breathe in at the same time.
• Asthalin Rotacaps: a powder capsule placed in a Rotahaler and breathed in quickly and deeply. It needs a strong breath, which can be hard for young children or during a bad flare. The powder is usually mixed with lactose, so check the leaflet if you have a milk-protein allergy.
• Asthalin Respules: a 2.5 mg dose breathed in as a mist from a nebulizer over several minutes, for people who cannot use a handheld inhaler. Use only as prescribed.
• Asthalin tablets: slower to act than inhaled albuterol (see below).

Some people are prescribed levalbuterol (levosalbutamol) instead, available as Levolin Inhaler. For an overview of relievers and preventers, see our guide to types of asthma inhalers.

How do you use an albuterol inhaler?

The US label dose for adults and children aged 4 and older is 2 puffs every 4 to 6 hours when needed; for some people 1 puff every 4 hours is enough. Before exercise: 2 puffs 15 to 30 minutes beforehand. Do not take more puffs, or take them more often, than prescribed.

1. Remove the cap and shake the inhaler.
2. Prime it when new, after a drop or after more than 2 weeks unused by spraying into the air (the Ventolin HFA label says 4 sprays; follow your own leaflet).
3. Breathe out, seal your lips around the mouthpiece and press the canister as you start a slow, deep breath in.
4. Hold your breath for about 10 seconds, then breathe out slowly. Shake again before any second puff.

At least weekly, remove the canister, rinse the plastic actuator under warm water and let it air-dry overnight (Ventolin HFA instructions; follow your leaflet). Without a dose counter, keep a tally of puffs.

How are albuterol tablets taken?

For adults and teenagers over 12, the US label starts at 2 or 4 mg three or four times a day, up to 32 mg a day. Children aged 6 to 12 start at 2 mg three or four times a day, up to 24 mg a day. Tablets start working within about 30 minutes and peak after 2 to 3 hours, so they do not suit sudden symptoms.

When does reliever use mean your asthma is not well controlled?

The NHS advises contacting your doctor, nurse or pharmacist if you need your reliever on 3 or more days a week, more than 4 times in 24 hours, or at night at least once a week (NHS salbutamol inhaler advice). The Ventolin HFA label also warns that needing more doses than usual can signal worsening asthma.

Reliever-only treatment is no longer advised. Since 2019, the Global Initiative for Asthma (GINA) has recommended against it for adults and adolescents, because short-acting relievers have no anti-inflammatory effect and do not prevent severe attacks; using 3 or more canisters a year has been linked with a higher risk of attacks (review of the GINA changes on PMC). If you use albuterol often, ask your doctor about a preventer such as Foracort Inhaler 200 mcg, or browse our asthma category.

During an attack, the NHS advises 1 puff every 30 to 60 seconds, up to 10 puffs, and calling emergency services (911 in the US) if you do not feel better after 10 puffs or feel worse at any time.

What are the side effects of albuterol?

Common effects include shaky hands, nervousness, headache, a fast or pounding heartbeat and muscle cramps; throat irritation was the most frequent reaction in US inhaler trials. Tablets cause these effects more often, with nervousness and tremor each reported by about 1 in 5 people (albuterol tablets label on DailyMed).

Get urgent help if wheezing suddenly worsens right after a dose (paradoxical bronchospasm), or if you have hives, facial or throat swelling, chest pain or an irregular heartbeat. Repeated high doses can lower blood potassium.

Who should not use albuterol?

Do not use it if you are allergic to albuterol or any ingredient in the product. Tell your doctor if you are pregnant or breastfeeding, or have heart disease, an irregular heartbeat, high blood pressure, an overactive thyroid, diabetes or seizures.

Beta-blockers can block albuterol's effect and may trigger severe bronchospasm. Extra care is needed with non-potassium-sparing water pills (diuretics), digoxin, and monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants, including within 2 weeks of stopping them.

Frequently asked questions

Is Asthalin the same as Ventolin?

It has the same active ingredient at 100 mcg per metered puff, matching Ventolin inhalers sold outside the US, and it is made by Cipla and licensed in India. Read our Asthalin vs Ventolin comparison.

How many puffs are in an albuterol inhaler?

Asthalin, Ventorlin and Bonair each hold 200 puffs, like a full-size Ventolin HFA or ProAir HFA. If you get through one quickly, tell your doctor.

Can children use an albuterol inhaler?

The US inhaler label covers children from age 4, and young children usually need a spacer, sometimes with a mask. Follow the dose their doctor sets.

Does albuterol help COPD?

It is often prescribed for breathlessness in COPD, usually with maintenance inhalers; the US label covers bronchospasm in reversible obstructive airway disease. See our COPD category.

This article gives general information and does not replace advice from your doctor or pharmacist. Albuterol is a prescription medicine; use it under a doctor's care. During a severe attack, call 911.