Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Levomethadyl: (Severe) Levomethadyl is associated with an established risk of QT prolongation and/or torsade de pointes, particularly at high drug concentrations. Acrivastine; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. The global Albuterol Sulfate Metered Dose Inhalers market is valued at million US$ in 2019 and will reach million US$ by the end of 2027, growing at a CAGR of during 2020-2027. Case reports indicate that QT prolongation and torsade de pointes (TdP) can occur during donepezil therapy. The concomitant use of dronedarone with other drugs that prolong the QTc may induce Torsade de Pointes (TdP) and is contraindicated. Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Closely monitor patients with known risk factors for cardiac disease or arrhythmias during coadministration. Desipramine: (Minor) Tricyclic antidepressants (TCAs) share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations). Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. Dextromethorphan; Guaifenesin; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Clomipramine: (Minor) Tricyclic antidepressants (TCAs) share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations). Carbinoxamine; Dextromethorphan; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. Chlophedianol; Dexchlorpheniramine; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Guaifenesin; Hydrocodone; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Weigh the risks of co-use, and where possible, allow a washout period after discontinuation of the MAOI before instituring beta-agonist treatment or vice-versa. Hold panobinostat if the QTcF increases to >= 480 milliseconds during therapy; permanently discontinue if QT prolongation does not resolve. For patients weighing at least 15 kg, the 0.083% solution may be used at a dose of 2.5 mg via oral inhalation 3 to 4 times daily as needed. Degarelix: (Minor) Consider whether the benefits of androgen deprivation therapy outweigh the potential risks in patients receiving short-acting beta-agonists as concurrent use may increase the risk of QT prolongation. Children younger than 2 years of age—Use and … Brompheniramine; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Beta-agonists should be administered with extreme caution to patients being treated with drugs known to prolong the QT interval because the action of beta-agonists on the cardiovascular system may be potentiated. In mature rats the subcutaneous (sc) median lethal dose of albuterol sulfate is approximately 450 mg/kg (approximately 110 times the maximum recommended daily oral dose for adults and … Carbetapentane; Guaifenesin; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Anagrelide: (Minor) Beta-agonists should be used cautiously and with close monitoring with anagrelide. Ephedrine: (Major) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. The patient will breathe out through the mouth and push as much air from the lungs as the patient can. Dofetilide: (Minor) Coadministration of dofetilide and short-acting beta-agonists may increase the risk of QT prolongation. Pharmacokinetics In a single-dose bioavailability study which enrolled six healthy, male volunteers, transient low albuterol levels (close to the lower limit of quantitation) were observed after administration of two puffs from both Albuterol Sulfate Inhalation Aerosol and a CFC 11/12 propelled albuterol inhaler. Ivosidenib: (Minor) Coadministration of ivosidenib with short-acting beta-agonists may increase the risk of QT prolongation. Amphetamine; Dextroamphetamine Salts: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Beta agonists infrequently produce cardiovascular adverse effects, mostly with high doses or in the setting of beta-agonist-induced hypokalemia. Sevoflurane: (Minor) Sevoflurane, like other halogenated anesthetics, can prolong the QT interval. The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long-term care facilities (LTCFs). Initially, 2 to 4 mg PO 3 to 4 times per day. This drug is available at a higher level co-pay. Thioridazine: (Severe) Thioridazine is associated with a well-established risk of QT prolongation and torsades de pointes (TdP). Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Concomitant use of salmeterol and lopinavir; ritonavir is not recommended as increased concentrations of salmeterol may occur via inhibition of CYP3A4, which might increase the risk for cardiac adverse reactions, like increased heart rate. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. This risk may be more clinically significant with long-acting beta-agonists than with short-acting beta-agonists. Therefore, the manufacturer recommends avoiding trazodone in patients receiving other drugs that increase the QT interval. 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate) Powder metered-dose albuterol inhaler. Agents associated with a low, but possible risk for QT prolongation and TdP based on varying levels of documentation include the beta-agonists. Lenvatinib: (Minor) Beta-agonists should be used cautiously and with close monitoring with lenvatinib. QT prolongation has occurred with pasireotide at therapeutic and supra-therapeutic doses. FDA recommends the following in vitro and in vivo studies to establish bioequivalence (BE) of the test (T) and reference (R) dry powder inhalers (DPIs) containing albuterol sulfate. Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Tranylcypromine: (Major) Beta-agonists should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors (MAOIs) due to their sympathomimetic effects. Frequency of administration has not been clearly defined in the neonatal population; albuterol administration is recommended every 1 to 4 hours as needed in other pediatric populations. Beta agonists infrequently produce cardiovascular adverse effects, mostly with high doses or in the setting of beta-agonist-induced hypokalemia. Higher maximum dosages for inhalation products have been recommended in NAEPP guidelines for acute exacerbations of asthma. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. (Minor) Use fluoxetine with caution in combination with short-acting beta-agonists. -If a previously effecti… NOTE: Do not use the device with a spacer or volume holding chamber. [31823] [43674] [44010] [49951] [59350] [64470]. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. No significant differences in FEV-1 have been demonstrated between metered-dose inhalers (with or without a spacer) and nebulizers among short-acting bronchodilators in clinical trials; nebulizers may be more convenient for patients that are more acutely ill.[63765]. Beta-agonists should be administered with caution to patients being treated with drugs known to prolong the QT interval because the action of beta-agonists on the cardiovascular system may be potentiated. Max: 32 mg/day PO. Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. For acute asthma exacerbations, the NAEPP recommends 0.15 mg/kg/dose (Min: 2.5 mg/dose) via oral inhalation every 20 minutes for 3 doses, then 0.15 to 0.3 mg/kg/dose (Max: 10 mg/dose) every 1 to 4 hours as needed or 0.5 mg/kg/hour by continuous nebulization. Albuterol belongs to a class of drugs known as bronchodilators. Sensitive patients might experience tremor, sleep difficulties, or mild increases in heart rate. Although not confirmed during clinical trials, the S-isomer of albuterol has bronchoconstrictive properties in animal models.Intracellularly, the actions of albuterol are mediated by cyclic AMP, the production of which is augmented by beta2-stimulation. Chlorpheniramine; Dihydrocodeine; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Administer using a calibrated measuring device. Prime the inhaler before the first use by spraying four times into the air, away from the eyes and face. For those who use a short-acting beta-agonist on a daily basis, a controller agent (e.g., inhaled corticosteroid, leukotriene receptor antagonist) should be considered if albuterol tolerance develops. Albuterol Sulfate may also be used to treat other conditions as determined by your Veterinarian. Monitor the patients lung and cardiovascular status closely. Ondansetron: (Minor) Ondansetron has been associated with QT prolongation and post-marketing reports of torsade de pointes (TdP). FDA-approved labeling recommends to not exceed 4 doses/day. The manufacturer recommends avoiding concurrent use of tetrabenazine with other drugs known to prolong QTc, such as beta-agonists. Caffeine is a CNS-stimulant and beta-agonists are sympathomimetic agents. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with TCAs include the beta-agonists. The action of beta-agonists on the cardiovascular system may be potentiated by a halogenated anesthetic. Thiazide diuretics: (Minor) Hypokalemia associated with thiazide diuretics can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. Published reports describe a wide range of effective doses; 0.2 to 5 mg/dose and 0.02 to 0.2 mg/kg/dose administered every 4 to 8 hours have been reported to improve pulmonary compliance and/or resistance in ventilator-dependent neonates. The combined use of these agents may have the potential for additive adrenergic stimulation and side effects, such as nervousness, insomnia, palpitations, or adverse cardiovascular effects. provider for the most current information. Beta-agonists may cause adverse cardiovascular effects such as QT prolongation, usually at higher doses and/or when associated with hypokalemia. Lofexidine: (Minor) Monitor ECG if lofexidine is coadministered with short-acting beta-agonists due to the potential for additive QT prolongation. Doxepin: (Minor) Tricyclic antidepressants (TCAs) share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations). commonly, these are "non-preferred" brand drugs or specialty Isoproterenol: (Major) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Androgen deprivation therapy may prolong the QT/QTc interval. Ceritinib causes concentration-dependent prolongation of the QT interval. Deutetrabenazine: (Minor) For patients taking a deutetrabenazine dosage more than 24 mg/day with a short-acting beta-agonist, assess the QTc interval before and after increasing the dosage of either medication. Chloroquine: (Minor) Beta-agonists should be used cautiously and with close monitoring with chloroquine. [59350] [64470] Inhalation solution for nebulizationFor a 2.5 mg dose of albuterol, dilute 0.5 mL of a 0.5% solution for nebulization to a final volume of 3 mL with 0.9% Sodium Chloride Solution or use 3 mL of the commercially available 0.083% solution for nebulization. Ketoconazole has been associated with prolongation of the QT interval. Close observation for such effects is prudent, particularly if beta-agonists are administered within 2 weeks of stopping the MAOI. 1413366-overview Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Specific guidelines for dosage adjustments in renal impairment are not available. Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. Dosing is not available for this age group; however, 0.1 to 0.2 mg/kg/dose PO every 8 hours has been used in neonates and young children. After oral inhalation, 80% to 100% of a dose is excreted via the kidneys within 72 hours; up to 10% may be eliminated in feces.[31823][49951][59350]. Beta2 receptor agonist with some beta1 activity; relaxes bronchial smooth muscle with little effect on heart rate, Onset: 25 min (Ventolin HFA); 0.5-2 hr (nebulization); 2-3 hr (PO), Peak plasma time: Inhalation, 2-5 hr; PO, 2-2.5 hr, Half-life: 3-8 hr (inhalation); 3.7-5 hr (PO), Extended-release tablets: Do not chew, crush, or mix with food. Brompheniramine; Hydrocodone; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Codeine; Phenylephrine; Promethazine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. In December 2001, the FDA issued a black box warning regarding the use of droperidol and its association with QT prolongation and potential for cardiac arrhythmias based on post-marketing surveillance data. GINA recommends transfer to an acute care setting if there is no response to inhaled SABA within 1 to 2 hours or if more than 6 puffs are required during the first 2 hours; if more than 10 puffs are required in 3 to 4 hours, hospital admission is recommended. The elimination half-life of albuterol ranges from 2.7 to 6 hours, with orally administered albuterol having a shorter half-life than the inhaled product. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Higher maximum dosages for inhalation products have been recommended in NAEPP guidelines for acute exacerbations of asthma.1 year: Safety and efficacy have not been established; nebulizer inhalation maximum dependent on patient response and formulation used. (Minor) Tricyclic antidepressants (TCAs) share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations).