Pharmacodynamics and pharmacokinetics
The drug is used to prevent bronchospasms . It is a bronchodilator, or more precisely, a selective beta-2-adrenergic agonist . It increases the vital capacity of the lungs and mucociliary clearance , activates the ciliated epithelium, improves mucus secretion, dilates the coronary arteries, reduces potassium content, acts as a hyperglycemic and lipolytic agent, affects glycogenolysis and insulin secretion, and increases the risk of acidosis .
The medicine acts quite quickly, almost 5 minutes after application (maximum - after 30-90 minutes). The duration of the effect is about 5 hours.
10-20% of salbutamol after use ends up in the lower respiratory tract. They are absorbed into the lung tissue and blood, but are not broken down. The remaining amount of the active substance is retained in the inhaler or in the oropharynx, after which it is swallowed and actively broken down when passing through the liver and is converted into phenolic sulfate .
The degree of binding to plasma proteins is approximately 10%.
Salbutamol entering the blood is broken down within 72 hours in the liver and is excreted mainly in the urine in the form of phenolic sulfate or unchanged. A small part is excreted in the feces.
Ventolin aerosol d/ing doses 100mcg/dose 200DOSES 10ml
Compound
Excipients: propellant (1,1,1,2-tetrafluoroethane) - up to 75 mg in 1 dose (up to 18 g in 1 inhaler). 1 to ensure a yield of 200 doses when using an inhaler, each inhaler contains an amount of suspension equivalent to 240 doses; 2, depending on the equipment used in the production of the drug, up to 10% excess of the active substance may be included in the production formula; 3 120.5 mcg salbutamol sulfate (micronized, humidified) is equivalent to 100 mcg salbutamol.
Pharmacokinetics
Suction
After inhalation administration, 10-20% of the dose of salbutamol reaches the lower respiratory tract. The rest of the dose remains in the inhaler or is deposited in the oropharynx and is then swallowed. The fraction deposited in the respiratory tract is absorbed into the lung tissue and blood, but is not metabolized in the lungs.
Distribution
The binding of salbutamol to plasma proteins is 10%.
Metabolism
When it enters the systemic circulation, salbutamol undergoes hepatic metabolism and is excreted primarily by the kidneys unchanged or in the form of phenolic sulfate. The ingested portion of the inhalation dose is absorbed from the gastrointestinal tract and undergoes significant first-pass metabolism through the liver to phenolic sulfate. Unchanged salbutamol and the conjugate are excreted primarily by the kidneys.
Removal
Salbutamol administered intravenously has a T1/2 of 4-6 hours. It is excreted partly by the kidneys and partly as a result of metabolism to inactive 4′-O-sulfate (phenolic sulfate), which is also excreted primarily by the kidneys. Only a small part of the administered dose of salbutamol is excreted through the intestines. Most of the dose of salbutamol administered intravenously, orally or by inhalation is excreted within 72 hours.
Indications for use
Bronchial asthma:
- relief of symptoms of bronchial asthma when they occur;
- prevention of bronchospasm attacks associated with exposure to an allergen or caused by physical activity;
- use as one of the components in long-term maintenance therapy of bronchial asthma.
Other chronic lung diseases accompanied by reversible airway obstruction, including COPD, chronic bronchitis, emphysema.
Bronchodilators should not be the only or main component of the treatment of unstable or severe bronchial asthma. In the absence of a response to salbutamol in patients with severe bronchial asthma, it is recommended to treat with GCS in order to achieve and maintain control of the disease. Failure to respond to salbutamol therapy may indicate the need for urgent medical consultation or treatment.
Contraindications
- management of preterm birth;
- threatened abortion;
- hypersensitivity to the components of the drug or any other component included in the drug.
Carefully
Salbutamol should be used in patients with thyrotoxicosis, tachyarrhythmia, myocarditis, heart defects, aortic stenosis, coronary artery disease, severe chronic heart failure, arterial hypertension, pheochromocytoma, decompensated diabetes mellitus, glaucoma.
Directions for use and doses
The drug Ventolin is intended for inhalation administration only.
An increased need for the use of beta2-adrenergic receptor agonists may be a sign of worsening bronchial asthma. In such a situation, it may be necessary to re-evaluate the patient's treatment regimen and consider the advisability of prescribing concomitant therapy with a glucocorticosteroid.
Since an overdose may be accompanied by the development of adverse events, the dose or frequency of use of the drug can be increased only on the recommendation of a doctor.
The duration of action of salbutamol in most patients is from 4 to 6 hours.
For patients who have difficulty synchronizing inhalation with a pressurized metered-dose inhaler, a spacer may be used.
In children and infants receiving Ventolin, it is advisable to use a pediatric spacer device with a face mask.
Relieving an attack of bronchospasm
- Adults
The recommended dose is 100 or 200 mcg.
- Children
100 mcg, if necessary, the dose can be increased to 200 mcg.
It is not recommended to use the Ventolin inhaler more than four times a day. The need for frequent use of maximum doses of Ventolin or a sudden increase in dose indicates a worsening of the course of AS).
Prevention of bronchospasm attacks associated with exposure to an allergen or caused by exercise
- Adults
200 mcg 10-15 minutes before exposure to a provoking factor or load.
- Children
100 mcg 10-15 minutes before exposure to a provoking factor or load; if necessary, the dose can be increased to 200 mcg.
Long-term maintenance therapy
- Adults
Up to 200 mcg 4 times a day.
- Children
Up to 200 mcg 4 times a day.
INSTRUCTIONS FOR USE OF THE INHALER
Checking the inhaler
Before using the inhaler for the first time, or if the inhaler has not been used for 5 days or more, remove the cap from the mouthpiece by lightly squeezing the sides of the cap, shake the inhaler well and spray twice into the air to ensure that the inhaler is working properly.
Using an inhaler
1. Remove the cap from the mouthpiece by lightly squeezing the sides of the cap.
2. Check the inside and outside of the inhaler, including the mouthpiece, for any foreign objects.
3. Shake the inhaler thoroughly to remove any foreign objects and to ensure that the contents of the inhaler are evenly mixed.
4. Hold the inhaler between your index finger and thumb in a vertical position, bottom up, with your thumb resting on the base under the mouthpiece.
5. Exhale as deeply as you can, then place the mouthpiece in your mouth between your teeth and cover it with your lips without squeezing your teeth.
6. Inhaling as deeply as possible through your mouth, simultaneously press the top of the inhaler to release one inhalation dose of Ventolin.
7. Hold your breath, remove the inhaler from your mouth and remove your finger from the top of the inhaler, continue to hold your breath as long as you can.
8. If you need to re-nebulize the drug, hold the inhaler in an upright position, wait about 30 seconds and then repeat steps 3-7.
9. Close the mouthpiece tightly with the protective cap.
IMPORTANT!
When performing stages 5, 6 and 7, you should not rush. It is important that you start inhaling as slowly as possible just before you press the inhaler. It is recommended to practice in front of a mirror the first few times. If you see a "fog" coming from the top of the inhaler or from the corners of your mouth, then you should start over at stage 2.
If your doctor gives you other instructions about using your inhaler, follow them strictly. Contact your doctor if you have difficulty using your inhaler.
Cleaning the inhaler
The inhaler must be cleaned at least once a week.
1. Remove the metal canister from the plastic body of the inhaler and remove the cap from the mouthpiece.
2. Rinse the valve thoroughly under running warm water.
3. Dry the valve thoroughly inside and out.
4. Place the metal can into the plastic case and put on the mouthpiece cap.
Do not place the metal can into water.
Storage conditions
Store at a temperature not exceeding 30°C, do not freeze, and avoid exposure to direct sunlight.
Keep out of the reach of children.
Best before date
2 years. Do not use after the expiration date stated on the package.
special instructions
Treatment of bronchial asthma is recommended to be carried out in stages, monitoring the patient's clinical response to treatment and lung function.
Bronchodilators should not be the only or main component of the treatment of unstable or severe bronchial asthma.
An increased need for the use of short-acting bronchodilators, in particular β2-adrenergic receptor agonists, to relieve the symptoms of bronchial asthma indicates a worsening of the disease. In such cases, the patient's treatment plan should be reconsidered. A sudden and progressive worsening of bronchial asthma may pose a potential threat to the patient's life, therefore, in such situations, the advisability of prescribing or increasing the dose of GCS should be considered. In patients at risk, daily monitoring of peak expiratory flow is recommended.
Therapy with β2-adrenergic agonists, especially when administered parenterally or via nebulizer, can lead to hypokalemia.
Particular caution is recommended when treating severe attacks of bronchial asthma, since in these cases hypokalemia may increase as a result of the simultaneous use of xanthine derivatives, corticosteroids, diuretics, as well as due to hypoxia. In such situations, it is recommended to monitor the concentration of potassium in the blood serum.
As with the use of other inhalation therapy agents, paradoxical bronchospasm may develop when taking salbutamol with increased wheezing immediately after using the drug. This condition requires immediate treatment using an alternative formulation of salbutamol or another short-acting inhaled bronchodilator. Ventolin should be discontinued immediately, the patient's condition assessed and, if necessary, another fast-acting bronchodilator prescribed to continue treatment.
If there is no effect of using a previously effective dose of inhaled salbutamol for at least 3 hours, the patient should consult a doctor to determine whether any additional measures need to be taken.
Patients should be instructed on the correct use of the Ventolin inhaler.
Description
Bronchodilator drug - beta2-adrenergic agonist.
Dosage form
Aerosol for inhalation dosed in the form of a suspension of white or almost white color.
Pharmacodynamics
Selective β2-adrenergic receptor agonist. In therapeutic doses, it acts on β2-adrenergic receptors of bronchial smooth muscle and has a short-term (4 to 6 hours) bronchodilator effect on β2-adrenergic receptors with a rapid onset of action (within 5 minutes) with reversible airway obstruction.
It has a pronounced bronchodilator effect, preventing or relieving bronchospasm, and reduces resistance in the respiratory tract. Increases vital capacity of the lungs. Increases mucociliary clearance (in chronic bronchitis up to 36%), stimulates mucus secretion, activates the functions of the ciliated epithelium.
In recommended therapeutic doses, it does not have a negative effect on the cardiovascular system and does not cause an increase in blood pressure. To a lesser extent, compared to drugs of this group, it has a positive chrono- and inotropic effect. Causes dilation of the coronary arteries.
It has a number of metabolic effects: it reduces the concentration of potassium in plasma, affects glycogenolysis and insulin secretion, has a hyperglycemic (especially in patients with bronchial asthma) and lipolytic effect, and increases the risk of developing acidosis.
Side effects
The adverse reactions presented below are listed according to the damage to organs and organ systems and the frequency of occurrence. The frequency of occurrence is defined as follows: very common (≥1/10), common (≥1/100 and <1/10), uncommon (≥1/1,000 and <1/100), rare (≥1/10,000 and <1/1,000), very rare (<1/10,000, including isolated cases). Frequency categories were formed based on clinical studies of the drug and post-registration surveillance.
From the immune system: very rarely - hypersensitivity reactions, including angioedema, urticaria, bronchospasm, decreased blood pressure and collapse.
Metabolism and nutrition: rarely - hypokalemia. Therapy with beta2-agonists may lead to clinically significant hypokalemia.
From the nervous system: often - tremor, headache; very rarely - hyperactivity.
From the cardiovascular system: often - tachycardia; infrequently - palpitations; rarely - peripheral vasodilation; very rarely - arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystole).
From the respiratory system: very rarely - paradoxical bronchospasm.
From the digestive system: infrequently - irritation of the mucous membrane of the mouth and pharynx.
From the musculoskeletal system: infrequently - muscle cramps.
Use during pregnancy and breastfeeding
Pregnancy
During pregnancy, the drug should be prescribed only if the expected benefit of therapy for the mother outweighs the potential risk to the fetus.
During post-registration surveillance, rare cases of various malformations in children, including the formation of a cleft palate and malformations of the limbs, were identified while taking salbutamol during pregnancy. In some of these cases, mothers took multiple concomitant medications during pregnancy. Due to the lack of permanent nature of the defects and the background incidence of congenital anomalies of 2 to 3%, a cause-and-effect relationship with the drug has not been established.
Breastfeeding period
Salbutamol is likely to pass into breast milk and is therefore not recommended for use in nursing women unless the expected benefit to the mother outweighs the potential risk to the baby. There is no evidence whether salbutamol present in breast milk is harmful to the newborn.
Fertility
There is no data on the effects of salbutamol on human fertility. In preclinical studies, no undesirable effects on animal fertility were identified.
Interaction
The simultaneous use of salbutamol and non-selective beta-adrenergic blockers such as propranolol is not recommended.
Salbutamol is not contraindicated in patients receiving MAO inhibitors.
In patients with thyrotoxicosis, Ventolin enhances the effect of central nervous system stimulants and tachycardia.
Theophylline and other xanthines, when used simultaneously with salbutamol, increase the likelihood of developing tachyarrhythmia.
Simultaneous administration with anticholinergic drugs (including inhaled ones) may increase intraocular pressure.
Diuretics and corticosteroids enhance the hypokalemic effect of salbutamol.
Overdose
Symptoms: signs and symptoms of salbutamol overdose are transient phenomena pharmacologically mediated by stimulation of β-adrenergic receptors, such as decreased blood pressure, tachycardia, muscle tremors, nausea, vomiting. The use of large doses of salbutamol can cause metabolic changes, including hypokalemia; it is necessary to monitor the concentration of potassium in the blood serum.
Treatment: when used in high doses, as well as with overdose of short-acting beta-agonists, the development of lactic acidosis has been observed, therefore, in case of overdose, control over the increase in serum lactate and the possibility of developing metabolic acidosis may be indicated (especially if tachypnea persists or worsens, despite the elimination other signs of bronchospasm such as wheezing).
Impact on the ability to drive vehicles and operate machinery
No data.
Side effects
As a rule, side effects include finger tremor headache , and anxiety. In addition, the following undesirable reactions are possible:
- hypersensitivity in the form of urticaria , hypotension , Quincke's edema , bronchospasm , collapse ;
- hyperactivity;
- paradoxical bronchospasm;
- muscle cramps;
- hypokalemia;
- lactic acidosis;
- tachycardia;
- strong heartbeat;
- dilatation of peripheral vessels;
- arrhythmia;
- extrasystole;
- supraventricular tachycardia;
- irritation of the mucous membrane of the mouth and pharynx.
Instructions for use of Ventolin (Method and dosage)
The instructions for use of Ventolin warn that the medicine must be used correctly, regardless of the form of release, otherwise the treatment process may go wrong.
In addition, the drug must be taken only after consultation with a doctor.
The instructions for Ventolin for inhalation in the form of an aerosol indicate that to use the drug it is necessary to use a nebulizer with a mask and an endotracheal tube .
Ventolin Nebula, which is sold in the form of an inhaler solution, is used without dilution. The duration of inhalation is about 10 minutes. The medicine can be diluted with a sterile sodium chloride solution (0.9%). It must be used in well-ventilated rooms, as some of the drug enters the environment.
The instructions for Ventolin Nebula for inhalation recommend a dose of 2.5 mg. If necessary, it can be increased to a maximum of 5 mg. Frequency of use – 3-4 times a day. For adult patients, if necessary, in a hospital setting, the dosage is increased to 40 mg per day.
The inhalation aerosol is designed for approximately 200 uses. It can be used by adult patients and children over 2 years of age after being prescribed by a specialist. For long-term maintenance therapy, adults are usually prescribed 200 mcg up to 4 times a day. To prevent bronchospasms in childhood, 100-200 mcg (1-2 inhalations) is used.
The syrup is prescribed to adult patients, 2 ml 3-4 times a day. If necessary, the dosage can be increased to 4 ml.
Pharmacological properties of the drug Ventolin™ nebula
Pharmacodynamics. Salbutamol is a selective β2-adrenergic receptor agonist. In therapeutic doses, it acts on β2-adrenergic receptors of the bronchial muscles with minimal or complete absence of effect on β1-adrenergic receptors of the heart. Pharmacokinetics. After inhalation administration, 10–20% of the administered dose reaches the lower respiratory tract. The remaining amount settles in the “delivery” device or in the nasopharynx, from where it is swallowed. Part of the dose that reaches the respiratory tract is absorbed into the lung tissue and enters the general bloodstream, but is not metabolized in the lungs. The onset of action of the drug occurs 4–5 minutes after inhalation, the duration of action is 4–6 hours. Once in the systemic circulation, the drug is metabolized in the liver and excreted mainly by the kidneys unchanged and in the form of a phenol sulfate metabolite. A dose of the drug that enters the digestive system from the nasopharynx is absorbed into the gastrointestinal tract, undergoes the first stage of metabolism in the liver to a phenol sulfate compound, and then is excreted by the kidneys.
Overdose
When using the drug in doses above the norm, hypokalemia , tachycardia , nausea, decreased blood pressure, muscle tremors , vomiting, agitation, respiratory alkalosis , headache , hyperglycemia , hypoxemia . In rare cases, hallucinations , tachyarrhythmia , dilatation of peripheral vessels, convulsions, and ventricular flutter .
Cardioselective beta-blockers are used for treatment , but with caution if there is a history of bronchospasm attacks.
Overdose of Ventolin™ nebula, symptoms and treatment
The most common signs and symptoms of Ventolin Nebula overdose are transient changes pharmacologically induced by β-adrenergic agonists (eg, tachycardia, tremor, headache). As a result of an overdose of salbutamol, severe hypokalemia may occur, so the level of potassium in the blood plasma should be checked. Treatment consists of discontinuing salbutamol and administering appropriate symptomatic therapy, such as cardioselective beta-blockers to treat patients with cardiac abnormalities (eg, tachycardia, palpitations). Drugs of the β-adrenergic blocker group should be prescribed with caution to patients with a history of bronchospasm.
Interaction
Ventolin for inhalation is not recommended for use in conjunction with non-selective beta-adrenergic blockers . In patients with thyrotoxicosis, this drug also increases the effect of nervous system stimulants and tachycardia .
If you combine an aerosol and an inhalation solution with xanthines tachyarrhythmia increases . The risk of severe ventricular arrhythmia with Levodopa and inhalational anesthetic . In combination with anticholinergic drugs, intraocular pressure may increase. When prescribed with diuretics and corticosteroids, the hypokalemic effect .
Ventolin Nebula solution for inhalation 2.5 mg/2.5 ml No. 20
A country
Germany
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Active substance
Salbutamol
Compound
sodium chloride - 9 mg, diluted sulfuric acid - qs to pH 3.5-4.5, purified water - up to 1 ml.
pharmachologic effect
Selective agonist of β2-adrenergic receptors. In therapeutic doses, it acts on β2-adrenergic receptors of bronchial smooth muscle and has a short-term effect (from 4 to 6 hours), a bronchodilator effect on β2-adrenergic receptors with a rapid onset of action (within 5 minutes) with reversible airway obstruction.
Indications for use
— relief and prevention of attacks of bronchial asthma (including as part of complex therapy for status asthmaticus); — as part of complex therapy of other chronic lung diseases accompanied by reversible airway obstruction, including
Interaction
The simultaneous use of salbutamol and non-selective beta-adrenergic blockers such as propranolol is not recommended. Salbutamol is not contraindicated in patients receiving MAO inhibitors (monoamine oxidase). In patients with thyrotoxicosis, it enhances the effect of central nervous system stimulants and tachycardia. Salbutamol increases the likelihood of developing extrasystole while taking cardiac glycosides. Theophylline and other xanthines, when used simultaneously, increase the likelihood of developing tachyarrhythmias. Concomitant use with inhalation anesthesia agents and levodopa increases the likelihood of developing severe ventricular arrhythmias. Concomitant use with anticholinergic drugs (including inhaled ones) may increase intraocular pressure. Diuretics and corticosteroids increase hypokalemia, which can be caused by salbutamol.
Side effect
The adverse reactions presented below are listed according to the damage to organs and organ systems and the frequency of occurrence. The frequency of occurrence is determined as follows: very often (≥1/10), often (≥1/100 and From the immune system: very rarely - hypersensitivity reactions, including angioedema, urticaria, bronchospasm, arterial hypotension and collapse. From the metabolic side and nutrition: rarely - hypokalemia. Therapy with drugs of the beta2-agonist group can lead to clinically significant hypokalemia. Very rarely - lactic acidosis. Very rare cases of lactic acidosis have been reported in patients who received salbutamol intravenously and in the form of nebulas for the treatment of exacerbations of bronchial asthma. With side of the nervous system: often - tremor, headache; very rarely - hyperactivity. From the heart: often - tachycardia; infrequently - palpitations; very rarely - arrhythmias, including atrial fibrillation, supraventricular tachycardia and extrasystole. From the blood vessels: rarely - peripheral vasodilation Disorders of the respiratory system, chest and mediastinal organs: very rarely - paradoxical bronchospasm. From the digestive system: infrequently - irritation of the mucous membrane of the mouth and pharynx. From the musculoskeletal system: infrequently - muscle cramps.
Contraindications
- hypersensitivity to any component of the drug; - children under 18 months of age (there are no data on the clinical effectiveness of nebulized salbutamol in children under 18 months of age). Non-injectable dosage forms of salbutamol should not be used for the management of uncomplicated preterm labor or threatened abortion. Ventolin® Nebula should be used with caution in patients with thyrotoxicosis, tachyarrhythmia, severe chronic heart failure, arterial hypertension, pheochromocytoma, during pregnancy, during breastfeeding, as well as in patients who have already taken high doses of other sympathomimetics.
Overdose
Symptoms: the most common signs and symptoms of salbutamol overdose are transient phenomena, pharmacologically caused by stimulation of β-adrenergic receptors (see sections “Special instructions” and “Side effects”). The use of large doses of salbutamol can cause hypokalemia; it is necessary to monitor the concentration of potassium in the blood serum. The development of lactic acidosis has been reported when used in high doses, as well as with overdose of short-acting beta-agonists, therefore, in case of overdose, it is recommended to monitor the increase in serum lactate concentration and the associated development of metabolic acidosis (especially if tachypnea persists or worsens despite eliminating other signs of bronchospasm, such as wheezing). Treatment: symptomatic therapy.
special instructions
Treatment of bronchial asthma is recommended to be carried out in stages, monitoring lung function and the patient's clinical response to treatment. Bronchodilators should not be the only or main component of the treatment of unstable or severe bronchial asthma. An increased need for the use of short-acting inhaled β2-adrenergic receptor agonists to relieve symptoms of bronchial asthma indicates an exacerbation of the disease. In such cases, it is recommended to reconsider the patient's treatment plan. A sudden and progressive deterioration in the course of bronchial asthma can pose a threat to the patient's life, therefore, in such situations, it is necessary to urgently decide on the issue of prescribing or increasing the dose of GCS. In such patients, daily monitoring of maximum expiratory flow is recommended. Therapy with β2-adrenergic agonists, especially when administered parenterally or via nebulizer, can lead to hypokalemia. Particular caution is recommended when treating severe attacks of bronchial asthma, since in these cases hypokalemia may increase as a result of the simultaneous use of xanthine derivatives, corticosteroids and diuretics, as well as due to hypoxia. In such situations, it is necessary to monitor the concentration of potassium in the blood serum. As with the use of other inhalation therapy agents, paradoxical bronchoslasm may develop when taking salbutamol with increased wheezing immediately after using the drug. This condition requires immediate treatment using an alternative formulation of salbutamol or another short-acting inhaled bronchodilator. Ventolin® Nebula should be immediately discontinued, the patient's condition assessed, and, if necessary, another fast-acting bronchodilator prescribed to continue treatment. Ventolin® Nebula should be used only by inhalation by inhalation through the mouth. The drug is not intended for injection or oral administration. Patients using Ventolin® Nebula at home should be warned that if the effect of the usual dose becomes less effective or less durable, they should not independently increase the dose or frequency of administration of the drug and should immediately consult a doctor. A small number of cases of acute angle-closure glaucoma have been reported in patients receiving a combination of salbutamol and ipratropium bromide via nebulizer. Given this fact, caution should be exercised when using salbutamol and anticholinergics via nebulizer simultaneously. Patients should receive appropriate instructions for the correct use of Ventolin® Nebula and should also be warned not to get the solution or “mist” into the eyes. Like other beta-adrenergic agonists, salbutamol can cause reversible metabolic changes, such as an increase in blood glucose concentrations. In patients with diabetes mellitus, decompensation may develop; in some cases, the development of ketoacidosis has been reported. Concomitant use of corticosteroids may enhance this effect. Very rare cases of lactic acidosis have been reported associated with the use of high doses of short-acting β2-adrenergic agonists intravenously or via nebulizer, mainly in patients with exacerbation of bronchial asthma). Increased lactate concentrations can lead to shortness of breath and compensatory hyperventilation, which may be misinterpreted as signs of unsuccessful asthma treatment and lead to an unnecessary increase in the use of short-acting β2-adrenergic agonists. Therefore, it is recommended to monitor the concentration of lactate in the blood serum, as well as monitor the possible subsequent development of metabolic acidosis. Effect on the ability to drive vehicles and machines There is no data on the effect of Ventolin® Nebula on the ability to drive vehicles or machines.
Dispensing conditions in pharmacies
On prescription
Analogs
Level 4 ATX code matches:
Onbrez Breezhaler
Formoterol Easyhaler
Fenoterol
Berotek
Foradil
Analogs of Ventolin, as well as Ventolin Nebula and Ventolin Easy Breathing in pharmacies can usually be obtained as follows:
- Ventilor;
- Nebutamol;
- Salamol Steri-Neb;
- Salamol-Eco;
- Salamol-Eco Easy Breathing;
- Salbutamol;
- Salbutamol-Inteli;
- Salbutamol-Neo.
They all have different prices. In many cases, analogues cost less than Ventolin itself.
For children
Inhalations for children can be used to relieve bronchospasm attacks at a dosage of 100-200 mcg (1-2 inhalations). Maintenance therapy with Ventolin – up to 200 mcg 4 times a day (2 inhalations). For prevention, 100-200 mcg is used 10-50 minutes before the provoking factor (1-2 inhalations).
For children, Babyhaler or Volumatic spacers are used.
The clinical effectiveness of this drug in children under 18 months using a nebulizer has not been studied.
Special instructions for the use of Ventolin™ nebula
Ventolin Nebulas should be used by inhalation through the mouth and should not be injected or swallowed. Treatment of asthma should be carried out according to a step-by-step program, the patient's condition must be assessed clinically and using pulmonary function tests. An increase in the frequency of use of inhaled β2-agonists indicates a deterioration in asthma control. In this case, the patient's therapy must be reconsidered, because worsening asthma is a life-threatening condition that requires the initiation or increase in the use of corticosteroids. Patients who belong to the risk group are recommended to monitor the maximum expiratory flow daily. Patients treated with Ventolin Nebula at home should be warned of the following: if a once effective dose of the drug does not provide relief from treatment or the duration of this relief decreases, they should consult a doctor rather than increase the dose of the drug or the frequency of its use on their own. Ventolin Nebula should be used with caution in the treatment of patients receiving high doses of other sympathomimetics. The use of sympathomimetics, including salbutamol, has an effect on the cardiovascular system. Based on post-licensing data and published literature, there is evidence of rare cases of myocardial ischemia associated with the use of salbutamol. Patients with heart disease (eg, coronary artery disease, arrhythmia, or severe heart failure) and who are being treated with salbutamol should seek medical attention if they experience chest pain or other symptoms that indicate worsening heart disease. Attention should be paid to assessing symptoms such as shortness of breath and chest pain, which can be the result of both heart disease and diseases of the respiratory system. Salbutamol is prescribed with caution to patients with thyrotoxicosis. When treating patients with a combination of nebulized salbutamol and ipratropium bromide, cases of acute angle-closure glaucoma were sometimes observed. Therefore, the combination of nebulized salbutamol with anticholinergic drugs, which are also administered by nebulization, should be used with caution. Patients should receive proper instructions regarding the correct use of the drug and be warned to avoid contact of the spray aerosol with the eyes. Severe hypokalemia may result from treatment with β2-adrenergic agonists; This is mainly observed when using parenteral forms or a nebulizer. Particular attention is paid to patients with severe exacerbation of asthma, because hypokalemia can be potentiated by the concomitant use of xanthine derivatives, steroids, diuretics and hypoxia. In this situation, it is recommended to check the level of potassium in the blood plasma. Like other β2-adrenergic agonists, Ventolin Nebula can lead to reversible metabolic changes, such as hyperglycemia. Compensation for such changes in patients with diabetes mellitus is not always possible, therefore there are isolated reports of the development of ketoacidosis in such patients. Concomitant use of corticosteroids may exacerbate this condition. Very rarely, cases of lactic acidosis have been reported in patients with acute asthma who were treated with high doses of salbutamol, which was administered intravenously or via a nebulizer. An increase in the level of lactate in the blood plasma can cause the development of suffocation and compensatory hyperventilation of the lungs, which can be mistakenly regarded as insufficient effectiveness of anti-asthma treatment and, in turn, lead to inappropriate intensification of treatment with short-acting β2-adrenergic receptor agonists. Therefore, it is recommended to monitor the level of lactate in the blood plasma of such patients and, accordingly, the presence of metabolic acidosis. During pregnancy and breastfeeding . Salbutamol during pregnancy is prescribed only if the expected benefit to the mother outweighs the potential risk to the fetus. Based on the fact that salbutamol can be excreted in breast milk, its use during breastfeeding may not be recommended, except in situations where the expected benefit to the mother will outweigh the potential risk to the child. Children . The clinical effectiveness of using salbutamol by nebulization in children under 18 months of age has not been established, therefore the use of the drug is not recommended. There are no reports of effects on the ability to drive vehicles or operate other machinery , but if side effects from the central nervous system (tremor) occur, these activities should be limited.
Ventolin price, where to buy
The price of Ventolin for inhalation in dosages of 100 mcg is about 150 rubles. In the form of a solution, this product is more expensive.
The price of Ventolin Nebula is on average 300 rubles. Ventolin Easy Breathing costs approximately 150 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Ventolin aerosol for in.
dosage 100mcg/dose 200 dosesGlaxo Wellcome Production RUB 149 order
Pharmacy Dialogue
- Ventolin (aerial 100mcg 200doses)Glaxo-Wellcome
148 RUR order
- Ventolin (aerial 100mcg 200doses)Glaxo-Wellcome
148 RUR order
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Pharmacy24
- Ventolin Evohaler 100 mcg 200 doses aerosol Glaxo Wellcome Production, France
72 UAH order
PaniPharmacy
- Ventolin liquid Ventolin Nebula d/ing solution. 2.5mg amp. 2.5ml No. 40 Germany, Aspen Bad Oldesloe
392 UAH. order
- Ventolin evohaler aerosol Ventolin evohaler aer. 100mcg/dose 200 doses Spain, Glaxo Wellcome
72 UAH order
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