Instructions for medical use

medicine

Tradename

Ventolin® breathing solution®

International nonproprietary name

Salbutamol

Dosage form

Nebulizer solution, 5 mg/ml

1 ml of solution contains

active substance - salbutamol 5 mg (equivalent to salbutamol sulfate),

Excipients: benzalkonium chloride solution, diluted sulfuric acid, purified water.

Description

Transparent liquid from colorless to light yellow.

Pharmacotherapeutic group

Drugs for the treatment of obstructive diseases respiratory tract. Inhalation sympathomimetics. Beta 2-adrenergic stimulants are selective. Salbutamol

ATX code R03AC02

Pharmacological properties

Pharmacokinetics

Absorption

When using the drug by inhalation, 10 to 20% of the dose taken reaches the lower respiratory tract, where it is adsorbed lung tissue and penetrates the blood vessels of the lungs, but is not metabolized here. The remaining part remains in the delivery device or settles in the oropharynx with further ingestion of the drug.

Distribution

Plasma protein binding is 10%.

Metabolism

When thresholds are reached by the circulatory system, salbutamol is metabolized through the hepatic mechanism and is excreted primarily in the urine as unchanged product and phenol sulfate.

Salbutamol is metabolized during the first passage through the liver and, due to the ingestion of small quantities during inhalation, in the intestinal wall; the main metabolite is an inactive sulfate conjugate, which is excreted in the urine.

Removal

T ½ of salbutamol when administered intravenously is 4-6 hours. Salbutamol is rapidly excreted in the urine as an inactive metabolite 4'-O-sulfate and unchanged substance; V small quantities excreted in feces. Most of the salbutamol taken is eliminated from the body within 72 hours.

Pharmacodynamics

Ventolin ® respiratory solution ® is a selective β 2 -adrenergic receptor agonist. In therapeutic doses, it affects β 2 -adrenergic receptors of the bronchial muscles.

Ventolin ® breathing solution ® has a short duration of action (4 to 6 hours) and a rapid onset of action (about 5 minutes from the moment of application).

Children

Clinical studies conducted in children under 4 years of age have demonstrated a similar safety profile compared to older children, adolescents and adults.

Indications for use

Relieving and preventing the development of bronchospasm in patients with reversible airway obstruction (asthma, chronic bronchitis, emphysema)

Stopping and preventing attacks bronchial asthma before the expected attack

Bronchodilators should not be the only or main component of asthma therapy. If the patient has asthma

inhaled corticosteroids to achieve and maintain symptom control. Insufficient response to salbutamol therapy may be a signal for urgent medical intervention/therapy.

Directions for use and doses

Ventolin ® respiratory solution ® is used only by inhalation by inhaling the drug through the mouth.

An increased need for β 2 -agonists may indicate a worsening of asthma. In such cases, it is recommended to re-evaluate the therapy and consider the possibility of additional administration of GCS.

Due to the risk of adverse reactions if recommended doses are exceeded, the frequency of administration and doses used should be increased only as directed by a doctor.

The duration of action of the drug Ventolin ® respiratory solution ® in most patients is 4-6 hours.

Ventolin ® breathing solution ® solution is not intended for intravenous administration or for oral administration.

The aerosol can be inhaled through a face mask, breathing tube (“T” configuration), or endotracheal tube. In some cases, it is necessary to create positive pressure during ventilation. When there is a risk of hypoxia, oxygen must be added to the breathing mixture.

Since many nebulizers operate only with a constant flow of air, it is possible that the nebulized medicine will enter the environment, so Ventolin ® breathing solution ® should be used in well-ventilated areas. This recommendation It should be especially strictly observed in hospitals, where several patients can simultaneously use nebulizers in the same room.

Ventolin ® breathing solution ® Use through a respirator or nebulizer only under the close supervision of a physician.

Administration can be carried out 4 times a day.

Adults and children over 12 years old

Ventolin ® breathing solution ® in an amount of 0.5-1.0 ml (corresponding to 2.5-5.0 mg of salbutamol) is diluted with sterile saline solution for injection to obtain a total volume of 2.0-2.5 ml. The resulting solution is inhaled using a nebulizer until the aerosol formation ends. When using a properly configured nebulizer, the procedure lasts about 10 minutes.

For periodic administration, you can also use undiluted Ventolin. ® breathing solution ® . For this, 2.0 ml of the drug Ventolin ® breathing solution ® (corresponding to 10.0 mg of salbutamol) is placed in a nebulizer, and the patient inhales the nebulized solution until bronchodilation occurs. This usually takes 3 to 5 minutes.

Some adult patients may require more high dose salbutamol, up to 10 mg, for which the undiluted drug is inhaled through a nebulizer until aerosol formation stops.

Children from 18 months to 12 years

The usual dose is 0.5 ml (corresponding to 2.5 mg salbutamol) diluted in 2.0-2.5 ml sterile saline injection. However, some children may need to increase the dose to 5.0 mg of salbutamol.

If continuous administration is necessary Ventolin ® breathing solution ® diluted to obtain a concentration of 50-100 mg of salbutamol in 1 ml. To do this, 1-2 ml of the drug is diluted with sterile saline to obtain a final volume of 100 ml, which is administered as an aerosol through a nebulizer. The usual rate of administration is 1-2 mg per hour.

Children under 18 months

The effectiveness of Ventolin administration ® breathing solution ® using a nebulizer in children under 18 months has not been established. Due to the possibility of developing transient hypoxemia, the possibility of oxygen therapy should be considered.

Side effects

Very often (>1/10), often (>1/100,<1/10), нечасто (>1/1,000, <1/100), редко (>1/10,000, <1/1,000), очень редко (<1/10,000).

Often

Tremor, headache

Tachycardia

Infrequently

Irritation of the mucous membrane of the mouth and pharynx

Cardiopalmus

Muscle cramps

Rarely

Hypokalemia (beta 2 agonist therapy may result in significant hypokalemia)

Peripheral vasodilation

Very rarely

Hypersensitivity reactions including urticaria, angioedema, bronchospasm, hypotension, collapse

Paradoxical bronchospasm

Lactic acidosis (in patients receiving salbutamol by intravenous injection and nebulizer for the treatment of an acute attack of bronchial asthma)

Hyperactivity

Arrhythmia, including atrial fibrillation, supraventricular tachycardia and extrasystole

Contraindications

Hypersensitivity to any component of the drug

Premature birth

Threatened abortion

Forms of release of salbumol not intended for intravenous administration should not be used to terminate premature labor and threatened miscarriage.

Drug interactions

The drug Ventolin ® breathing solution ® not contraindicated in patients receiving monoamine oxidase inhibitors (MAOIs).

special instructions

Treatment of asthma is usually done in stages, with the patient's response monitored clinically and with pulmonary function tests.

An increased need for β2-agonists may indicate worsening asthma control. In such cases, the patient's treatment plan should be reconsidered.

Sudden and progressive worsening of bronchial asthma can pose a threat to the patient's life, therefore, similar situations It is urgent to decide on the issue of prescribing or increasing the dose of glucocorticosteroids. In such patients, daily monitoring of peak expiratory flow is recommended.

The drug should be used with caution in patients with thyrotoxicosis.

Therapy with b 2 -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 be exacerbated by simultaneous use xanthine derivatives, glucocorticosteroids, diuretics, and also due to hypoxia. In such situations, it is necessary to monitor the level of potassium in the blood serum. As with other inhaled drugs, paradoxical bronchospasm may develop immediately after dosing. If paradoxical bronchospasm occurs, immediate relief is required using an alternative drug or a fast-acting inhaled bronchodilator from a different pharmacological group. Treatment with Ventolin ® respiratory solution should be stopped immediately ® , and, if necessary, prescribe another fast-acting bronchodilator for further treatment.

Ventolin ® breathing solution ® is used only for inhalation use by inhaling the drug through the mouth. The drug should not be used orally or by injection.

Patients receiving treatment with Ventolin ® breathing solution ® at home, should be warned that if the usual relief has become weaker or the duration of action of the medicine has become shorter, they should in no case independently increase the dose or frequency of administration of the drug without consulting the treating doctor.

Ventolin ® breathing solution ® Use with caution in patients who have already received high doses of other sympathomimetics.

Isolated cases of acute angle-closure glaucoma have been reported in patients receiving a combination of the drug Ventolin ® breathing solution ® and ipatropium bromide via nebulizer. Given this fact, caution should be exercised when using salbutamol and anticholinergics via nebulizer simultaneously. Patients should review the appropriate instructions for proper use and avoid contact of the solution with the eyes.

Like other beta-adrenergic agonists, Ventolin ® breathing solution ® may cause reversible metabolic changes, such as increased blood glucose concentrations. In patients with diabetes mellitus the development of decompensation is possible, and in some cases the development of ketoacidosis. Concomitant use of glucocorticosteroids may enhance this effect.

Lactic acidosis has been reported very rarely in association with Ventolin use. ® breathing solution ® in patients with exacerbation of bronchial asthma. Increased lactate levels lead to shortness of breath and compensatory hyperventilation, which can be misinterpreted as symptoms of improperly treated asthma. This may lead to inappropriate intensification of treatment with rapidly acting beta-agonists, so monitoring for increased serum lactate and therefore metabolic acidosis is recommended.

Fertility

There is no data on the effect of the drug on fertility in humans. The drug does not have a negative effect on the fertility of animals.

Pregnancy and lactation

The use of the drug during pregnancy and lactation is justified only if the expected benefit to the mother outweighs the risk to the fetus/infant. Salbutamol is likely excreted in breast milk.

In some studies, polydactyly and cleft palate were identified in children when mothers took drugs during pregnancy, including salbutamol (a clear causal relationship between their occurrence and drug use has not been established), and therefore the risk is estimated at 2-3%. Experimental studies revealed the presence of a teratogenic effect of salbutamol: in mice with subcutaneous administration (doses 11.5-115 times higher than the maximum recommended in humans for inhalation administration), the development of a “cleft palate” was noted; in rabbits when administered orally (doses 2315 times higher than the maximum for inhalation administration) - non-fusion of the skull bones.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

Considering the possible side effects, it is necessary to be careful when driving a vehicle and driving potentially dangerous mechanisms.

Overdose

Symptoms: Most symptoms of salbutamol overdose are transient adverse reactions of beta-agonists; in case of overdose, hypokalemia and lactic acidosis may develop.

Treatment: monitoring serum potassium levels, lactate levels and the subsequent development of metabolic acidosis (especially in the presence or worsening of tachypnea despite the elimination of bronchospasm).

During continuous administration of Ventolin ® breathing solution ® any signs of overdose are usually eliminated when the drug is stopped, and symptomatic therapy is carried out if necessary.

Release form and packaging

20 ml of solution is placed in an opaque glass bottle, closed with a plastic cap.

1 bottle, along with instructions for medical use in the state and Russian languages, is placed in a cardboard pack.

Storage conditions

Store in a place protected from light at a temperature not exceeding

Keep out of the reach of children!

Shelf life

Use the contents of the bottle within 28 days after opening.

Do not take the drug after the expiration date.

Conditions for dispensing from pharmacies

On prescription

Manufacturer/packer

Glaxo Operations UK Limited, UK

(Harmire Road, Barnard Castle, Co Durham, DL12 8DT, UK)

Owner registration certificates

Glaxo Operations UK Limited. Glaxo Wellcome Operations, UK (Berkeley avenue, Greenford, Middlesex, UB6 0NN, UK)

Address of the organization that accepts claims from consumers regarding the quality of products (products) on the territory of the Republic of Kazakhstan

Representative office of GlaxoSmithKline Export Ltd in Kazakhstan

050059, Almaty, Furmanov st., 273

Phone number: +7 701 9908566, +7 727 258 28 92, +7 727 259 09 96

Fax number: + 7 727 258 28 90

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Ventolin solution for inhalation- a drug for the treatment of obstructive respiratory diseases.
Selective beta2-adrenergic receptor agonist. In therapeutic doses, it acts on beta2-adrenergic receptors of bronchial smooth muscle, having little or no effect on beta1-adrenergic receptors of the myocardium. Due to the rapid onset of action, the drug is especially suitable for relieving and preventing an asthma attack.

Pharmacokinetics

After inhalation administration, 10 to 20% of the dose taken enters the lower respiratory tract, the rest is retained in the inhaler or in the mouth and pharynx, and then swallowed. Part of the dose that remains in the respiratory tract is adsorbed by lung tissue without being metabolized and enters the bloodstream.
Upon reaching the systemic circulation, salbutamol undergoes metabolism in the liver. It is excreted in the urine unchanged and in the form of phenol sulfate. The ingested portion of the inhalation dose is absorbed from the gastrointestinal tract and undergoes extensive metabolism during the first pass through the liver to phenolic sulfate. Unchanged salbutamol and the conjugate are excreted mainly in the urine.
About 10% of salbutamol is bound to plasma proteins.
The half-life of salbutamol is 4-6 hours. Partially metabolized to inactive 4"-O-sulfate (phenolic acid), which is excreted primarily in urine. A small amount is excreted in feces. Most of the salbutamol dose is excreted from the body within 72 hours.

Indications for use

Indications for use of the drug Ventolin are:
- treatment and prevention of bronchial asthma attacks;
- treatment of status asthmaticus as part of complex therapy;
- treatment of bronchial obstruction that is not amenable to traditional bronchodilator therapy.

Mode of application

Respiratory solution Ventolin Intended for inhalation use only by inhalation through the mouth.
The need for frequent use of beta2-agonists may be a symptom of worsening asthma. In these circumstances, it is necessary to reconsider the treatment plan and consider initiating corticosteroid therapy.
Due to possible side effects associated with an overdose of the drug, increasing its dose or frequency of use should only be prescribed after medical consultation.
The duration of action of Ventolin respiratory solution is from 4 to 6 hours.
The solution is not intended for intravenous administration or oral administration.
The aerosol can be inhaled through a face mask, breathing tube (“T” configuration), or endotracheal tube. In some cases, it is necessary to create positive pressure during ventilation. When there is a risk of hypoxia, oxygen must be added to the breathing mixture.
Since many nebulizers operate only in the presence of a constant flow of air, it is possible that the sprayed medicine will enter the environment, so Ventolin breathing solution should be used in well-ventilated areas. This recommendation should be observed especially strictly in hospitals where nebulizers can be used by several patients at the same time.
Ventolin breathing solution is used through a respirator or nebulizer only under the close supervision of a physician.
Administration can be carried out 4 times a day.
Adults and children over 12 years old
Ventolin respiratory solution in an amount of 0.5-1.0 ml (corresponding to 2.5-5.0 mg of salbutamol) is diluted with sterile saline solution for injection to obtain a total volume of 2.0-2.5 ml. The resulting solution is inhaled using a nebulizer until aerosol formation stops. When using a properly configured nebulizer, the procedure lasts about 10 minutes.
For periodic administration, you can also use undiluted Ventolin respiratory solution. To do this, 2.0 ml of Ventolin respiratory solution (corresponding to 10.0 mg of salbutamol) is placed in a nebulizer, and the patient inhales the nebulized solution until bronchodilation occurs. This usually takes 3 to 5 minutes.
Children from 18 months to 12 years
The usual dose is 0.5 ml (corresponding to 2.5 mg salbutamol) diluted in 2.0-2.5 ml sterile saline injection. However, some children may need to increase the dose to 5.0 mg of salbutamol.
If continuous administration of Ventolin is necessary, the respiratory solution is diluted to obtain a concentration of 50-100 mg of salbutamol per 1 ml. To do this, 1-2 ml of the drug is diluted with sterile saline to obtain a final volume of 100 ml, which is administered as an aerosol through a nebulizer. The usual rate of administration is 1-2 mg per hour.
Children under 18 months
The effectiveness of administering Ventolin respiratory solution by nebulizer in children under 18 months of age has not been established. Due to the possibility of developing transient hypoxemia, the possibility of oxygen therapy should be considered.

Side effects

Side effects are listed below, based on the classification by organs and systems, as well as by frequency.
Frequency classification: very often (≥1/10), often (≥1/100, but<1/10), нечасто (≥1/1000, но <1/100), редко (≥1/10 000, но <1/1000) и очень редко (<1/10000), включая единичные случаи.
Often - tremor, headache, tachycardia.
Uncommon: palpitations, irritation of the mucous membrane of the mouth and pharynx, muscle spasms.
Rarely - hypokalemia, dilatation of peripheral vessels.
Very rarely - hypersensitivity reactions (angioedema, urticaria, bronchospasm, hypotension and collapse), paradoxical bronchospasm; increased activity; cardiac arrhythmia, cardiac arrhythmia, including atrial fibrillation, supraventricular tachycardia and extrasystole; lactic acidosis.

Contraindications

Contraindications to the use of the drug Ventolin are: hypersensitivity to any component included in the drug; premature birth; threatened abortion.

Pregnancy

Application Ventolina breathing solution during pregnancy and lactation is justified only if the expected benefit to the mother outweighs any possible risk to the fetus or infant.
Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms
In view of the possible development of side effects after taking the drug, caution should be exercised when driving vehicles and potentially dangerous mechanisms.

Interaction with other drugs

It is not recommended to use simultaneously Ventolin breathing solution and non-selective blockers such as propranolol.
Ventolin Respiratory Solution is not contraindicated in patients receiving monoamine oxidase inhibitors (MAOIs).

Overdose

Overdose symptoms Ventolina: In case of overdose, hypokalemia may develop. Serum potassium levels should be monitored.
Treatment: The preferred antidote for salbutamol overdose is a cardioselective β-blocker. β-adrenergic blockers should be used with caution in patients with a history of bronchospasm attacks.
During continuous administration of Ventolin respiratory solution
any signs of overdose usually resolve when the drug is stopped.

Storage conditions

Store in a place protected from light at a temperature not exceeding
25 ºС.
Keep out of the reach of children!

Release form

Ventolin - solution for nebulizer, 5 mg/ml.
20 ml of solution is placed in an opaque glass bottle, closed with a plastic cap.
1 bottle, along with instructions for medical use in the state and Russian languages, is placed in a cardboard pack.

Compound

1 ml solution Ventolin contains the active substance - salbutamol 5 mg (in the form of salbutamol sulfate).
Excipients: benzalkonium chloride solution, diluted sulfuric acid, purified water.

Additionally

Treatment of asthma is usually done in stages, with the patient's response monitored clinically and with pulmonary function tests. The need for frequent use of maximum doses indicates a worsening of the disease. In such cases, it is recommended to reconsider the patient's treatment plan.
If there is a sudden and progressive deterioration of the condition, the issue of prescribing or increasing the dose of glucocorticosteroids should be decided. The drug should be used with caution in patients with thyrotoxicosis.
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, glucocorticosteroids, diuretics, as well as due to hypoxia. In such cases, it is necessary to monitor the level of potassium in the blood serum.
Bronchodilators are not the only or primary treatment for severe or unstable asthma.

Severe asthma requires constant medical monitoring due to the possibility of death. Patients with severe asthma have persistent symptoms and frequent exacerbations with limited physical ability and a peak expiratory flow (PEF) value less than 60% of normal and a variability greater than 30%, and the value does not return to normal after use of a bronchodilator. Such patients require high doses of inhaled (more than 1 mg/day beclomethasone dipropionate) or oral corticosteroids.
Patients receiving treatment with Ventolin breathing solution at home should be warned that if the usual relief has become weaker or the duration of action of the drug has become shorter, they should in no case increase the dose or frequency of administration of the drug without consulting their doctor.
Ventolin breathing solution Use with caution in patients who have already received high doses of other sympathomimetics.
Isolated cases of the development of acute angle-closure glaucoma have been reported in patients receiving a combination of Ventolin respiratory solution and ipatropium bromide using a nebulizer. Given this fact, caution should be exercised when using salbutamol and anticholinergics via nebulizer simultaneously.
Patients should receive appropriate instructions for proper use.
Like other beta-agonists, Ventolin Respiratory Solution may cause reversible metabolic changes, such as an increase in blood glucose concentrations. Patients with diabetes may develop decompensation, and in some cases, the development of ketoacidosis. Concomitant use of glucocorticosteroids may enhance this effect.
Very rarely, lactic acidosis has been reported to occur in association with the use of Ventolin Respiratory Solution in patients with exacerbation of bronchial asthma.
Increased lactate levels lead to shortness of breath and compensatory hyperventilation, which can be misinterpreted as symptoms of improperly treated asthma. This may lead to inappropriate intensification of treatment with rapidly acting beta-agonists, so monitoring for increased serum lactate and therefore metabolic acidosis is recommended.
Inhaled drugs can cause paradoxical bronchospasm. Paradoxical bronchospasm must be immediately relieved using another alternative dosage form or another fast-acting inhaled bronchodilator. You should immediately stop using the drug Ventolin respiratory solution, assess the patient's condition, conduct the necessary examination and prescribe alternative treatment.

Main settings

Name:	VENTOLIN
ATX code:	R03AC02 -

Latin name: Ventolin
ATX code: R03A C02
Active substance:
Manufacturer: Aspen Bad Oldesloe GmbH (Germany),
"Glaxo Smith Kline" (UK),
Farmaclair (France)
Dispensing from the pharmacy: On prescription

Ventolin is not a hormonal drug. The INN of its active ingredient is salbutamol. It has a bronchodilator effect, stopping and preventing contractions of the bronchi, and consequently reduces organ obstruction respiratory system.

Indications for use

Symptoms, diseases and their complications for which Ventolin is appropriate:

• Bronchospasms
• Allergy
• Bronchitis in acute form
• Emphysema
• Bronchial asthma.

Composition of the drug

The drug is available in different forms, which determines the concentration of the active component in the recommended dosage.

• Nebulas for inhalation (2.5 ml). The main component is salbutamol in an amount of 2.5 mg. Additional components of the solution: water (purified), sulfuric acid (not concentrated), sodium chloride
• Spray. The main medicinal substance is salbutamol sulfate (micronized) 120.5 mg/1 dose, in an inhalation bottle for 100 doses - 28.92 mg of the drug. Additional component: propellant - up to 75 mg/1 dose
• Tablet form. Tablets containing 2 mg, 4 mg, 8 mg of salbutamol are available. Additional components: magnesium stearate, Aerosil 200, cellulose (microcrystalline), talc (purified)
• Syrup. A 150 ml bottle contains 2 mg of salbutamol in 5 ml of syrup. Ventolin syrup (50 ml) is more concentrated: 1 ml contains 1 mg of salbutamol. Additional components: citric acid, food additive E110 (colorant), strawberry flavoring agent, hydroxypropyl methylcellulose (food additive/stabilizer), saccharin, sodium benzoate, sodium citrate trihydrate, water (purified).

Medicinal properties

Ventolin for inhalation has the most positive therapeutic effects. When it enters the body, it immediately has a wide range of actions, improving well-being in the first minutes after the inhalation procedure. The positive effect lasts for at least 4 hours.

Effects of Ventolin on the body:

• Stopping the release of histamine, leukotrienes, prostaglandin from mast cells
• Inhibition of bronchial reactivity
• Increased vital capacity of the lungs
• Awakening the function of the ciliated epithelium
• Production of lipolytic and hyperglycemic effects
• Manifestation of satisfactory inotropic and chronotropic effects
• Normalizing breathing and overcoming resistance
• Reduction of bronchospasm caused by allergen
• Increased mucociliary clearance
• Decreased potassium concentration in the circulatory system
• Influencing insulin production and glycogenolysis
• Dilation of the coronary arteries.

The drug Ventolin has unique properties of self-excretion from the body, which greatly facilitates the work of the liver. During inhalation, only 20-30% of the dose used enters the body, the rest settles on the inner walls of the nose and mouth. Penetrating into the internal organs of the respiratory system, the drug easily enters the bloodstream; it does not settle in the lungs and is not converted.

Through the blood, the components of the solution enter the liver, where they are processed and excreted in the urine in an unchanged chemical compound. Approximately 70-80% of the consumed dose of Ventolin, deposited on the portable device and nasopharynx, enters the gastrointestinal tract. They are then converted by hepatocytes and excreted by the kidneys: 90% in urine and 4% in bile.

When taken orally, Ventolin is quickly absorbed by the walls of the gastrointestinal tract. Its maximum concentration in the blood is achieved within the first 2 hours after administration. It decreases within 5-6 hours. The drug is excreted from the body mainly through urine during the day. Ventolin's instructions contain data on the period of its complete removal from the body - 72 hours.

Release forms

The product is available in different forms:

• Ventolin aerosol. The inhaler is made of aluminum, equipped with a plastic metering device and a protective cap. The medicinal suspension is white. The aerosol is sold in cardboard packaging. The inhaler is convenient for everyday wear
• Ventolin nebulas for inhalation. Polyethylene nebulae are soldered to each other and sealed in laminated foil. The drug is sold in cardboard packaging. The medicinal solution has a transparent color. The contents of the ampoules are used using a nebulizer, which is inferior in portability to other forms of release.
• Ventolin tablets. For convenience, it is available in three interpretations: 10-20-50 tablets. Blisters are packaged in cardboard packaging. Ventolin tablets are round, the end surface is flat. There is a chamfer on both sides, a risk on one. Advantage: tablets can be carried with you
• Ventolin syrup. Yellow-orange liquid with the taste and smell of strawberries. The glass bottle is packed in a cardboard box. Ventolin in syrup form is very suitable for treating children.

Mode of application

Familiarization with the instructions for use of Ventolin is necessary for productive therapy:

Aerosol

The cost of such a spray ranges from 140-160 rubles/bottle.

Used to treat children over 2 years of age and adults. If the patient does not coordinate the inhalation and the moment of Ventolin nebulization, then for effective inhalations he needs a spacer. Preschool children are advised to use aerosol Ventolin through the Bebihaler device. Dosage to reduce spasms: adults - 0.1-0.2 mg/4 times a day, children - up to 0.1-0.2 mg/4 times a day

The price of the drug is from 270 to 350 rubles/pack/10 nebula.

The product must not be used for injection procedures; shake before opening. It is used exclusively by inhalation through a nebulizer in a ventilated area. If necessary for use by children under 18 months or for prolonged inhalations (longer than 10 minutes), it can be diluted with a solution of sodium chloride (0.9%) 1:1. The dosage of one nebula of Ventolin for inhalation in the instructions is 2.5 mg of the active ingredient salbutamol. To treat bronchospasms, 2 inhalation procedures per day are sufficient, regardless of age. At home, it is better to combine Ventolin with saline in a 1:1 ratio. Treatment in a hospital allows the dose to be increased to 40 mg/day as prescribed by a doctor. In case of severe bronchial obstruction, Ventolin is not diluted.

Ventolin tablets

The average price is 140 rubles.

To be taken orally 30 minutes before meals, without chewing. Dosage of tablets containing 2 or 4 mg of salbutamol: for adults - 2 tablets/day, for children - 2 times 0.5 tablets/day. Your doctor should give detailed recommendations. Dosage of tablets containing 8 mg of salbutamol: for adults - 1 tablet every 12 hours, identical for children.

The cost of the bottle is 50 rubles.

A solution of 150 ml is taken orally 30 minutes before meals. Dosage for adults is 4 ml/3 times, for children from 2 to 6 years old - 1 ml/3 times, from 6 to 12 - 2 ml/3 times and from 12 years no more than 4 ml/3 times a day. For adults, in case of urgent need, you can increase the dose to 8 ml, but not more than 3 doses per 24 hours. A 50 ml solution is taken orally 30 minutes before meals. Dosage of the drug for adults: 2 ml/2 r per day, for children no more than 2 ml per day.

During pregnancy and pregnancy

Taking Ventolin during pregnancy, even starting from 3 weeks, has not been clinically studied. That is why it should be taken in the third trimester of pregnancy only in case of urgent need. In the first trimester, and throughout pregnancy, taking Ventolin can cause tachycardia in the mother and fetus, as well as hyperglycemia. Cases have been recorded when labor weakened, but whether these data are statistically confirmed or not is unknown. Doctors have noticed the following problems when taking Ventolin during pregnancy:

• Pulmonary edema
• Fall in blood pressure.

During breastfeeding, salbutamol passes into mother's milk, and consequently into the body of the newborn. It has not been clinically studied whether this has a positive or harmful effect. Nursing mothers are not recommended to prescribe a course of Ventolin, the only exception being when the woman’s health is a priority over the reaction of salbutamol on the baby’s body.

Contraindications and precautions

For safe use, it is necessary to follow the fixed dosages, and also familiarize yourself with the list of restrictions for taking the drug. The instructions for use of Ventolin indicate the following contraindications:

• Premature birth
• Tachyarrhythmia
• Threatened abortion
• Heart failure
• Allergic reaction to any component
• Complicated pregnancy
• Therapeutic use in children under 18 months
• Arterial hypertension
• Pheochromocytoma
• Styrotoxicosis
• Decompensated diabetes mellitus.

Although Ventolin is not from the “hormones” group, do not self-medicate, contact specialists for advice and prescription.

Side effects and overdose

If you notice the following side effects, you should stop taking Ventolin and consult a specialist for advice.

Adverse reactions to the drug:

• Increasing headache
• Noticeable trembling in the hands
• Paradoxical bronchospasms
• Heartbeat disorders
• Vasodilation
• Restless sleep
• Malfunction of taste buds
• Dryness and irritation of the mucous membranes of the mouth and nasopharynx
• Epidermal rashes
• Allergies: arterial hypotension and bronchospasm, angioedema, urticaria, collapse and decreased blood pressure
• Hypokalemia
• Hyperactivity in children
• Minor cramps.

To quickly relieve and get rid of these symptoms, you should seek help from a specialist, and in some cases call an ambulance.

Symptoms of Ventolin overdose:

• Muscle tremors
• Gagging
• Convulsions
• Tachycardia
• Decreased blood pressure
• Hallucinations
• Excitation
• Nausea
• Respiratory alkalosis
• Reduced phosphate levels
• Hypokalemia
• Changes in the blood, at the cellular level - “Leukocidosis”
• Lactic acidosis.

To avoid such disorders and symptoms, you should follow your doctor's instructions. Most often, the course of treatment is prescribed for a week or two. You should not experiment with dosages, especially for children.

Conditions and shelf life

Ventolin nebula instructions provide a shelf life of 2 years. Once opened, the foil must be used within 3 months. The tablets must be used within 3 years from the date of production. An inhaler with Ventolin is good for two years if it does not contain freons. Otherwise, it can be used for 3 years. Ventolin syrup is valid for 2 years.

Regardless of the form of release, the drug must be stored in a dark place out of reach of children, at an air temperature not exceeding 30 0 C. Do not freeze. The remaining drug in the nebulizer cannot be used.

Analogs

Manufacturer: Binnopharm (Russia)

Price: within 70-100r

Advantages:

• Safe for the body
• Lack of hormones
• It dilates the bronchi well, 5 minutes after administration, breathing improves by 40%.

Flaws:

• A sore throat or mild cough may occur.

Manufacturer: Ivax Pharmaceuticals (Czech Republic)

Price: within 330-350r

Description of the drug: main active ingredient: Salbutamol

Advantages:

• Effective within 5 minutes
• Makes breathing easier during bronchitis
• According to indications, can be used for infants and preschool children

Flaws:

• Paradoxical bronchospasm may occur.

In this article you can read the instructions for use of the drug Ventolin. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Ventolin in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Ventolin analogues in the presence of existing structural analogues. Use for the treatment of bronchial asthma and chronic bronchitis in adults, children, as well as during pregnancy and breastfeeding.

Ventolin- selective beta2-adrenergic receptor agonist. In therapeutic doses, it acts on beta2-adrenergic receptors of bronchial smooth muscle, having little or no effect on beta1-adrenergic receptors of the myocardium. It has a pronounced bronchodilator effect, preventing or relieving bronchospasm, and reduces resistance in the respiratory tract. Increases vital capacity of the lungs (VC). 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.

After using inhalation forms, the action develops quickly, the onset of the effect is after 5 minutes, the maximum is after 30-90 minutes (75% of the maximum effect is achieved within 5 minutes), the duration is 4-6 hours.

Compound

Micronized salbutamol sulfate + excipients.

Pharmacokinetics

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.

The ingested portion of the inhalation dose is absorbed from the gastrointestinal tract and undergoes extensive first-pass metabolism through the liver, turning into inactive 4"-O-sulfate (phenolic sulfate).

The binding of salbutamol to plasma proteins is 10%. It is excreted partly by the kidneys unchanged and partly in the form of inactive 4"-0-sulfate (phenolic sulfate), which is also excreted mainly in the urine. Only a small part of the administered dose of salbutamol is excreted in feces. Most of the dose of salbutamol administered intravenously is excreted orally. or by inhalation, excreted within 72 hours.

Indications

Bronchial asthma:

• relief of attacks of bronchial asthma, incl. during exacerbation of bronchial asthma severe course;
• 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.

Chronic obstructive pulmonary disease (COPD), accompanied by reversible airway obstruction, chronic bronchitis.

Release forms

Dosed aerosol for inhalation (sometimes mistakenly called a spray).

Solution for inhalation in nebulas in ampoules (Ventolin Nebulas) (sometimes mistakenly called syrup).

Instructions for use and dosage

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 with consideration of the advisability of prescribing simultaneous therapy with GCS.

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.

To relieve an attack of bronchospasms in 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 4 times a day. The need for frequent use of maximum doses of Ventolin or a sudden increase in dose indicates a worsening of asthma.

To prevent bronchospasm attacks associated with exposure to an allergen or caused by physical activity, 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.

For long-term maintenance therapy for adults - up to 200 mcg 4 times a day; children - up to 200 mcg 4 times a day.

Rules for using the inhaler

Checking the inhaler

Before using the inhaler for the first time or if the inhaler has not been used for a week or longer, you should remove the cap from the mouthpiece by lightly squeezing the cap on the sides, shake the inhaler well and spray two times 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. Inspect the mouthpiece inside and out to make sure it is clean.
3. Shake the inhaler well.
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 slowly and deeply, wrap your lips around the mouthpiece without squeezing it with your teeth.
6. While inhaling as deeply as possible through your mouth, simultaneously press the top of the inhaler to release one inhalation dose of salbutamol.
7. Hold your breath for a few seconds, remove the mouthpiece from your mouth, then exhale slowly.
8. To receive the second dose, 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.

When performing stages 5, 6 and 7, you should not rush. You should begin inhaling as slowly as possible, just before pressing the inhaler valve. It is recommended to practice in front of a mirror the first few times. If a "fog" is visible coming from the top of the inhaler or from the corners of the mouth, then you should start all over again at stage 2.

If the doctor has given other instructions for using the inhaler, the patient must strictly follow them. If the patient has difficulty using the inhaler, he should consult a doctor.

Cleaning the inhaler

The inhaler must be cleaned at least once a week.

1. Remove the metal can from the plastic case and remove the mouthpiece cover.
2. Thoroughly rinse the plastic housing and mouthpiece cover under running warm water.
3. Dry the plastic case and mouthpiece cover completely, both outside and inside. Avoid overheating.
4. Place the metal can into the plastic case and put on the mouthpiece cap.

Do not immerse the metal can in water.

Ventolin Nebula

Used by inhalation. Ventolin Nebula is not intended for injection.

The drug Ventolin Nebula must be used under the supervision of specialists using a special inhaler (nebulizer) with a mask, T-tube or endotracheal tube. If there is a risk of developing hypoxia due to hypoventilation, the inhaled air can be enriched with oxygen.

Ventolin Nebula is intended for use undiluted, however, if long-term administration of a salbutamol solution (more than 10 minutes) is necessary, the drug can be diluted with a sterile 0.9% sodium chloride solution. The solution remaining unused in the nebulizer chamber after inhalation should be discarded.

Because Many nebulizers operate only in the presence of a constant flow of air; it is possible that the sprayed drug will enter the environment. Taking this into account, Ventolin Nebula should be used in well-ventilated areas; This recommendation should be observed especially strictly in hospitals where nebulizers can be used by several patients at the same time.

Adults and children over 1.5 years old

The average starting dose of salbutamol administered by inhalation using a nebulizer is 2.5 mg, but can be increased to 5 mg. Inhalations can be repeated 4 times a day. To treat severe airway obstruction, adult patients can use the drug in higher doses - up to 40 mg per day - under strict medical supervision in a hospital setting.

Side effect

• angioedema;
• hives;
• bronchospasm;
• hypotension;
• collapse;
• hypokalemia;
• tremor;
• headache;
• hyperactivity;
• tachycardia;
• arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystole);
• peripheral vasodilation;
• paradoxical bronchospasm;
• irritation of the mucous membrane of the oral cavity and pharynx;
• muscle cramps.

Contraindications

• management of preterm birth;
• threatened abortion;
• hypersensitivity to the components of the drug.

Use during pregnancy and breastfeeding

During pregnancy, Ventolin is prescribed only in cases where 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 were identified, including the formation of a cleft palate and malformations of the limbs, while taking salbutamol during pregnancy. In some of these cases, mothers were taking multiple concomitant medicines during pregnancy. Due to the lack of constant nature of defects and background frequency of occurrence congenital anomalies, ranging from 2 to 3%, a cause-and-effect relationship with taking the drug has not been established.

Salbutamol is likely to pass into breast milk and is therefore not recommended for use in nursing women unless the expected benefit to the patient outweighs the potential risk to the baby. There is no information about whether those present have breast milk salbutamol harmful effect for a newborn.

Use in children

Contraindicated in children under 2 years of age for aerosol (up to 1.5 years for Nebula).

special instructions

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 beta2-adrenergic agonists, to control the symptoms of bronchial asthma indicates a worsening of the disease. In such cases, the patient's treatment plan should be reconsidered. Sudden and progressive worsening of bronchial asthma can pose a potential threat to the patient's life, so in such situations the advisability of prescribing or increasing the dose of corticosteroids should be considered. In patients at risk, daily monitoring of peak expiratory flow is recommended.

Therapy with beta2-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 serum potassium levels.

If there is no effect from previous use effective dose inhaled salbutamol for at least 3 hours, the patient should consult a doctor to see if any additional measures are necessary.

Patients should be instructed about correct use Ventolin inhaler.

Impact on the ability to drive vehicles and operate machinery

No data.

Drug interactions

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 Ventolin, increase the likelihood of developing tachyarrhythmia.

Simultaneous administration with anticholinergic drugs (including inhaled ones) may increase intraocular pressure.

Diuretics and glucocorticosteroids (GCS) enhance the hypokalemic effect of salbutamol.

Analogues of the drug Ventolin

Structural analogues of the active substance:

• Aloprol;
• Astalin;
• Ventolin Nebula;
• Volmax;
• Salamol;
• Salmo;
• Salben;
• Salbuvent;
• Salbutamol;
• Salgim;
• Saltos;
• Cibutol Cyclocaps.

Analogs for therapeutic effect (medicines for the treatment of asthma):

• Adrenalin;
• Akolat;
• Aldecin;
• Ambroxol;
• Atrovent;
• Beclazon;
• Benacort;
• Berodual;
• Berotek;
• Betamethasone;
• Bricanil;
• Bronchosan;
• Budesonide;
• Hydrocortisone;
• Hypoxene;
• Dexamethasone;
• Derinat;
• Diprospan;
• Zaditen;
• Intal;
• Ifiral;
• Kenacort;
• Kenalog;
• Clenbuterol;
• Cortisone;
• Cromogen;
• Cromoghlin;
• Lazolvan;
• Libexin Muco;
• Mucomist;
• Platyfillin;
• Polyoxidonium;
• Polcortolon;
• Prednisolone;
• Pulmicort;
• Pulmicort Turbuhaler;
• Serevent;
• Seretide;
• Seretide Multidisc;
• Solutan;
• Theotard;
• Theophylline;
• Fenoterol;
• Halixol;
• Erespal;
• Eufillin;
• Euphylong.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Ventolin is a bronchodilator drug. Widely used in the treatment of bronchial asthma at its different stages. As you know, the most powerful bronchodilator is adrenaline, which was used for asthma attacks inspired by bronchial asthma until the middle of the 20th century. However, the side effects of this biologically active substance secreted by the adrenal cortex - palpitations, hypertension, agitation - excluded the possibility of its further use as a means of relieving asthma attacks. This is due to the fact that adrenaline interacts both with beta-1 adrenergic receptors, located mainly in the heart, and with beta-2 adrenergic receptors in the bronchi. For this reason, selective beta-2 adrenergic receptors were created, marking a new era in the treatment of bronchial asthma. The first such drug was salbutamol, which appeared on the world pharmaceutical market in the late 60s of the last century. Ventolin is the original salbutamol from GlaxoSmithKline. Today Ventolin is the “gold standard” for relieving asthma attacks. The drug has a strong bronchodilator effect, preventing or completely eliminating bronchospasm and reducing resistance in the respiratory tract. It does not have a negative effect on the heart and blood vessels (subject to use in the dosages specified in the instructions for use). Increases the lumen of coronary vessels. Increases blood glucose levels and has a fat-burning effect.

The drug begins to act within 5 minutes after inhalation and reaches peak activity after 0.5-1.5 hours. Duration of action - 4-6 hours. Only 10-20% of the administered dose reaches the lower respiratory tract. The main losses occur in the inhaler itself, in which part of the dose remains, and the other part settles in the mouth and pharynx, after which it is swallowed. Ventolin is contraindicated in persons with individual intolerance to salbutamol, as well as those at risk of premature birth. In pediatric practice, the drug is used starting from the age of two. Inhalations should not be performed more than 4 times a day. If the need to use the drug increases, this indicates a deterioration in the clinical situation. The rules for using the inhaler and checking its performance are described in detail in the instructions for use. For unstable or severe asthma, Ventolin should not be the main component of treatment. If the patient notices a weakening of the effect of the drug (determined by the need to use it more often and/or in larger quantities), then he should consult a doctor. Ventolin should be used with caution in persons with signs of thyroid hormone intoxication. The inhaler must be cleaned in accordance with the instructions for use at least once every 7 days. Concomitant use of Ventolin with non-selective beta-blockers is not advisable.

Pharmacology

Selective agonist of β 2 -adrenergic receptors. In therapeutic doses, it acts on β 2 -adrenergic receptors of bronchial smooth muscle and has a short-term (4 to 6 hours) bronchodilator effect on β 2 -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. 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.

Pharmacokinetics

Absorption and Metabolism

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. 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 inhaled by, excreted excreted within 72 hours.

Release form

Aerosol for inhalation dosed in the form of a suspension of white or almost white color.

Excipients: propellant GR106642X (1,1,1,2-tetrafluoroethane, HFA 134a, norflurane); does not contain chlorofluorocarbons.

200 doses - aluminum inhalers (1) with a plastic dosing device with a protective cap - cardboard packs.

Dosage

Ventolin is intended only for inhalation administration by inhalation through the mouth.

An increased need for the use of beta 2-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 with consideration of the advisability of prescribing simultaneous therapy with GCS.

Since an overdose may be accompanied by the development of undesirable reactions, 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.

To relieve an attack of bronchospasms in 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 4 times a day. The need for such frequent use of additional doses of Ventolin or a sharp increase in dose indicates a worsening of asthma.

To prevent attacks of bronchospasm associated with exposure to an allergen or caused by physical activity, 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.

For long-term maintenance therapy for adults - up to 200 mcg 4 times a day; children - up to 200 mcg 4 times a day.

Rules for using the inhaler

Checking the inhaler

Before using the inhaler for the first time or if the inhaler has not been used for a week or longer, you should remove the cap from the mouthpiece by lightly squeezing the cap on the sides, shake the inhaler well and spray two times 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. Inspect the mouthpiece inside and out to make sure it is clean.

3. Shake the inhaler well.

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 slowly and deeply, wrap your lips around the mouthpiece without squeezing it with your teeth.

6. While inhaling as deeply as possible through your mouth, simultaneously press the top of the inhaler to release one inhalation dose of salbutamol.

7. Hold your breath for a few seconds, remove the mouthpiece from your mouth, then exhale slowly.

8. To receive the second dose, hold the inhaler in a vertical position, wait about 30 seconds and then repeat steps. 3-7.

9. Close the mouthpiece tightly with the protective cap.

When performing stages 5, 6 and 7, you should not rush. You should begin inhaling as slowly as possible, just before pressing the inhaler valve. It is recommended to practice in front of a mirror the first few times. If a "fog" is visible coming from the top of the inhaler or from the corners of the mouth, then you should start all over again at stage 2.

If the doctor has given other instructions for using the inhaler, the patient must strictly follow them. If the patient has difficulty using the inhaler, he should consult a doctor.

Cleaning the inhaler

The inhaler must be cleaned at least once a week.

1. Remove the metal can from the plastic case and remove the mouthpiece cover.

2. Rinse the plastic case and mouthpiece cover thoroughly under running warm water.

3. Dry the plastic case and mouthpiece cover completely, both outside and inside. Avoid overheating.

4. Place the metal can into the plastic case and put on the mouthpiece cap.

Do not immerse the metal can in water.

Overdose

Symptoms: signs and symptoms of salbutamol overdose are transient phenomena pharmacologically mediated by stimulation of beta-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. When using high doses, as well as when overdosing beta-agonists short acting 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 (especially if tachypnea persists or worsens despite the elimination of other signs of bronchospasm, such as wheezing) may be indicated.

Interaction

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.

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 often (> 1/10), often (> 1/100 and< 1/10), нечасто (>1/1 000 and< 1/100), редко (>1/10,000 and< 1/1 000), очень редко (< 1/10 000, включая отдельные случаи). Категории частоты были сформированы на основании clinical trials drug and post-registration surveillance.

From the outside immune system: very rarely - hypersensitivity reactions, including angioedema, urticaria, bronchospasm, decreased blood pressure and collapse.

Metabolism and nutrition: rarely - hypokalemia. Therapy with beta 2 agonists can lead to clinically significant hypokalemia.

From the outside nervous system: often - tremor, headache; very rarely - hyperactivity.

From the side of the heart: often - tachycardia; infrequently - palpitations; very rarely - arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystole).

Vascular disorders: rarely - peripheral vasodilation.

From the respiratory system, organs chest and mediastinum: very rarely - paradoxical bronchospasm.

From the gastrointestinal tract: infrequently - irritation of the mucous membrane of the oral cavity and pharynx.

From the musculoskeletal and connective tissue: uncommon - muscle cramps.

Indications

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 diseases lungs, accompanied by reversible airway obstruction, including chronic obstructive pulmonary disease (COPD), chronic bronchitis, pulmonary emphysema.

Bronchodilators should not be the only or main component of the treatment of unstable or severe bronchial asthma. If there is no response to salbutamol in patients with severe bronchial asthma, it is recommended to treat with glucocorticosteroids in order to achieve and maintain disease control. 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.

Salbutamol should be used with caution in patients with thyrotoxicosis, tachyarrhythmia, myocarditis, heart defects, aortic stenosis, coronary disease heart, severe chronic heart failure, arterial hypertension, pheochromocytoma, decompensated diabetes mellitus, glaucoma.

Features of application

Use during pregnancy and breastfeeding

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 were identified, including the formation of a cleft palate and malformations of the limbs, 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.

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.

Use for liver dysfunction

The drug should be used with caution if patients have a history of liver failure.

Use for renal impairment

The drug should be used with caution if patients have a history of renal failure.

Use in children

Can be used in children according to indications.

special instructions

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 beta 2-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 can pose a potential threat to the patient's life, so in such situations the advisability of prescribing or increasing the dose of glucocorticosteroids should be considered. In patients at risk, daily monitoring of peak expiratory flow is recommended.

Therapy with beta 2-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, glucocorticosteroids, 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 other means of inhalation therapy, when taking salbutamol, paradoxical bronchospasm may develop with increased wheezing immediately after taking 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.

Impact on the ability to drive vehicles and operate machinery