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Albuterol

Also indexed as: Albuterol® Inhaled, Proventil®, Ventolin®

Combination drug: Combivent®

Albuterol is a short-acting, beta-adrenergic bronchodilator drug used for relief and prevention of bronchospasm. It is also used to prevent exercise-induced bronchospasm. While albuterol is available in tablet form, it is most commonly used by oral inhalation into the lungs.

Interactions with Dietary Supplements

Minerals
Therapeutic amounts of intravenous salbutamol (albuterol) in four healthy people were associated with decreased plasma levels of calcium, magnesium, phosphate, and potassium.1 Decreased potassium levels have been reported with oral,2 intramuscular, and subcutaneous albuterol administration.3 How frequently this effect occurs is not known; whether these changes are preventable through diet or supplementation is also unknown.

Interactions with Herbs

Digitalis (Digitalis lanata, Digitalis purpurea)
Digitalis refers to a family of plants (commonly called foxglove) that contain digitalis glycosides, chemicals with actions and toxicities similar to the prescription drug digoxin.

In a small study of salbutamol (albuterol) in people receiving digoxin, albuterol was associated with decreased serum digoxin levels.4 No interactions between albuterol and digitalis have been reported. Until more is known, albuterol and digitalis-containing products should be used only under the direct supervision of a doctor trained in their use.

Coleus
A test tube study demonstrated that the bronchodilating effects of salbutamol (albuterol) were significantly increased by the addition of forskolin, the active component of the herb Coleus forskohlii.5 The results of this preliminary research suggest that the combination of forskolin and beta-agonists such as albuterol might provide an alternative to raising the doses of the beta-agonist drugs as they lose effectiveness. Until more is known, coleus should not be combined with albuterol without the supervision of a doctor.

Interactions with Foods and Other Compounds

Food
Albuterol may be taken with food to prevent stomach upset.6

Summary of Interactions for Albuterol

Depletion or interference Calcium*
Magnesium*
Phosphate*
Potassium*
Adverse interaction None known
Side effect reduction/prevention None known
Supportive interaction Coleus*
Reduced drug absorption/bioavailability None known
Other (see text) Digitalis

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Phillips PJ, Vedig AE, Jones PL, et al. Metabolic and cardiovascular side effects of the beta 2-adrenoceptor agonists salbutamol and rimiterol. Br J Clin Pharmacol 1980;9:483–91.

2. Edner M, Jogestrand T. Oral salbutamol decreases serum digoxin concentration. Eur J Clin Pharmacol 1990;38:195–7.

3. Spector SL. Adverse reactions associated with parenteral beta agonists: serum potassium changes. N Engl Reg Allergy Proc 1987;8:317–22.

4. Edner M, Jogestrand T. Oral salbutamol decreases serum digoxin concentration. Eur J Clin Pharmacol 1990;38:195–7.

5. Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51:181–6.

6. Threlkeld DS, ed. Respiratory Drugs, Bronchodilators, Sympathomimetics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1994, 174a–5.