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Respiratory Handbook

The professional's guide to product selection

Short-acting selective beta2: agonists

Airomir and Salamol - Salbutamol

Short-acting selective beta2 agonist.

Inhaled
• Child, by aerosol inhalation: 100 mcg (1 puff), increased to 200 mcg (2 puffs) if necessary. For persistent symptoms, up to four times daily.
• Adult, by aerosol inhalation: 100–200 mcg (1–2 puffs), for persistent symptoms up to 4 times daily.
• Adult, by inhalation of nebulised solution: 2.5–5 mg, repeated up to four times daily for persistent symptoms.

Moderate and severe acute asthma by inhalation of aerosol.
• Children and adults: 2–10 puffs, each puff to be inhaled separately, repeat every 10–20 minutes or when required. Each puff is equivalent to 100 mcg.

Bricanyl - Terbutaline

Short-acting selective beta2 agonist.

For asthma
By mouth
Adult: 2.5 mg 3 times a day for 1–2 weeks, then increased to up to 5 mg 3 times a day, use by inhalation preferred over by mouth.
By subcutaneous injection, or slow intravenous injection
Adult:250–500 micrograms up to 4 times a day, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect.
By continuous intravenous infusion
Adult: 90–300 micrograms/hour for 8-10 hours, to be administered as a solution containing 3–5 micrograms/mL, high doses require close monitoring, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect.
By inhalation of powder
Adult: 500 micrograms up to 4 times a day, for persistent symptoms.
By inhalation of nebulised solution
Adult: 5–10 mg 2–4 times a day, additional doses may be necessary in severe acute asthma.

For acute asthma
By subcutaneous injection, or by slow intravenous injection
• Child 2–14 years: 10 mcg/kg up to four times/day (maximum per dose 300 mcg)
• Child 15–17 years: 250–500 mcg up to four times/day
By continuous intravenous infusion
• Child: loading dose of 2–4 mcg/kg, then 1–10 mcg/kg/hour

For moderate, severe, or life-threatening acute asthma (given via oxygen-driven nebuliser if available)
• Child 1 month–4 years: 5 mg, repeated every 20–30 minutes or when required.
• Child 5–11 years: 5–10 mg, repeated every 20–30 minutes or when required.
• Over 12 years: 10 mg, repeated every 20–30 minutes or when required.

Exacerbation of reversible airway obstruction (including nocturnal asthma), prevention of exercise-induced bronchospasm
By inhalation of powder
• Child 5–17 years: 500 mcg up to four times/day
By mouth
• Child 1 month–6 years: 75 mcg/kg three times/day (maximum per dose 2.5 mg)
• Child 7–14 years: 2.5 mg 2–3 times daily
• Child 15–17 years: 2.5 mg three times/day, then increased if necessary to 5 mg three times/day.

Easyhaler - Salbutamol

Short-acting selective beta2 agonist.

Inhaled
• Child, by aerosol inhalation: 100 mcg (1 puff), increased to 200 mcg (2 puffs) if necessary. For persistent symptoms, up to four times daily.
• Adult, by aerosol inhalation: 100–200 mcg (1–2 puffs), for persistent symptoms up to 4 times daily.
• Adult, by inhalation of nebulised solution: 2.5–5 mg, repeated up to four times daily for persistent symptoms.

Moderate and severe acute asthma by inhalation of aerosol.
• Children and adults: 2–10 puffs, each puff to be inhaled separately, repeat every 10–20 minutes or when required. Each puff is equivalent to 100 mcg.

Salbulin Novolizer - Salbutamol

Short-acting selective beta2 agonist.

For acute bronchospasm, Salbulin Novolizer® by inhalation of powder
Adult: Initially 100–200 micrograms, up to 800 micrograms daily for persistent symptoms.

For prophylaxis of allergen- or exercise-induced bronchospasm, Salbulin Novolizer® by inhalation of powder
Adult: 200 micrograms.

Salbutamol - AAH Pharmaceuticals Ltd

Short-acting selective beta2 agonist.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Salbutamol - Accord Healthcare Ltd

Short-acting selective beta2 agonist.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Salbutamol - Alliance Healthcare (Distribution) UK

Short-acting selective beta2 agonist.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Salbutamol - DE Pharmaceuticals

Short-acting selective beta2 agonist.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Salbutamol - Medihealth (Northern) Ltd

Short-acting selective beta2 agonist.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Salbutamol - Phoenix Healthcare Distribution Ltd

Short-acting selective beta2 agonist.

Injection
• Child 1–23 months, by intravenous injection over 5 minutes: 5 mcg/kg as a single dose.
• Child 2–17 years, by intravenous injection over 5 minutes: 15 mcg/kg (maximum 250 mcg) as a single dose.
• Adult, subcutaneous or intramuscular injection: 500 mcg, repeated every four hours if necessary.
• Adult, by slow intravenous injection: (dilute to a concentration of 50 mcg/ml), 250 mcg, repeated if necessary.

Infusion
• Child 1 month–18 years: 1–2 mcg/kg/minute, adjusted according to response and heart rate, up to 5 mcg/kg/minute. Doses above 2 mcg/kg/minute should be given in an intensive care setting.
• Adult, by intravenous infusion: initially 5 mcg/minute, adjusted according to response and heart rate, usually in range 3–20 mcg/minute, or more if necessary.

Inhaled
• Child, by aerosol inhalation: 100 mcg (1 puff), increased to 200 mcg (2 puffs) if necessary. For persistent symptoms, up to four times daily.
• Adult, by aerosol inhalation: 100–200 mcg (1–2 puffs), for persistent symptoms up to 4 times daily.
• Adult, by inhalation of nebulised solution: 2.5–5 mg, repeated up to four times daily for persistent symptoms.

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Moderate and severe acute asthma by inhalation of aerosol.
• Children and adults: 2–10 puffs, each puff to be inhaled separately, repeat every 10–20 minutes or when required. Each puff is equivalent to 100 mcg.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Salbutamol - Pinewood Healthcare

Short-acting selective beta2 agonist.

Injection
• Child 1–23 months, by intravenous injection over 5 minutes: 5 mcg/kg as a single dose.
• Child 2–17 years, by intravenous injection over 5 minutes: 15 mcg/kg (maximum 250 mcg) as a single dose.
• Adult, subcutaneous or intramuscular injection: 500 mcg, repeated every four hours if necessary.
• Adult, by slow intravenous injection: (dilute to a concentration of 50 mcg/ml), 250 mcg, repeated if necessary.

Infusion
• Child 1 month–18 years: 1–2 mcg/kg/minute, adjusted according to response and heart rate, up to 5 mcg/kg/minute. Doses above 2 mcg/kg/minute should be given in an intensive care setting.
• Adult, by intravenous infusion: initially 5 mcg/minute, adjusted according to response and heart rate, usually in range 3–20 mcg/minute, or more if necessary.

Inhaled
• Child, by aerosol inhalation: 100 mcg (1 puff), increased to 200 mcg (2 puffs) if necessary. For persistent symptoms, up to four times daily.
• Adult, by aerosol inhalation: 100–200 mcg (1–2 puffs), for persistent symptoms up to 4 times daily.
• Adult, by inhalation of nebulised solution: 2.5–5 mg, repeated up to four times daily for persistent symptoms.

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Moderate and severe acute asthma by inhalation of aerosol.
• Children and adults: 2–10 puffs, each puff to be inhaled separately, repeat every 10–20 minutes or when required. Each puff is equivalent to 100 mcg.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Terbutaline - AAH Pharmaceuticals Ltd

By inhalation of nebulised solution for asthma
• Over 12 years: 5–10 mg 2–4 times daily, additional doses may be necessary in severe acute asthma.

By inhalation of nebulised solution for moderate to severe acute asthma
• Child 1 month–4 years: 5 mg, repeat every 20–30 minutes or as required
• Child 5–11 years: 5–10 mg, repeat every 20–30 minutes or as required
• Over 12 years: 10 mg, repeat every 20–30 minutes or as required

Terbutaline - Accord Healthcare Ltd

Short-acting selective beta2 agonist.

By inhalation of nebulised solution for asthma
• Over 12 years: 5–10 mg 2–4 times daily, additional doses may be necessary in severe acute asthma.

By inhalation of nebulised solution for moderate to severe acute asthma
• Child 1 month–4 years: 5 mg, repeat every 20–30 minutes or as required
• Child 5–11 years: 5–10 mg, repeat every 20–30 minutes or as required
• Over 12 years: 10 mg, repeat every 20–30 minutes or as required

Terbutaline - Alliance Healthcare (Distribution) Ltd

By inhalation of nebulised solution for asthma
• Over 12 years: 5–10 mg 2–4 times daily, additional doses may be necessary in severe acute asthma.

By inhalation of nebulised solution for moderate to severe acute asthma
• Child 1 month–4 years: 5 mg, repeat every 20–30 minutes or as required
• Child 5–11 years: 5–10 mg, repeat every 20–30 minutes or as required
• Over 12 years: 10 mg, repeat every 20–30 minutes or as required

Ventolin - Salbutamol

Short-acting selective beta2 agonist.

Injection
• Child 1–23 months, by intravenous injection over 5 minutes: 5 mcg/kg as a single dose.
• Child 2–17 years, by intravenous injection over 5 minutes: 15 mcg/kg (maximum 250 mcg) as a single dose.
• Adult, subcutaneous or intramuscular injection: 500 mcg, repeated every four hours if necessary.
• Adult, by slow intravenous injection: (dilute to a concentration of 50 mcg/ml), 250 mcg, repeated if necessary.

Infusion
• Child 1 month–18 years: 1–2 mcg/kg/minute, adjusted according to response and heart rate, up to 5 mcg/kg/minute. Doses above 2 mcg/kg/minute should be given in an intensive care setting.
• Adult, by intravenous infusion: initially 5 mcg/minute, adjusted according to response and heart rate, usually in range 3–20 mcg/minute, or more if necessary.

Inhaled
• Child, by aerosol inhalation: 100 mcg (1 puff), increased to 200 mcg (2 puffs) if necessary. For persistent symptoms, up to four times daily.
• Adult, by aerosol inhalation: 100–200 mcg (1–2 puffs), for persistent symptoms up to 4 times daily.
• Adult, by inhalation of nebulised solution: 2.5–5 mg, repeated up to four times daily for persistent symptoms.

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Moderate and severe acute asthma by inhalation of aerosol.
• Children and adults: 2–10 puffs, each puff to be inhaled separately, repeat every 10–20 minutes or when required. Each puff is equivalent to 100 mcg.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).