Proventil, VoSpire ER (sustained release tabs), Proventil HFA (aerosol inhaler), Ventolin HFA (aerosol inhaler), AccuNeb (prediluted nebulized solution), and many other nebulized solutionsKeyTabs:
2, 4 mg Sustained release tabs:
4, 8 mg Oral solution:
2 mg/5 mL (473 mL) Aerosol inhaler (HFA):
90 mcg/actuation (60 actuations/inhaler) (8.5 g) Nebulization solution:
0.5% (5 mg/mL) (20 mL) Prediluted nebulized solution:
0.63 mg in 3 mL NS, 1.25 mg in 3 mL NS, and 2.5 mg in 3 mL NS (0.083%)
Inhalations (non-acute use):
Aerosol (HFA): 2 puffs (90 mcg) Q4–6 hr PRN
<1 yr: 0.05–0.15 mg/kg/dose Q4–6 hr
1–5 yr: 1.25–2.5 mg/dose Q4–6 hr
5–12 yr: 2.5 mg/dose Q4–6 hr
>12 yr: 2.5–5 mg/dose Q4–8 hr
For use in acute exacerbations more aggressive dosing may be employed.
Oral (discouraged—see remarks):
2–6 yr: 0.3 mg/kg/24 hr PO ÷ TID; max. dose: 12 mg/24 hr
6–12 yr: 6 mg/24 hr PO ÷ TID; max. dose: 24 mg/24 hr
>12 yr and adult: 2–4 mg/dose PO TID-QID; max. dose: 32 mg/24 hr
Inhaled doses may be given more frequently than indicated. In such cases, consider cardiac monitoring and monitoring of serum potassium (hypokalemia). Systemic effects are dose related. Please verify the concentration of the nebulization solution used.
Use of oral dosage form is discouraged due to increased side effects and decreased efficacy compared to inhaled formulations.
Possible side effects include tachycardia, palpitations, tremor, insomnia, nervousness, nausea, and headache.
The use of tube spacers or chambers may enhance efficacy of the metered dose inhalers and have been proven to be just as effective and sometimes safer than nebulizers.