Asthalin (Salbutamol Sulphate)
Also sold as: Asthalin, Levolin (levosalbutamol), Ventorlin, Aerocort (with steroid)
Pregnancy
Cat C
Lactation
Safe
Schedule
H
Forms
Inhaler 100mcg/puff +4
Indications
- Acute asthma/COPD exacerbation (rescue)
- Exercise-induced bronchospasm prevention
- Hyperkalemia (IV/nebulised, off-label)
Adult Dosing
Acute attack (inhaler)
2 puffs every 4-6 hours PRN
Severe exacerbation (nebulised)
2.5-5 mg neb every 20 min × 3, then every 1-4 h
Oral (rarely used)
2-4 mg PO TDS
Pediatric Dosing
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| No adjustment needed | No CrCl-based dose adjustment required |
Pregnancy & Lactation
Pregnancy: Category C
Inhaled is preferred — minimal systemic absorption. Continue in pregnancy.
Lactation: Safe
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Beta-blockers (esp. non-selective) | Antagonize bronchodilation; may precipitate asthma | Major |
| Diuretics, theophylline, steroids | Hypokalemia | Moderate |
| Digoxin | Reduced digoxin levels | Moderate |
| MAOIs, TCAs | Tachycardia, BP changes | Moderate |
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Side Effects
Common
- Tremor
- Tachycardia
- Palpitations
- Headache
- Hypokalemia
- Muscle cramps
Serious / Discontinue If
- Paradoxical bronchospasm
- Severe hypokalemia (in severe asthma + steroids + theophylline)
- Cardiac arrhythmias
Contraindications
- Hypersensitivity
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Asthalin Inhaler 100mcg | Cipla | 200 doses ₹125 |
| Levolin Inhaler | Cipla | 200 doses ₹165 |
| Ventorlin Inhaler | GSK | 200 doses ₹135 |
Monitoring Required
- Frequency of use — overuse signals poor control. ECG, K+ in severe acute use
Patient Counseling Points
- Use inhaler with spacer for better delivery
- Rinse mouth after use
- If using >2 days/week or >2 canisters/year — your asthma is poorly controlled, consult doctor
- Report palpitations or chest pain
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References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- Specialty society guidelines (RSSDI/CSI/IAP)