albuterol (Rx)

Brand and Other Names:Proventil HFA, Ventolin HFA, more...Proair HFA, ProAir RespiClick, Proventil, AccuNeb, Ventolin Injection, Ventolin Nebules PF, Ventolin Oral Liquid, Ventolin Respirator Solution, ProAir Digihaler
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

aerosol metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate)

powder metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate); ProAir RespiClick

powder metered-dose inhaler with electronic module

  • 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate); ProAir Digihaler

tablet

  • 2mg
  • 4mg

tablet, extended release

  • 4mg
  • 8mg

nebulizer solution

  • 1.25mg/3mL (contains 1.50 mg albuterol sulfate/3 mL)
  • 0.63mg/3mL (contains 0.75 mg albuterol sulfate/3 mL)

syrup

  • 2mg/5mL

Bronchospasm

Indicated for treatment or prevention of bronchospasm in patients with reversible obstructive airway disease

Nebulizer solution: 2.5 mg BID/TID PRN; 1.25 - 5 mg q4-8hr PRN for quick relief

Aerosol metered-dose inhaler: 180 mcg (2 puffs) inhaled PO q4-6hr; not to exceed 12 inhalations/24 hr

Powder metered-dose inhaler (ProAir RespiClick or ProAir Digihaler): 180 mcg (2 puffs) inhaled PO q4-6hr; not to exceed 12 inhalations/24 hr; in some patients 1 inhalation (90 mcg) q4hr may be sufficient

Tablet and syrup: 2-4 mg PO q6-8hr; not to exceed 32 mg/day

Extended-release tablets: 8 mg PO q12hr; in some patients 4 mg PO q12hr sufficient; not to exceed 32 mg/day

Acute or Severe Bronchospasm

Nebulizer solution: 2.5-5 mg q20min for 3 doses; follow with 2.5-10 mg q1-4hr PRN or 10-15 min by continuous nebulization

Metered-dose inhaler: 4-8 puffs inhaled q20min for up to 4 hr and then q1-4hr PRN

Exercise-induced Bronchospasm

Indicated for prevention of exercise-induced bronchospasm

Aerosol or powder metered-dose inhaler: 180 mcg (2 puffs) inhaled 15-30 min before exercise

Spinal Cord Injury (Orphan)

Prevention of paralysis caused by spinal cord injury

Orphan indication sponsor

  • MotoGen, Inc, 3 Pine View Road, Mount Kisco, NY 10549

Dosing Considerations

ProAir Digihaler: Contains a QR code and a built-in electronic module which automatically detects, records, and stores data on inhaler events, including peak inspiratory flow rate (L/min)

Dosage Forms & Strengths

aerosol metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate)

powder metered-dose inhaler

  • 90mcg (base)/actuation (equivalent to 108mcg abluterol sulfate); ProAir RespiClick

powder metered-dose inhaler with electronic module

  • 90mcg (base)/actuation (equivalent to 108mcg albuterol sulfate); ProAir Digihaler

tablet

  • 2mg
  • 4mg

tablet, extended-release

  • 4mg
  • 8mg

nebulizer solution

  • 1.25mg/3mL (contains 1.50 mg albuterol sulfate/3 mL)
  • 0.63mg/3mL (contains 0.75 mg albuterol sulfate/3 mL)

syrup

  • 2mg/5mL

Bronchospasm

Treatment and prevention of bronchospasm associated with obstructive airway disease

Aerosol metered-dose inhaler

  • <4 years: Safety and efficacy not established
  • ≥4 years: 90-180 mcg (1-2 puffs) inhaled PO q4-6 hr

Powder metered-dose inhaler (ProAir RespiClick or ProAir Digihaler)

  • <4 years: Safety and efficacy not established
  • ≥4 years: 180 mcg (2 puffs) inhaled PO q4-6hr; not to exceed 12 inhalations/24 hr
  • In some patients 1 inhalation (90 mcg) q4hr may be sufficient

Nebulizer solution

  • <2 years (off-label): 0.2-0.6 mg/kg/day divided q4-6hr  
  • 2-12 years and <15 kg: 2.5 mg/0.5mL (0.5 % solution) q6-8hr; not to exceed 10 mg (4 vials)/24hr
  • 2-12 years and >15 kg: 1 vial (2.5 mg/3mL) q6-8hr; not to exceed 10 mg (4 vials)/24hr
  • >12 years: 2.5 mg (1 vial) q6-8hr PRN; not to exceed 10 mg/24hr
  • Flow rate of delivery adjusted over period of 5-15 minutes

AccuNeb

  • <2 years: Safety and efficacy not established
  • 2-12 years 1 vial (1.25 or 0.63 mg/vial) q6-8hr inhaled PO via nebulizer over 5-15 min; 4 vials (5 mg)/24 hr
  • >12 years: Not studied

Tablet

  • <6 years: 0.3-0.6 mg/kg/day PO divided q8hr; not to exceed 12 mg/day
  • 6-12 years: 2 mg PO q6-8hr; may be gradually increased to ≤24 mg/day in divided doses
  • >12 years: 2-4 mg PO q6-8hr; not to exceed 32 mg/day

Extended-release Tablet

  • <6 years: Safety and efficacy not established
  • 6-12 years: 4 mg PO q12hr; not to exceed 24 mg/day
  • >12 years: 8 mg PO q12hr; in some patients 4 mg q12hr sufficient

Syrup

  • 2-6 years: 0.1 mg (0.25 mL)/kg PO q8hr initially, not to exceed 2 mg (5 mL) q8hr; if necessary, may be increased to 0.2 mg/kg PO q8hr, not to exceed 4 mg (10 mL) q8hr
  • 6-14 years: 2 mg (5 mL) PO q6-8hr; may be gradually increased to ≤24 mg/day in divided doses
  • >14 years: 2-4 mg PO q6-8hr; not to exceed 32 mg/day

Exercise-induced Bronchospasm Prevention

Aerosol metered-dose inhaler

  • <4 years: Safety and efficacy not established
  • ≥4 years: 180 mcg (2 puffs) inhaled 15-30 min before exercise

Powder metered-dose inhaler (ProAir RespiClick or ProAir Digihaler)

  • <4 years: Safety and efficacy not established
  • ≥4 years: 180 mcg (2 puffs) inhaled 15-30 min before exercise

Dosing Considerations

Potential toxic dose for children <6 years: 1 mg/kg

ProAir Digihaler: Contains a QR code and a built-in electronic module which automatically detects, records, and stores data on inhaler events, including peak inspiratory flow rate (L/min)

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Interactions

Interaction Checker

and albuterol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (4)

            • cisapride

              albuterol and cisapride both increase QTc interval. Contraindicated.

            • dronedarone

              albuterol and dronedarone both increase QTc interval. Contraindicated.

            • saquinavir

              saquinavir, albuterol. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Contraindicated. Saquinavir boosted with ritonavir increases risk of hypokalemia, QT prolongation, and cardiac arrhythmias.

            • thioridazine

              albuterol and thioridazine both increase QTc interval. Contraindicated.

            Serious - Use Alternative (21)

            • amitriptyline

              amitriptyline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • amoxapine

              amoxapine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • azithromycin

              albuterol and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

            • clomipramine

              clomipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • desipramine

              desipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • doxepin

              doxepin, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • fexinidazole

              fexinidazole and albuterol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels and/or prolong QT interval.

            • hydroxychloroquine sulfate

              albuterol and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.

            • imipramine

              imipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • isocarboxazid

              isocarboxazid increases effects of albuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • linezolid

              linezolid increases effects of albuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • lofepramine

              lofepramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • lopinavir

              albuterol and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.

            • maprotiline

              maprotiline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • nortriptyline

              nortriptyline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • phenelzine

              phenelzine increases effects of albuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • pimozide

              albuterol and pimozide both increase QTc interval. Contraindicated.

            • protriptyline

              protriptyline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • tranylcypromine

              tranylcypromine increases effects of albuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • trazodone

              trazodone, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • trimipramine

              trimipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            Monitor Closely (331)

            • acebutolol

              acebutolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              acebutolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • aceclofenac

              aceclofenac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • acemetacin

              acemetacin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alfentanil

              alfentanil increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alprazolam

              alprazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amiloride

              amiloride increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • amiodarone

              albuterol and amiodarone both increase QTc interval. Use Caution/Monitor.

            • amisulpride

              albuterol and amisulpride both increase QTc interval. Use Caution/Monitor.

            • amitriptyline

              amitriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and amitriptyline both increase QTc interval. Use Caution/Monitor.

            • amobarbital

              amobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amoxapine

              amoxapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • anagrelide

              albuterol and anagrelide both increase QTc interval. Use Caution/Monitor.

            • apomorphine

              albuterol and apomorphine both increase QTc interval. Use Caution/Monitor.

            • arformoterol

              albuterol and arformoterol both decrease serum potassium. Use Caution/Monitor.

              albuterol and arformoterol both decrease sedation. Use Caution/Monitor.

              albuterol and arformoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • aripiprazole

              aripiprazole increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • armodafinil

              albuterol and armodafinil both decrease sedation. Use Caution/Monitor.

            • arsenic trioxide

              albuterol and arsenic trioxide both increase QTc interval. Use Caution/Monitor.

            • artemether/lumefantrine

              albuterol and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • asenapine

              albuterol and asenapine both increase QTc interval. Use Caution/Monitor.

            • aspirin

              aspirin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aspirin rectal

              aspirin rectal increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • aspirin/citric acid/sodium bicarbonate

              aspirin/citric acid/sodium bicarbonate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • atenolol

              atenolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              atenolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • atomoxetine

              atomoxetine, albuterol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of tachycardia, increased blood pressure.

            • azelastine

              azelastine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • bedaquiline

              albuterol and bedaquiline both increase QTc interval. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • bendroflumethiazide

              albuterol and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.

            • benperidol

              benperidol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benzphetamine

              albuterol and benzphetamine both decrease sedation. Use Caution/Monitor.

              albuterol and benzphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • betaxolol

              betaxolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              betaxolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • bisoprolol

              bisoprolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              bisoprolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • brompheniramine

              brompheniramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • bumetanide

              albuterol and bumetanide both decrease serum potassium. Use Caution/Monitor.

            • buprenorphine

              buprenorphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and buprenorphine both increase QTc interval. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butabarbital

              butabarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butalbital

              butalbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butorphanol

              butorphanol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • caffeine

              albuterol and caffeine both decrease sedation. Use Caution/Monitor.

            • carbenoxolone

              albuterol and carbenoxolone both decrease serum potassium. Use Caution/Monitor.

            • carbinoxamine

              carbinoxamine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carvedilol

              carvedilol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              carvedilol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • celecoxib

              celecoxib increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • celiprolol

              celiprolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              celiprolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • chloral hydrate

              chloral hydrate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chloroquine

              albuterol and chloroquine both increase QTc interval. Use Caution/Monitor.

            • chlorothiazide

              albuterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and chlorpromazine both increase QTc interval. Use Caution/Monitor.

            • chlorthalidone

              albuterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.

            • choline magnesium trisalicylate

              choline magnesium trisalicylate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • cinnarizine

              cinnarizine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ciprofloxacin

              albuterol and ciprofloxacin both increase QTc interval. Use Caution/Monitor.

            • citalopram

              albuterol and citalopram both increase QTc interval. Use Caution/Monitor.

            • clarithromycin

              albuterol and clarithromycin both increase QTc interval. Use Caution/Monitor.

            • clemastine

              clemastine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clomipramine

              clomipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clonazepam

              clonazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clorazepate

              clorazepate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clozapine

              clozapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and clozapine both increase QTc interval. Use Caution/Monitor.

            • codeine

              codeine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • crizotinib

              albuterol and crizotinib both increase QTc interval. Use Caution/Monitor.

            • cyclizine

              cyclizine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyclopenthiazide

              albuterol and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dasatinib

              albuterol and dasatinib both increase QTc interval. Use Caution/Monitor.

            • deflazacort

              albuterol and deflazacort both decrease serum potassium. Use Caution/Monitor.

            • degarelix

              albuterol and degarelix both increase QTc interval. Use Caution/Monitor.

            • desipramine

              desipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and desipramine both increase QTc interval. Use Caution/Monitor.

            • deutetrabenazine

              albuterol and deutetrabenazine both increase QTc interval. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexfenfluramine

              albuterol and dexfenfluramine both decrease sedation. Use Caution/Monitor.

              albuterol and dexfenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dexmedetomidine

              dexmedetomidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexmethylphenidate

              albuterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              albuterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dextroamphetamine

              albuterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              albuterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dextromoramide

              dextromoramide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diamorphine

              diamorphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dichlorphenamide

              dichlorphenamide and albuterol both decrease serum potassium. Use Caution/Monitor.

              dichlorphenamide, albuterol. Either increases levels of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

            • diclofenac

              diclofenac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diethylpropion

              albuterol and diethylpropion both decrease sedation. Use Caution/Monitor.

              albuterol and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diflunisal

              diflunisal increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • digoxin

              digoxin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dipipanone

              dipipanone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • disopyramide

              albuterol and disopyramide both increase QTc interval. Use Caution/Monitor.

            • dobutamine

              albuterol and dobutamine both decrease serum potassium. Use Caution/Monitor.

              albuterol and dobutamine both decrease sedation. Use Caution/Monitor.

              albuterol and dobutamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dolasetron

              albuterol and dolasetron both increase QTc interval. Use Caution/Monitor.

            • dopamine

              albuterol and dopamine both decrease sedation. Use Caution/Monitor.

              albuterol and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dopexamine

              albuterol and dopexamine both decrease serum potassium. Use Caution/Monitor.

              albuterol and dopexamine both decrease sedation. Use Caution/Monitor.

              albuterol and dopexamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

              dopexamine, albuterol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.

            • doxepin

              doxepin increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • droperidol

              droperidol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and droperidol both increase QTc interval. Use Caution/Monitor.

            • drospirenone

              drospirenone increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • encorafenib

              albuterol and encorafenib both increase QTc interval. Use Caution/Monitor.

            • entrectinib

              albuterol and entrectinib both increase QTc interval. Use Caution/Monitor.

            • ephedrine

              albuterol and ephedrine both decrease serum potassium. Use Caution/Monitor.

              albuterol and ephedrine both decrease sedation. Use Caution/Monitor.

              albuterol and ephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine

              albuterol and epinephrine both decrease serum potassium. Use Caution/Monitor.

              albuterol and epinephrine both decrease sedation. Use Caution/Monitor.

              albuterol and epinephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine racemic

              albuterol and epinephrine racemic both decrease serum potassium. Use Caution/Monitor.

              albuterol and epinephrine racemic both decrease sedation. Use Caution/Monitor.

              albuterol and epinephrine racemic both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • eribulin

              albuterol and eribulin both increase QTc interval. Use Caution/Monitor.

            • erythromycin base

              albuterol and erythromycin base both increase QTc interval. Use Caution/Monitor.

            • erythromycin ethylsuccinate

              albuterol and erythromycin ethylsuccinate both increase QTc interval. Use Caution/Monitor.

            • erythromycin lactobionate

              albuterol and erythromycin lactobionate both increase QTc interval. Use Caution/Monitor.

            • erythromycin stearate

              albuterol and erythromycin stearate both increase QTc interval. Use Caution/Monitor.

            • escitalopram

              albuterol and escitalopram both increase QTc interval. Use Caution/Monitor.

            • esmolol

              esmolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              esmolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • estazolam

              estazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ethacrynic acid

              albuterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

            • ethanol

              ethanol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • etodolac

              etodolac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fenfluramine

              albuterol and fenfluramine both decrease sedation. Use Caution/Monitor.

              albuterol and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • fenoprofen

              fenoprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fexinidazole

              albuterol and fexinidazole both increase QTc interval. Use Caution/Monitor.

            • flecainide

              albuterol and flecainide both increase QTc interval. Use Caution/Monitor.

            • fluconazole

              albuterol and fluconazole both increase QTc interval. Use Caution/Monitor.

            • fluoxetine

              albuterol and fluoxetine both increase QTc interval. Use Caution/Monitor.

            • fluphenazine

              fluphenazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and fluphenazine both increase QTc interval. Use Caution/Monitor.

            • flurazepam

              flurazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • flurbiprofen

              flurbiprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • formoterol

              albuterol and formoterol both decrease serum potassium. Use Caution/Monitor.

              albuterol and formoterol both decrease sedation. Use Caution/Monitor.

              albuterol and formoterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • foscarnet

              albuterol and foscarnet both increase QTc interval. Use Caution/Monitor.

            • fostemsavir

              albuterol and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

            • furosemide

              albuterol and furosemide both decrease serum potassium. Use Caution/Monitor.

            • gemifloxacin

              albuterol and gemifloxacin both increase QTc interval. Use Caution/Monitor.

            • gemtuzumab

              albuterol and gemtuzumab both increase QTc interval. Use Caution/Monitor.

            • gentamicin

              albuterol and gentamicin both decrease serum potassium. Use Caution/Monitor.

            • gilteritinib

              albuterol and gilteritinib both increase QTc interval. Use Caution/Monitor.

            • glasdegib

              albuterol and glasdegib both increase QTc interval. Use Caution/Monitor.

            • goserelin

              albuterol and goserelin both increase QTc interval. Use Caution/Monitor.

            • granisetron

              albuterol and granisetron both increase QTc interval. Use Caution/Monitor.

            • green tea

              green tea increases effects of albuterol by pharmacodynamic synergism. Use Caution/Monitor. Due to caffeine content. Combination may increase CNS stimulatory effects due to caffeine in green tea.

            • haloperidol

              haloperidol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and haloperidol both increase QTc interval. Use Caution/Monitor.

            • histrelin

              albuterol and histrelin both increase QTc interval. Use Caution/Monitor.

            • hydrochlorothiazide

              albuterol and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.

            • hydromorphone

              hydromorphone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and hydroxyzine both increase QTc interval. Use Caution/Monitor.

            • ibuprofen

              ibuprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ibuprofen IV

              ibuprofen IV increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ibutilide

              albuterol and ibutilide both increase QTc interval. Use Caution/Monitor.

            • iloperidone

              iloperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and iloperidone both increase QTc interval. Use Caution/Monitor.

            • imipramine

              imipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • indapamide

              albuterol and indapamide both decrease serum potassium. Use Caution/Monitor.

            • indomethacin

              indomethacin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • inotuzumab

              albuterol and inotuzumab both increase QTc interval. Use Caution/Monitor.

            • irbesartan

              irbesartan increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • isoflurane

              albuterol and isoflurane both increase QTc interval. Use Caution/Monitor.

            • isoproterenol

              albuterol and isoproterenol both decrease serum potassium. Use Caution/Monitor.

              albuterol and isoproterenol both decrease sedation. Use Caution/Monitor.

              albuterol and isoproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • itraconazole

              albuterol and itraconazole both increase QTc interval. Use Caution/Monitor.

            • ivosidenib

              albuterol and ivosidenib both increase QTc interval. Use Caution/Monitor.

            • ketoprofen

              ketoprofen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketorolac

              ketorolac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketorolac intranasal

              ketorolac intranasal increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • ketotifen, ophthalmic

              ketotifen, ophthalmic increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • labetalol

              labetalol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              labetalol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • lapatinib

              albuterol and lapatinib both increase QTc interval. Use Caution/Monitor.

            • lefamulin

              albuterol and lefamulin both increase QTc interval. Use Caution/Monitor.

            • lenvatinib

              albuterol and lenvatinib both increase QTc interval. Use Caution/Monitor.

            • leuprolide

              albuterol and leuprolide both increase QTc interval. Use Caution/Monitor.

            • levalbuterol

              albuterol and levalbuterol both decrease serum potassium. Use Caution/Monitor.

              albuterol and levalbuterol both decrease sedation. Use Caution/Monitor.

              albuterol and levalbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • levofloxacin

              albuterol and levofloxacin both increase QTc interval. Use Caution/Monitor.

            • levorphanol

              levorphanol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lisdexamfetamine

              albuterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

              albuterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • lithium

              albuterol and lithium both increase QTc interval. Use Caution/Monitor.

            • lofepramine

              lofepramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lofexidine

              lofexidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and lofexidine both increase QTc interval. Use Caution/Monitor.

            • loperamide

              albuterol and loperamide both increase QTc interval. Use Caution/Monitor.

            • loprazolam

              loprazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lorazepam

              lorazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lormetazepam

              lormetazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lornoxicam

              lornoxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine

              loxapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • maprotiline

              maprotiline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and maprotiline both increase QTc interval. Use Caution/Monitor.

            • marijuana

              marijuana increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meclofenamate

              meclofenamate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mefenamic acid

              mefenamic acid increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mefloquine

              albuterol and mefloquine both increase QTc interval. Use Caution/Monitor.

            • melatonin

              melatonin increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meloxicam

              meloxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meperidine

              meperidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meprobamate

              meprobamate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaproterenol

              albuterol and metaproterenol both decrease serum potassium. Use Caution/Monitor.

              albuterol and metaproterenol both decrease sedation. Use Caution/Monitor.

              albuterol and metaproterenol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methadone

              methadone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and methadone both increase QTc interval. Use Caution/Monitor.

            • methamphetamine

              albuterol and methamphetamine both decrease sedation. Use Caution/Monitor.

              albuterol and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methyclothiazide

              albuterol and methyclothiazide both decrease serum potassium. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              albuterol and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.

              albuterol and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methylphenidate

              albuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • metolazone

              albuterol and metolazone both decrease serum potassium. Use Caution/Monitor.

            • metoprolol

              metoprolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              metoprolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • midazolam

              midazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • midodrine

              albuterol and midodrine both decrease sedation. Use Caution/Monitor.

              albuterol and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • mifepristone

              albuterol and mifepristone both increase QTc interval. Use Caution/Monitor.

            • mirtazapine

              mirtazapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and mirtazapine both increase QTc interval. Use Caution/Monitor.

            • modafinil

              albuterol and modafinil both decrease sedation. Use Caution/Monitor.

            • morphine

              morphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • motherwort

              motherwort increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • moxifloxacin

              albuterol and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • moxonidine

              moxonidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nabilone

              nabilone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nabumetone

              nabumetone increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nadolol

              nadolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              nadolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • nalbuphine

              nalbuphine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • naproxen

              naproxen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nebivolol

              nebivolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              nebivolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • nilotinib

              albuterol and nilotinib both increase QTc interval. Use Caution/Monitor.

            • norepinephrine

              albuterol and norepinephrine both decrease serum potassium. Use Caution/Monitor.

              albuterol and norepinephrine both decrease sedation. Use Caution/Monitor.

              albuterol and norepinephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • nortriptyline

              nortriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and nortriptyline both increase QTc interval. Use Caution/Monitor.

            • octreotide

              albuterol and octreotide both increase QTc interval. Use Caution/Monitor.

            • ofloxacin

              albuterol and ofloxacin both increase QTc interval. Use Caution/Monitor.

            • olanzapine

              olanzapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances

            • olodaterol inhaled

              albuterol and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects

              albuterol and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.

            • ondansetron

              albuterol and ondansetron both increase QTc interval. Use Caution/Monitor.

            • opium tincture

              opium tincture increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • osilodrostat

              osilodrostat and albuterol both increase QTc interval. Use Caution/Monitor.

              albuterol and osilodrostat both increase QTc interval. Use Caution/Monitor. Dose dependent QT prolongation - avoid drugs known to prolong the QT interval

            • osimertinib

              albuterol and osimertinib both increase QTc interval. Use Caution/Monitor.

            • oxaliplatin

              oxaliplatin will increase the level or effect of albuterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

              albuterol and oxaliplatin both increase QTc interval. Use Caution/Monitor.

            • oxaprozin

              oxaprozin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxazepam

              oxazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxycodone

              oxycodone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxymorphone

              oxymorphone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ozanimod

              albuterol and ozanimod both increase QTc interval. Use Caution/Monitor.

            • paliperidone

              paliperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and paliperidone both increase QTc interval. Use Caution/Monitor.

            • panobinostat

              albuterol and panobinostat both increase QTc interval. Use Caution/Monitor.

            • papaveretum

              papaveretum increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • papaverine

              papaverine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • parecoxib

              parecoxib increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pasireotide

              albuterol and pasireotide both increase QTc interval. Use Caution/Monitor.

            • pazopanib

              albuterol and pazopanib both increase QTc interval. Use Caution/Monitor.

            • penbutolol

              penbutolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              penbutolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • pentamidine

              albuterol and pentamidine both increase QTc interval. Use Caution/Monitor.

            • pentazocine

              pentazocine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pentobarbital

              pentobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • perphenazine

              perphenazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phendimetrazine

              albuterol and phendimetrazine both decrease sedation. Use Caution/Monitor.

              albuterol and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenobarbital

              phenobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenoxybenzamine

              phenoxybenzamine, albuterol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

            • phentermine

              albuterol and phentermine both decrease sedation. Use Caution/Monitor.

              albuterol and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenylephrine

              albuterol and phenylephrine both decrease sedation. Use Caution/Monitor.

              albuterol and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenylephrine PO

              albuterol and phenylephrine PO both decrease sedation. Use Caution/Monitor.

              albuterol and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • pholcodine

              pholcodine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimavanserin

              albuterol and pimavanserin both increase QTc interval. Use Caution/Monitor.

            • pimozide

              pimozide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pindolol

              pindolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              pindolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • pirbuterol

              albuterol and pirbuterol both decrease serum potassium. Use Caution/Monitor.

              albuterol and pirbuterol both decrease sedation. Use Caution/Monitor.

              albuterol and pirbuterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • piroxicam

              piroxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pitolisant

              albuterol and pitolisant both increase QTc interval. Use Caution/Monitor.

            • ponesimod

              albuterol and ponesimod both increase QTc interval. Use Caution/Monitor.

            • posaconazole

              albuterol and posaconazole both increase QTc interval. Use Caution/Monitor.

            • potassium acid phosphate

              potassium acid phosphate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • potassium chloride

              potassium chloride increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • primaquine

              albuterol and primaquine both increase QTc interval. Use Caution/Monitor.

            • primidone

              primidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • procainamide

              albuterol and procainamide both increase QTc interval. Use Caution/Monitor.

            • procarbazine

              procarbazine increases effects of albuterol by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.

            • prochlorperazine

              prochlorperazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • promethazine

              promethazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • propafenone

              albuterol and propafenone both increase QTc interval. Use Caution/Monitor.

            • propranolol

              propranolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              propranolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • propylhexedrine

              albuterol and propylhexedrine both decrease sedation. Use Caution/Monitor.

              albuterol and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • protriptyline

              protriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and protriptyline both increase QTc interval. Use Caution/Monitor.

            • pseudoephedrine

              albuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • quazepam

              quazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quetiapine

              quetiapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and quetiapine both increase QTc interval. Use Caution/Monitor.

            • quinidine

              albuterol and quinidine both increase QTc interval. Use Caution/Monitor.

            • quinine

              albuterol and quinine both increase QTc interval. Use Caution/Monitor.

            • ranolazine

              albuterol and ranolazine both increase QTc interval. Use Caution/Monitor.

            • ribociclib

              albuterol and ribociclib both increase QTc interval. Use Caution/Monitor.

            • rilpivirine

              albuterol and rilpivirine both increase QTc interval. Use Caution/Monitor.

            • risperidone

              risperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and risperidone both increase QTc interval. Use Caution/Monitor.

            • romidepsin

              albuterol and romidepsin both increase QTc interval. Use Caution/Monitor.

            • sacubitril/valsartan

              sacubitril/valsartan increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • salicylates (non-asa)

              salicylates (non-asa) increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • salmeterol

              albuterol and salmeterol both decrease serum potassium. Use Caution/Monitor.

              albuterol and salmeterol both decrease sedation. Use Caution/Monitor.

              albuterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • salsalate

              salsalate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • saquinavir

              albuterol and saquinavir both increase QTc interval. Use Caution/Monitor.

            • scullcap

              scullcap increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • secobarbital

              secobarbital increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • selpercatinib

              albuterol and selpercatinib both increase QTc interval. Use Caution/Monitor.

            • sertraline

              albuterol and sertraline both increase QTc interval. Use Caution/Monitor.

            • sevoflurane

              albuterol and sevoflurane both increase QTc interval. Use Caution/Monitor.

            • shepherd's purse

              shepherd's purse increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • siponimod

              albuterol and siponimod both increase QTc interval. Use Caution/Monitor.

            • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

              albuterol and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.

            • solifenacin

              albuterol and solifenacin both increase QTc interval. Use Caution/Monitor.

            • solriamfetol

              albuterol and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • sorafenib

              albuterol and sorafenib both increase QTc interval. Use Caution/Monitor.

            • sotalol

              sotalol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              sotalol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

              albuterol and sotalol both increase QTc interval. Use Caution/Monitor.

            • spironolactone

              spironolactone increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • succinylcholine

              succinylcholine increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sufentanil

              sufentanil increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sulfasalazine

              sulfasalazine increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sulindac

              sulindac increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sunitinib

              albuterol and sunitinib both increase QTc interval. Use Caution/Monitor.

            • tacrolimus

              albuterol and tacrolimus both increase QTc interval. Use Caution/Monitor.

            • tapentadol

              tapentadol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • telavancin

              albuterol and telavancin both increase QTc interval. Use Caution/Monitor.

            • temazepam

              temazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • terbutaline

              albuterol and terbutaline both decrease serum potassium. Use Caution/Monitor.

              albuterol and terbutaline both decrease sedation. Use Caution/Monitor.

              albuterol and terbutaline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • tetrabenazine

              albuterol and tetrabenazine both increase QTc interval. Use Caution/Monitor.

            • thioridazine

              thioridazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • thiothixene

              thiothixene increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • timolol

              timolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              timolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

            • tolfenamic acid

              tolfenamic acid increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tolmetin

              tolmetin increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tolvaptan

              tolvaptan increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • topiramate

              topiramate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • toremifene

              albuterol and toremifene both increase QTc interval. Use Caution/Monitor.

            • torsemide

              albuterol and torsemide both decrease serum potassium. Use Caution/Monitor.

            • tramadol

              tramadol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trazodone

              trazodone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and trazodone both increase QTc interval. Use Caution/Monitor.

            • triamterene

              triamterene increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • triazolam

              triazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triclabendazole

              albuterol and triclabendazole both increase QTc interval. Use Caution/Monitor.

            • triclofos

              triclofos increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trimipramine

              trimipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and trimipramine both increase QTc interval. Use Caution/Monitor.

            • triprolidine

              triprolidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triptorelin

              albuterol and triptorelin both increase QTc interval. Use Caution/Monitor.

            • vandetanib

              albuterol and vandetanib both increase QTc interval. Use Caution/Monitor.

            • vardenafil

              albuterol and vardenafil both increase QTc interval. Use Caution/Monitor.

            • vemurafenib

              albuterol and vemurafenib both increase QTc interval. Use Caution/Monitor.

            • voclosporin

              albuterol and voclosporin both increase QTc interval. Use Caution/Monitor.

            • voriconazole

              albuterol and voriconazole both increase QTc interval. Use Caution/Monitor.

            • vorinostat

              albuterol and vorinostat both increase QTc interval. Use Caution/Monitor.

            • xylometazoline

              albuterol and xylometazoline both decrease sedation. Use Caution/Monitor.

              albuterol and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • yohimbine

              albuterol and yohimbine both decrease sedation. Use Caution/Monitor.

              albuterol and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • ziconotide

              ziconotide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziprasidone

              ziprasidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and ziprasidone both increase QTc interval. Use Caution/Monitor.

            Minor (15)

            • bendroflumethiazide

              albuterol, bendroflumethiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • bumetanide

              albuterol, bumetanide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • chlorothiazide

              albuterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • chlorthalidone

              albuterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • cyclopenthiazide

              albuterol, cyclopenthiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • ethacrynic acid

              albuterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • eucalyptus

              eucalyptus increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • furosemide

              albuterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • hydrochlorothiazide

              albuterol, hydrochlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • indapamide

              albuterol, indapamide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • methyclothiazide

              albuterol, methyclothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • metolazone

              albuterol, metolazone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

            • noni juice

              noni juice increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • sage

              sage increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • torsemide

              albuterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

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            Adverse Effects

            >10%

            Tremor (20%)

            Nervousness in children aged 2-6 years (20%)

            Insomnia in children aged 6-12 years receiving 4-12 mg q12hr (11%)

            1-10%

            Nausea (10%)

            Fever (1.6-9%)

            Bronchospasm (8%)

            Vomiting (7%)

            Headache (4-7%)

            Dizziness (1-7%)

            Cough (5%)

            Allergic reactions (4%)

            Otitis media (3.3%)

            Epistaxis in children (3%)

            Increased appetite (3%)

            Urinary tract infection (3%)

            Dry mouth (<3%)

            Eructation or flatulence (<3%)

            Increased sweating (<3%)

            Pain (2.7%)

            Dyspepsia (1-2%)

            Hyperactivity (1-2%)

            Chills (<2%)

            Lymphadenopathy (<2%)

            Ocular pruritus (<2%)

            Sweating (<2%)

            Conjunctivitis in children aged 2-6 years (1%)

            Dysphonia (>1%)

            Flu syndrome

            Nervousness

            <1%

            Epigastric pain

            Epistaxis in adults

            Hyperactivity in children

            Frequency Not Defined

            Adverse reactions such as hypertension, angina, vertigo, central nervous system stimulation, insomnia, headache, metabolic acidosis, and drying or irritation of oropharynx

            Hypersensitivity

            Hypokalemia

            Increased blood glucose levels

            Prolonged QT interval and ST-segment depression

            Sleeplessness

            Tachycardia (incidence varies with formulation)

            Urticaria, angioedema, rash, bronchospasm, and oropharyngeal edema (rare)

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            Warnings

            Contraindications

            Hypersensitivity to albuterol

            Severe hypersensitivity to milk proteins

            Cautions

            Some inhalers use hydrofluoroalkane (HFA) as propellant instead of chlorofluorocarbons (CFCs); otherwise, devices are equivalent

            Immediate hypersensitivity reactions may occur after administration of albuterol sulfate, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis, and oropharyngeal edema

            Paradoxical bronchospasm may occur

            Need for more doses than usual may be a sign of deterioration of asthma and requires reevaluation of treatment

            Use with caution in patients with cardiovascular disease, asthma, glaucoma, diabetes, hypokalemia, hyperthyroidism, or seizures

            Use face mask in children <4 years

            Excessive use may be fatal; do not exceed recommended dose; serious adverse effects occur when administered dose exceeds recommended dose

            May exacerbate heart failure in patients with reduced ejection fraction (dose related increased risk for hospital admission)

            Use of beta-adrenergic-agonist bronchodilators alone may not be adequate to control asthma; consider adding anti-inflammatory agents (eg, corticosteroids) to therapy

            May produce significant hypokalemia, possibly through intracellular shunting, which potentially produces adverse cardiovascular effects

            Drug interactions overview

            • Do not use other short-acting sympathomimetic bronchodilators concomitantly with an albuterol inhaler
            • Additional adrenergic drugs by any route should be used with caution to avoid deleterious cardiovascular effects
            • ECG changes and/or hypokalemia which may result from coadministration of non-potassium sparing diuretics (eg, loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when recommended dose of beta-agonist is exceeded
            • Mean decreases of 16% and 22% in serum digoxin levels were demonstrated after single dose IV and oral administration of albuterol, respectively, to normal volunteers who had received digoxin for 10 days; clinical significance is unclear; carefully evaluate serum digoxin levels in patients who are concurrently receiving digoxin and albuterol inhaler
            • Use extreme caution in patients being treated with monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs), or within 2 weeks of discontinuation of such agents, because coadministration may potentiate cardiovascular effects of albuterol; consider alternative therapy in patients taking MAOIs or TCAs
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            Pregnancy & Lactation

            Pregnancy

            There are no randomized clinical studies of use during pregnancy

            Available data from published epidemiological studies and postmarketing case reports of pregnancy outcomes following inhaled albuterol use do not consistently demonstrate a risk of major birth defects or miscarriage

            In animal reproduction studies, when administered SC to pregnant mice there was evidence of cleft palate at ≤9x the maximum recommended human daily inhalation dose (MRHDID)

            Clinical considerations

            • Disease-associated maternal and/or embryo/fetal risk
              • In women with poorly or moderately controlled asthma, there is an increased risk of preeclampsia in the mother and prematurity, low birth weight, and small for gestational age in the neonate
              • Closely monitor pregnant women and adjust medications as necessary to maintain optimal control
            • Labor or delivery
              • Because of potential for beta-agonist interference with uterine contractility, restrict use for relief of bronchospasm during labor to those patients in whom the benefits clearly outweigh the risk

            Lactation

            There are no available data on the presence of albuterol in human milk, the effects on the breastfed child, or the effects on milk production

            Consider developmental and health benefits of breastfeeding along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from drug or from underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Beta2 receptor agonist with some beta1 activity; relaxes bronchial smooth muscle with little effect on heart rate

            Absorption

            Onset: 25 min (Ventolin HFA); 0.5-2 hr (nebulization); 2-3 hr (PO)

            Duration: 4-6 hr (PO);

            Peak plasma time: Inhalation, 2-5 hr; PO, 2-2.5 hr

            Distribution

            Protein bound: 10%

            Metabolism

            Metabolized in liver

            Elimination

            Half-life: 3-8 hr (inhalation); 3.7-5 hr (PO)

            Excretion: Urine

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            Administration

            Oral Inhalation Administration

            For oral inhalation only

            Nebulizer solution

            • Remove one vial from foil pouch
            • Twist cap off vial and squeeze contents into nebulizer reservoir
            • Attach mouthpiece/face mask and compressor to nebulizer
            • Sit in a comfortable, upright position; place the mouthpiece in your mouth or put on mask, and turn on compressor
            • Calmly breathe and evenly as possible through your mouth until no more mist is formed in the nebulizer chamber (~5-15 minutes)
            • Clean nebulizer according to manufacturer instructions

            Aerosol metered-dose inhaler

            • Prime inhaler (before first-time use or when inhaler has not been used for >2 weeks): Release 4 test sprays into the air, away from the face
            • Shake well before each use
            • Breathe out fully through the mouth; place mouthpiece fully into mouth, holding inhaler in its upright position and close lips around it
            • While breathing in deeply and slowly through the mouth, fully depress the top of the metal canister with your index finger
            • Hold your breath for ≤10 sec; before breathing out
            • For additional puffs, wait 1 minute, shake inhaler again, and repeat steps listed above; replace cap after use
            • Cleaning: To maintain proper use of this product, wash and dry mouthpiece thoroughly ≥1/week

            Powder metered-dose inhaler

            • Does NOT require priming
            • Do not use with a spacer or volume holding chamber
            • Cleaning
              • Keep clean and dry at all times
              • Never wash or put any part of inhaler in water
              • Routine maintenance not required

            Oral Administration

            Extended-release tablets: Do not chew, crush, or mix with food

            Storage

            Nebulizer solution

            • Store between 2-25°C (36-77°F)
            • Protect from light before use, therefore, keep unused vials in the foil pouch

            Aerosol metered-dose inhaler

            • Store at room temperature (15-25°C [59-77°F])

            Powder metered-dose inhaler

            • Store at room temperature (15-25°C [59-77°F])
            • Avoid exposure to extreme heat, cold, or humidity
            • Discard 13 months after opening the foil pouch, when the dose counter displays zero, or after the expiration date on the product, whichever comes first
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            Images

            No images available for this drug.
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            Patient Handout

            A Patient Handout is not currently available for this monograph.
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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.