Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. In general, inhaled long-acting beta-agonists are preferred since they are longer-acting and have fewer side effects than oral sustained-release agents. This risk may be more clinically significant with long-acting beta-agonists versus short-acting beta-agonists. FDA-approved labeling for albuterol 0.083% solution recommends 2.5 mg via oral inhalation 3 to 4 times daily as needed; do not exceed 4 doses/day. Alfuzosin: (Minor) Use caution when administering alfuzosin with beta-agonists due to the potential for QT prolongation. These combinations can lead to symptomatic hypokalemia and associated ECG changes in some susceptible individuals. Bedaquiline: (Minor) Due to the potential for QT prolongation and torsade de pointes (TdP), caution is advised when administering bedaquiline with beta-agonists. Beta agonists infrequently produce cardiovascular adverse effects, mostly with high doses or in the setting of beta-agonist-induced hypokalemia. QT prolongation and TdP have been reported during postmarketing use of fluvoxamine. Albuterol is preferred over other SABAs due to extensive safety-related information during pregnancy. The product's dosage form is aerosol, metered and is administered via respiratory (inhalation) form. Goserelin: (Minor) Consider whether the benefits of androgen deprivation therapy (i.e., goserelin) outweigh the potential risks of QT prolongation in patients receiving short-acting beta-agonists. This risk may be more clinically significant with long-acting beta-agonists (i.e., formoterol, arformoterol, indacaterol, olodaterol, salmeterol, umeclidinium; vilanterol) than with short-acting beta-agonists. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Midostaurin: (Minor) Concomitant use may result in additive effects on the QT interval. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Mechanism of Action: Albuterol is a moderately selective beta2-adrenergic agonist that stimulates receptors of the smooth muscle in the lungs, uterus, and vasculature supplying skeletal muscle. Fluctuations in plasma concentrations are similar for albuterol extended-release tablets administered at 12-hour intervals and immediate-release tablets administered at 6-hour intervals. Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Coadminister with caution. Not a Member? Clozapine: (Minor) Treatment with clozapine has been associated with QT prolongation, torsade de pointes (TdP), cardiac arrest, and sudden death. The effects of these beta-agonists on the cardiovascular system may be potentiated. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. All rights reserved. Beta-agonists and beta-blockers are pharmacologic opposites, and will counteract each other to some extent when given concomitantly, especially when non-cardioselective beta blockers are used. Drugs with a possible risk for QT prolongation that should be used cautiously with halogenated anesthetics include the beta-agonists. [44002], Following oral inhalation, albuterol is absorbed over several hours from the respiratory tract. Most cases involve patients being treated for pain with large, multiple daily doses of methadone, although cases have been reported in patients receiving doses commonly used for maintenance treatment of opioid addiction. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Pentamidine: (Minor) Pentamidine has been associated with QT prolongation. Max: 2.5 mg/dose 3 to 4 times daily. However, large increases (greater than 60 msecs from pre-dose) have occurred in two patients receiving 6 mg doses. Pimozide: (Severe) Pimozide is associated with a well-established risk of QT prolongation and torsade de pointes (TdP) and should not be used with other drugs that might prolong the QT interval. Osimertinib: (Minor) Use osimertinib and short-acting beta-agonists together with caution due to the risk of QT prolongation. Monitor the patients lung and cardiovascular status closely. In some patients, 1 puff every 4 hours may be sufficient. [43674] Other products state that the vials should be stored in the foil pouch until time of use. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Norfloxacin should be used cautiously with other agents that may prolong the QT interval such as the beta-agonists. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. The increase in QTc is approximately 10 milliseconds at doses of 400 mg twice daily (the FDA-approved dose) and up to 25 milliseconds at doses of 1600 mg twice daily. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Patients using prescription beta-agonists for the treatment of asthma should generally avoid the concurrent use of racepinephrine inhalation since additive cardiovascular and nervous system adverse effects are possible, some which may be undesirable. FDA-approved labeling recommends to not exceed 4 doses/day. The effects of beta-agonists can be reduced with concurrent use of sotalol, which is a non-selective beta-blocker. Chlorpromazine: (Minor) Phenothiazines have been associated with a risk of QT prolongation and/or torsade de pointes (TdP). Make sure a "click" sound is heard; if not, the inhaler may not be activated to give a dose of medicine.The cap should not be opened unless the patient is ready to take a dose; opening and closing the cap without inhaling a dose will waste the medicine and may damage the inhaler.The patient should breathe out through the mouth and push as much air from the lungs as they can. Ranolazine: (Minor) Ranolazine is associated with dose- and plasma concentration-related increases in the QTc interval. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Initially, 2 to 4 mg PO 3 to 4 times per day. Asthma may deteriorate acutely over a period of hours or chronically over several days or weeks. Cases of QT prolongation, TdP, ventricular tachycardia, and sudden death have been reported during postmarketing use of mirtazapine, primarily following overdose or in patients with other risk factors for QT prolongation, including concomitant use of other medications associated with QT prolongation. What is Albuterol 0.083% Inhalation Solution 2.5 mg x 3 ml? Exercise Induced Bronchospasm Prevention: The usual dosage for adults and children 4 years of age and older is two inhalations 15 to 30 minutes before exercise. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Fingolimod has not been studied in patients treated with drugs that prolong the QT interval, however, drugs that prolong the QT interval have been associated with cases of TdP in patients with bradycardia. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Beta-agonists may be associated with cardiovascular effects, usually at higher doses and/or when associated with hypokalemia. Right after the spray comes out, release the canister. Early consideration should be given to adding anti-inflammatory agents (e.g., corticosteroids) to the therapeutic regimen. Avoid concurrent use of quinine with other drugs that may cause QT prolongation and TdP including beta-agonists. If vemurafenib and another drug that is associated with a possible risk for QT prolongation and torsade de pointes (TdP) must be coadministered, ECG monitoring is recommended; closely monitor the patient for QT interval prolongation. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. However, there is no evidence of fetal injury with the use of other inhaled SABAs, and maintaining a previously established treatment regimen may be more beneficial to the patient. Protection lasts 2 to 3 hours in most patients. Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Ziprasidone has been associated with a possible risk for QT prolongation and/or torsade de pointes (TdP). Adjuvant or alternative therapy is warranted for patients experiencing electrocardiographic (ECG) changes or significantly elevated serum potassium concentrations (e.g., more than 7.5 mmol/L). Weigh the risks of co-use, and where possible, allow a washout period after discontinuation of the MAOI before instituring beta-agonist treatment or vice-versa. Additive side effects may occur between caffeine and beta-agonists. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. If prescribed more sprays, wait 1 minute and shake the inhaler again. Phenelzine: (Major) Beta-agonists should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors (MAOIs) due to their sympathomimetic effects. The combined use of these agents may have the potential for additive adrenergic stimulation and side effects, such as nervousness, insomnia, palpitations, or adverse cardiovascular effects. Pseudoephedrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. QTc prolongation has been observed with the use of efavirenz. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. Beta-agonists may be associated with adverse cardiovascular effects including QT prolongation, usually at higher doses and/or when associated with hypokalemia. Doses were repeated every 2 hours as needed. Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed. Amphetamine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. The likelihood of QTc prolongation may increase with increasing dose of the drug; therefore, the recommended dose should not be exceeded especially in patients with renal or hepatic impairment where the Cmax and AUC are slightly higher. Monitor the patients lung and cardiovascular status closely. Doses should be delivered over 5 to 15 minutes. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Inhaled bronchodilators are preferred over oral bronchodilators for the management of COPD. Telithromycin: (Minor) Use caution if short-acting beta-agonists are administered with telithromycin as concurrent use may increase the risk of QT prolongation. In some patients, 90 mcg (1 oral inhalation) every 4 hours may be sufficient. Beta-agonists should be administered with extreme caution to patients being treated with drugs known to prolong the QT interval because the action of beta-agonists on the cardiovascular system may be potentiated. [31823] [43674] [44010] [49951] [59350] [64470], Monitor heart rate and blood pressure in patients receiving high doses of albuterol for acute asthma exacerbations; cardiovascular adverse effects are more likely to occur when aggressive doses are used. All material on this website is protected by copyright, Copyright © 1994-2021 by WebMD LLC. Therefore, linezolid has the potential for interaction with adrenergic agents, such as the beta-agonists. Concomitant use can cause additive CNS stimulation; some patients may experience tremor or nervousness with combined use. Maprotiline: (Minor) Maprotiline has been reported to prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations). Prime the inhaler before the first use by spraying four times into the air, away from the eyes and face. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with escitalopram. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses and/or when associated with hypokalemia. Drugs with a possible risk for QT prolongation that should be used cautiously with halogenated anesthetics include the beta-agonists. Ribociclib; Letrozole: (Minor) Coadministration may result in additive effects on the QT interval. Triptorelin: (Minor) Consider whether the benefits of androgen deprivation therapy (i.e., triptorelin) outweigh the potential risks of QT prolongation in patients receiving short-acting beta-agonists. (3) CONTRAINDICATIONS • Patients with hypersensitivity to albuterol. Halofantrine should be avoided in patients receiving drugs which may induce QT prolongation. Beta agonists infrequently produce cardiovascular adverse effects, mostly with high doses or in the setting of beta-agonist-induced hypokalemia. This risk may be more clinically significant with long-acting beta-agonists (i.e., formoterol, arformoterol, indacaterol, olodaterol, salmeterol, fluticasone; vilanterol, umeclidinium; vilanterol) than with short-acting beta-agonists. Clinically relevant QTc prolongation may occur with deutetrabenazine. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Supratherapeutic doses of rilpivirine (75 to 300 mg/day) have caused QT prolongation. QT prolongation and TdP have been reported in patients treated with fluoxetine. Perphenazine; Amitriptyline: (Minor) Perphenazine, a phenothiazine, is associated with a possible risk for QT prolongation. For the acute treatment of severe episodes, the National Asthma Education and Prevention Program Expert Panel recommends 4 to 8 puffs every 20 minutes for up to 4 hours, then 4 to 8 puffs every 1 to 4 hours as needed. Androgen deprivation therapy may prolong the QT/QTc interval. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval. (Moderate) Beta-agonists are commonly used in conjunction with aminophylline or theophylline therapy. Safety and efficacy have not been established ; adjust dose according to clinical symptoms and tolerance/adverse.! Albuterol aerosol and inhalation solution 2.5 mg via oral inhalation 3 to 4 mg PO every 12 hours for. Without consulting your physician donepezil therapy children 2 to 4 mg PO every 12 (! Mouthpiece is not a substitute for inhaled or oral solution but is more likely with doses. Can breathe more easily of use usually at higher doses and/or when associated with adverse cardiovascular including... Solifenacin: ( Minor ) beta-agonists should be delivered over 5 to 30 minutes before you exercise extremely half-life... 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