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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Adrenergics in combination with corticosteroids or other drugs, excl. anticholinergics
salbutamol and budesonide
R03AK15
Forms & Strengths
- Inhalation aerosol: salbutamol 90 mcg / budesonide 80 mcg per actuation
- Inhalation aerosol: salbutamol 90 mcg / budesonide 160 mcg per actuation
- Dry powder inhaler: salbutamol 100 mcg / budesonide 200 mcg per actuation
Adult Dosing
- Asthma/COPD rescue/maintenance therapy: 1 to 2 inhalations as needed for symptoms
- Maximum daily dose: Not to exceed 8 inhalations in a 24-hour period
Pediatric Dosing
- Children < 12 years: Safety and efficacy not established
- Adolescents >= 12 years: 1 inhalation as needed for acute symptoms, max 6 inhalations daily
Indications
- Treatment of asthma as a combination reliever and controller therapy
- Maintenance treatment of airflow obstruction in chronic obstructive pulmonary disease (COPD)
Mechanism of Action
- Salbutamol is a short-acting beta-2 adrenergic agonist (SABA) causing bronchodilation by relaxing bronchial smooth muscle
- Budesonide is a potent glucocorticoid with anti-inflammatory action, reducing airway hyper-responsiveness and edema
Contraindications
- Primary treatment of status asthmaticus requiring intensive measures
- Hypersensitivity to albuterol, budesonide, or any component of the formulation
- Severe hypersensitivity to milk proteins (if lactose is present in dry powder formulations)
Adverse Reactions
- Tremor, nervousness, and palpitations due to the beta-agonist component
- Oropharyngeal candidiasis, hoarseness, and throat irritation from the inhaled corticosteroid
- Tachycardia, hypokalemia, and hyperglycemia with higher systemic absorption
- Paradoxical bronchospasm
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) increase systemic exposure of budesonide
- Beta-blockers (e.g., propranolol) can antagonize the bronchodilating effect of salbutamol and induce severe bronchospasm
- Diuretics, loop or thiazide, may potentiate hypokalemia and ECG changes from beta-agonists
- Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants potentiate vascular effects of salbutamol
Curated Content: Needs Vetting Before Put to Clinical Use