Salbutamol inhaler for asthma and wheeze

Name of medicine

Salbutamol

Why is it important for my child to take Salbutamol?

During an asthma or wheezing attack, the air passages into the lungs become narrow, making it hard to breathe and causing symptoms such as cough, wheezing and breathlessness. Salbutamol helps the airways to open up and so relieves (eases) the symptoms of the attack. It is given using a special device called an inhaler, so that the medicine goes into the airways and lungs.

What is Salbutamol available as?

Salbutamol comes in a variety of different aerosol and dry powder inhalers, which have different brand names. These inhalers are usually blue.

When should I give Salbutamol

Your doctor or asthma nurse will write an asthma management plan which explains the treatments your child has and when they should be used. Your doctor or asthma nurse will explain how to use salbutamol according to this plan.

Salbutamol is usually given when it is needed, to treat an asthma attack when it first starts (an acute attack) and for wheezing caused by cold or exercise, for example.

How should I give Salbutamol?

When should the medicine start working?

Salbutamol should start working almost as soon as each dose is given, and your child should start to breathe more easily.

What if my child is sick (vomits)?

If  your child is sick you do not need to give them another dose, as the medicine will still work.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects). However, because salbutamol is delivered directly into the lungs, it is unlikely to cause any side-effects.

It is possible, but unlikely, that your child may get shakiness (particularly in the hands), nervous tension, headache, fast or fluttering heartbeat, disturbed sleep, behaviour changes or muscle cramps if they have had a lot of salbutamol.

Can other medicines be given at the same time as Salbutamol?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

How to use the Salbutamol inhaler

This section provides instructions on how to use the salbutamol inhalers. An instruction leaflet will also be provided with the inhaler. This will tell you how to put the inhaler together and how to use it.

If you are not sure whether you are using the inhaler properly, or need help, contact your asthma nurse or pharmacist, who will be able to show you or check what you are doing. It is important that the device is used properly, otherwise enough medicine will not get into the lungs.

The aerosol inhaler is usually used with a device called a spacer, so that the medicine is breathed into the lungs more easily. The correct way to use an aerosol inhaler and spacer is described below.

Older children may be able to use an inhaler without a spacer, for example at school. In this case, your doctor will give you a slightly different device called a dry powder inhaler. The correct way to use the dry powder inhaler is described further down.

Using an aerosol inhaler with a ‘spacer’ device

• Put the spacer device together, following the instructions that come with it. Attach the mask to the spacer mouth piece.
• For a young child, attach the mask to the spacer mouth piece. If your child can hold the spacer mouthpiece in their mouth and hold it firmly between their lips, creating a good seal, you may not need to use the mask.
• Take the cap off the inhaler, making sure that the mouth piece is clean.
• While holding the inhaler upright, place your thumb on the bottom of the inhaler and your first finger on the top. Then shake the inhaler several times up and down.
• If the inhaler is new or has not been used for 3 days or more, one puff should be released into the air.
• Insert the mouth piece of the inhaler into the spacer. It should fit easily and securely.
• Place the mask over your child’s mouth and nose, ensuring a good seal with the skin around the mouth. Reassure your child during this step, as they may be distressed.
• Press down once on the aerosol canister with the first finger. This releases one puff into the spacer.
• Hold the mask in place and encourage your child to take five deep and slow breaths in and out.
• It is important not to rush this step.
• If more than one dose/puff is required, wait for one minute then repeat the previous steps.
• Your child should rinse their mouth out thoroughly with water or clean their teeth.

Using a dry-powder inhaler

There are many different types of dry-powder inhaler. These are not used with a spacer.

Follow the instructions that come with your inhaler for how to get it ready. If you are not sure how to do this, ask your pharmacist or nurse to show you.

The following instructions are for most dry-powder inhalers.

• Ask your child to breathe out normally, as far as they can. Place the mouthpiece of the inhaler firmly between the lips, ensuring a good seal around the mouthpiece.
• Once they have started to breathe in, load the dose as directed by your pharmacist or nurse. Your child should continue to finish the breath in, so that they inhale the puff of medicine.
• Take the inhaler out of your child’s mouth. They should close their mouth and hold their breath for 5–10 seconds, or for as long as they can comfortably manage. They can then breathe normally. It is important not to rush this step.
• If your child has to take more than one puff, they should breathe normally for a minute or so before giving the next one.
• Your child should rinse their mouth out thoroughly with water or clean their teeth.

Is there anything else I need to know about this medicine?

General advice about medicines

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• If you think someone else may have taken the medicine by accident, contact your doctor for advice.

• Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

• Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Salbutamol and about other medicines used to treat asthma and wheeze.

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by January 2014.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.