Albuterol
Albuterol sulfate
Also known as: Proventil ยท Ventolin ยท ProAir ยท AccuNeb ยท VoSpire ยท Salbutamol hemisulphate ยท Salbutamol sulphate ยท Salbutamoli sulfas ยท Albuterol sulfate ยท Salbutamol sulfate
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
๐ NA โ North America๐ EU โ Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Bronchodilation | 0.05 mg/kg (50 micrograms /kg) PO q8h | PO | q8h | โ | ๐ NA |
| Bronchodilation | 0.02 mg/kg PO q12h for 5 days; if no improvement and no adverse effects may increase to 0.05 mg/kg PO q8-12h. If patient responds, reduce to lowest effective dose. | PO | q12h initially, then q8-12h | 5 days initially | ๐ NA |
| Bronchodilation (Inhalation) | 0.5 mL of the 0.5% solution for nebulization in 4 mL of saline nebulized every 6 hours | Inhalation | q6h | โ | ๐ NA |
- Bronchodilation: WARNING: Older references stating 50 mg/kg q8h are an obvious overdose and should not be followed.
- Bronchodilation (Inhalation): Based on a 60 lb dog.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Feline asthma (mild symptoms) | one puff albuterol as needed with one puff of 110 micrograms fluticasone twice daily. | Inhalation | PRN | โ | ๐ NA |
| Feline asthma (moderate symptoms) | albuterol one puff as needed with a 5 day course of prednisone at 1 mg/kg PO daily, and 220 micrograms of fluticasone twice daily. | Inhalation | PRN | โ | ๐ NA |
| Feline asthma (severely affected/emergency) | 90 micrograms (one puff) albuterol every 30 minutes as needed. | Inhalation | q30min PRN | โ | ๐ NA |
| Feline asthma (chronic therapy) | 90 micrograms albuterol as needed | Inhalation | PRN | โ | ๐ NA |
| Feline asthma (intermittent signs) | two puffs into an appropriate spacer ( e.g., Aerokat ยฎ) twice daily; cat should breathe through the mask and spacer for 7-10 seconds. Positive clinical effect should be seen within 5-10 minutes. Can be used every 1/2 hour for 2-4 hours in crisis. | Inhalation | BID or q30min in crisis | โ | ๐ NA |
- Feline asthma (mild symptoms): Using the 90 micrograms/puff aerosol albuterol inhaler and an appropriate spacer and mask.
- Feline asthma (severely affected/emergency): Should be treated on an emergency basis with oxygen and an intravenous dose of a glucocorticoid.
- Feline asthma (chronic therapy): Should include fluticasone 220 micrograms twice daily and 1 mg/kg prednisone every other day.
- Feline asthma (intermittent signs): For intermittent signs (e.g., wheeze, increased cough or respiratory rate and effort at rest).
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Rescue therapy (respiratory difficulty at rest) | 360 micrograms (4 puffs) inhaled; if severe airway obstruction, may give at 15 minute increments for up to 2 hours. Continue as needed every 4-6 hours. | Inhalation | q15min up to 2h, then q4-6h PRN | โ | ๐ NA |
| Moderate to severe respiratory disease | 360 micrograms followed in 5 minutes with aerosolized corticosteroid (beclomethasone or fluticasone) therapy. | Inhalation | โ | โ | ๐ NA |
| Bronchodilation | 2-3 micrograms/kg via inhalation using a specially designed mask and spacer ( Aeromask ยฎ and Aerovent ยฎ) | Inhalation | โ | โ | ๐ NA |
| Heaves | 0.8-2 micrograms/kg in a metered dose inhaler | Inhalation | โ | โ | ๐ NA |
| Short-acting bronchodilation | 450-900 micrograms (5-10 puffs) as needed, not to exceed 4 times per week unless in conjunction with a corticosteroid | Inhalation | PRN (max 4x/week without steroids) | โ | ๐ NA |
| Heaves | 360 micrograms (4 puffs) inhaled as needed. Tolerance develops rapidly if used as a sole therapy. | Inhalation | PRN | โ | ๐ NA |
- Rescue therapy (respiratory difficulty at rest): Beneficial effects may last approximately 1 hour in severely affected horses. ARCI UCGFS Class 3 Drug.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Albuterol (also known internationally as salbutamol) is a short-acting $\beta_2$-adrenergic receptor agonist (SABA). It is widely used in veterinary medicine as a potent bronchodilator to alleviate bronchospasm and cough associated with lower airway diseases.
Key clinical applications include:
- Feline Asthma: Used primarily as a "rescue" inhaler for acute asthmatic crises.
- Canine Chronic Bronchitis: Provides symptomatic relief of bronchospasm.
- โEquine Recurrent Airway Obstruction (RAO / Heaves)โ: Used for acute relief of respiratory distress.
Clinical Pearl: While highly effective for acute rescue therapy, chronic monotherapy with racemic albuterol is discouraged, particularly in cats. The S-enantiomer in the racemic mixture can paradoxically increase airway inflammation over time. It should ideally be paired with inhaled corticosteroids (e.g., fluticasone) for long-term management.
Mechanism of action
Albuterol selectively binds to and stimulates โ$\beta_2$-adrenergic receptorsโ on bronchial smooth muscle.
Mechanism Pathway: $\beta_2$-receptor activation $\rightarrow$ stimulates adenylyl cyclase $\rightarrow$ increases intracellular โcyclic AMP (cAMP)โ $\rightarrow$ activates โprotein kinase A (PKA)โ $\rightarrow$ decreases intracellular calcium concentrations $\rightarrow$ results in smooth muscle relaxation and bronchodilation.
- Secondary Effects: It also stabilizes mast cell membranes (preventing inflammatory mediator release) and increases mucociliary clearance.
- Metabolic/Electrolyte Effects: Beta-adrenergic stimulation activates the โ$Na^+/K^+$-ATPase pumpโ, driving potassium from the serum into the intracellular space, which can cause temporary hypokalemia.
- Cardiac Effects: At standard doses, it has minimal $\beta_1$ (cardiac) activity, but at high doses or in sensitive individuals, it can cause tachycardia.
Safety & warnings
Contraindications
- Known hypersensitivity to albuterol
- Use with extreme caution in patients with cardiac disease (especially concurrent arrhythmias)
- Use with caution in patients with diabetes, hyperthyroidism, hypertension, or seizure disorders
- Use during late stages of pregnancy (may inhibit uterine contractions)
- Known hypersensitivity to salbutamol
- Severe cardiac tachyarrhythmias
Adverse effects
- Tachycardia
- Tremors and trembling
- CNS excitement, nervousness, and agitation
- Dizziness
- Hypokalemia (decreased serum potassium)
- Paradoxical airway inflammation in cats (associated with chronic use of the S-enantiomer in racemic albuterol)
- Muscle tremors
- Restlessness or excitement
- Hypokalemia (with high doses)
Precautions
Albuterol should be used with caution in animals with underlying cardiovascular disease, particularly those prone to arrhythmias, as well as those with hyperthyroidism, hypertension, or seizure disorders.
Pregnancy Warning: In very large doses, albuterol is teratogenic in rodents. It may also delay preterm labor by inhibiting uterine contractions. Use only when potential benefits outweigh the risks (FDA Category C in humans).
Feline Specific Warning: Chronic use of racemic albuterol in cats can exacerbate airway inflammation. Its use in cats should generally be restricted to acute rescue therapy.
Drug interactions
May antagonize the bronchodilatory actions of albuterol
Albuterol may increase the risk of cardiac arrhythmias
May predispose the patient to ventricular arrhythmias, particularly in patients with preexisting cardiac disease
Concurrent use may increase the risk of developing adverse cardiovascular effects
May potentiate the vascular effects of albuterol
Antagonizes the bronchodilating effects of salbutamol
May exacerbate hypokalemia
Monitoring
- Clinical symptom improvement (respiratory rate, effort)
- Thoracic auscultation
- Blood gases (if indicated in severe respiratory distress)
- Cardiac rate and rhythm (especially in overdose or susceptible patients)
- Serum potassium levels (early in therapy if animal is susceptible to hypokalemia)
- Respiratory rate and effort
- Heart rate and rhythm
- Serum potassium levels (if used frequently or in high doses)
Pharmacokinetics
Half-life
Absorption
Absorbed rapidly and well after oral administration. Effects occur within 5 minutes after oral inhalation, and 30 minutes after oral administration (e.g., tablets).
Distribution
Does not cross the blood-brain barrier but does cross the placenta.
Metabolism
Extensively metabolized in the liver principally to the inactive metabolite, albuterol 4'-O-sulfate.
Elimination
Duration of effect generally persists for 3-6 hours after inhalation and up to 12 hours after oral administration.
Overdose
Significant overdose (often occurring when dogs puncture an aerosol canister with their teeth) leads to massive systemic absorption and severe sympathomimetic toxicity.
Clinical Signs:
- Severe tachycardia and arrhythmias (extrasystoles)
- Hypertension
- Tremors, agitation, and CNS stimulation
- Panting, tachypnea, and fever
- Vomiting
- Mydriasis
- Hypokalemia and hypophosphatemia (due to intracellular shifts)
Treatment:
- โOral Ingestion (Tablets)โ: If recent and asymptomatic, perform standard decontamination (emesis, activated charcoal, cathartic).
- Inhaler Puncture: Decontamination is generally not effective as absorption across the oral mucosa is extremely rapid.
- Medical Management:
- Use beta-blocking agents (e.g., atenolol, metoprolol, or propranolol) to control severe tachycardia and arrhythmias.
- Administer diazepam for severe tremors or agitation.
- Monitor electrolytes closely; potassium supplementation via IV fluids is frequently required to correct hypokalemia.
- Contact an animal poison control center for guided management.
Available products
Formulations
- Extended-release oral tablets
- Oral syrup
- Aerosol metered-dose inhaler (MDI)
- Solution for inhalation (nebulization)
- Inhalational: 100 ฮผg per metered inhalation (Evohaler)
Human-labeled
- Albuterol Oral Tablets: 2 mg & 4 mg
- Albuterol Extended Release Oral Tablets: 4 mg & 8 mg (VoSpire ER)
- Albuterol Oral Syrup: 2 mg/5 mL
- Albuterol Aerosol (MDI): 90 micrograms/actuation (ProAir HFA, Proventil HFA, Ventolin HFA)
- Albuterol Solution for Inhalation ('Nebs'): 0.083% (2.5 mg/3 mL), 0.5% (5 mg/mL), 0.021% (0.63 mg/3mL), 0.042% (1.25 mg/3 mL) (AccuNeb, Proventil)
- Combination Aerosol: 103 mcg albuterol / 18 mcg ipratropium bromide per puff (Combivent)
- Combination Solution for Inhalation: 3 mg albuterol / 0.5 mg ipratropium bromide (DuoNeb)
- Ventolin Evohaler (100 ฮผg per metered inhalation)
Regulatory status
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
No regulatory data for: ๐บ๐ธ US ยท ๐ญ๐ฐ HK ยท ๐น๐ผ TW ยท ๐ฏ๐ต JP ยท ๐ฐ๐ท KR ยท ๐ฆ๐บ AU
Storage & stability
Oral albuterol sulfate products should be stored at 2-30ยฐC. The inhaled aerosol should be stored at room temperature; do not allow exposure to temperatures above 120ยฐF or the canister may burst. The 0.5% nebulizer solutions should be stored at room temperature; the 0.083% nebulizer solutions should be stored in the refrigerator. Discard solutions if they become colored.
Client information
- Proper Administration: If using the aerosol inhaler, shake well before using. Ensure you know how to properly use the spacer device (e.g., Aerokat, Aerodawg) and mask to maximize drug delivery to the lungs.
- Rescue Use: This medication is typically used as a "rescue" inhaler for acute breathing difficulty. Contact your veterinarian immediately if your pet's condition deteriorates, if the inhaler stops providing relief, or if your pet becomes acutely ill.
- Storage & Safety: Do not puncture the aerosol canister or use it near an open flame. Do not expose to temperatures greater than 120ยฐF (49ยฐC) as it may explode.
- Toxicity Warning: โKeep inhalers strictly out of reach of dogs.โ Dogs that chew and puncture the canister receive a massive, potentially fatal overdose of the drug. Seek emergency veterinary care immediately if this occurs.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturerโs current label.