Talk:Salbutamol/Archive 1

Chemical structure
The chemical formula for this was changed by user:cacycle. The formula at http://chemfinder.cambridgesoft.com is alpha1-((tert-butylamino)methyl)-4-hydroxy-m-xylene-alpha,alpha-diol (search for salbutamol). The formula 4-(2-(tert-butylamino)-1-hydroxyethyl)-2-(hydroxymethyl)phenol doesn't seem to represent the image (though my ability to interpret IUPAC names is weak). http://www.ch.ic.ac.uk/local/projects/j_hettich/salbutamol/project/start.html also has the first formula listed as IUPAC. Matt 17:15, 17 Aug 2004 (UTC)
 * Ok after re-reading the formula, the current one does seem to represent the image (I told you my ability to interpret IUPAC names is weak), but I still don't know which one is more correct. The current one does seem shorter. Matt 17:20, 17 Aug 2004 (UTC)

Albuterol as a vasoconstrictor?
I've heard that Albuterol also acts as a vasoconstrictor. Can someone more knowledgeable about this confirm of deny this as it would be an important side effect it seems. Mediocretes 23:26, 25 March 2006 (UTC)
 * No, activation of &beta;2-adrenergic receptors does not cause vasoconstriction. -Techelf 07:52, 26 March 2006 (UTC)
 * It actually appears that it might cause vasodilation. It does have a high potential for causing tachycardia, though. Zuiram 01:37, 27 October 2006 (UTC)

Other brand names
Xpenex I believe is different as the active ingredient is Levalbuterol HCl. Someone possibly needs to do a cleanup? RonEJ 19:18, 17 March 2007 (UTC)

Aleta, thank you. RonEJ 21:36, 17 March 2007 (UTC)
 * You're welcome. :) Aleta 21:52, 17 March 2007 (UTC)

Effects on libido
I was a long term user of Ventolin (the brand I know it by) - for probably 15 years. I switched to Seretide, mainly because it lasted for longer periods (12 hrs vs 4 hrs). I remember thinking 'I'm not so... randy... all the time' but wrote it off as moving from teenagerhood to mid 20's etc etc. This was 10 years ago. The other day I ran out of seretide, and needed a script to get more, so used a ventolin I had lying around (I have one in my gym bag for instant relief if required) for a few days. My libido skyrocketed. After switching back to seretide, I stabilised again. This is just a personal anecdote, but I wonder if anyone else has noticed this. Luke, 14 August 2007

Salbutamol Brand Name:
Salbutral= contains: Salbutamol When administered the recommended dosage, the absorbtion on a systematic level from bronchial administration is low. Peak plasmatic concentration is between 2-4 hours. Data from urinary excretion indicate that salbutamol is eliminated in 3-4 hours. Aproximately 72% of inhaled is excreted during the following 24 hours in urine, 28% as unaltered drug and 44% as metabolites.

Overdose symptoms: Hyperglycemia, hypokalemia, hypotension, lactic acidosis, tachycardia, trembling, vomiting.

Less common symptoms: Agitation, neck pain, headache, hyperkalemia, hypertension, hypophosphatemia, peripheral vasoconstriction, respiratory alkalosis.

Rare effects: Alucinations, tachycardia, agitation

Treatment for overdose: Drug to use as antidote is an agent B-blocker cardioselective. Should be used carefully on pacients with bronchospasm. Should'nt be combined with other inhalers. —Preceding unsigned comment added by Rdx4u 2 (talk • contribs) 16:29, 17 March 2008 (UTC)

Is this common?
I stutter when I have my inhaler.

What does this mean??

Thanks,

Lunakeet 13:19, 6 May 2008 (UTC)

Never mind, that's all just part of the tremors.

Lunakeet 13:42, 6 May 2008 (UTC)

Genetic variability
I removed a request for clarification from the text of the article. I have pasted it below, in context:

However, some asthmatics do not have the required DNA base sequence in a specific gene and may not respond to these medications. (please expand this - is the effect of the drug purely based on genetic variability?!) Birkett (talk) 09:00, 7 August 2008 (UTC)

possible contraindications?
I came to this article in the first place in search of possible contraindications, finding none. Are there any? I have heard (I admit, from a sort of a "I heard from a friend that heard from a friend" way) that albuterol and cocaine will literally make your heart explode. That's why i came, to see if there's any credibility in that claim or with any other pharms/drugs. Anyone have any knowledge on albuterol contraindications? ````11/07 3:50 pm —Preceding unsigned comment added by 68.76.171.123 (talk) 21:54, 7 November 2008 (UTC)

long-term overuse of albuterol?
For the last month or so, I've been heavily (over)using my albuterol inhaler. I finally went to see my doctor and have upped my daily steroids to get my chronic asthma under control, however, I'm very interested in the possible side effects of this kind of overuse. It's possible that on some days I did 30-40 puffs, and I don't think I went through many nights/days with out at least 2-4 puffs. It was not uncommon for me to do 5-10 puffs at a time, just to be able to go back to sleep or to continue regular activities. Yesterday morning I did 10-15 puffs, went on a 15mi bike ride, and now, over 24 hours later, I still have tremors in my hands when I hold my arms out (I haven't done a single puff since then).

I'm particularly interested in studies that have been done about overuse of albuturol, or other individuals' experiences. I was not able to find out much about this even after a fairly extensive web search.


 * The talk page of Wikipedia is probably not the most appropriate place to be having such a discussion, but here goes... I'm not surprised that you've experienced tremors, because the high doses you took would've resulted in systemic absorption of the salbutamol/albuterol, leading to systemic &beta;2-adrenoceptor activation. Tremors are probably the most common manifestation, in addition to palpitations and headache. A more serious outcome of excessive doses of salbutamol is hypokalaemia (in fact, IV salbutamol is often used to treat hyperkalaemia). The long-term overuse of &beta;2-agonist may also cause downregulation of the &beta;2-adrenergic receptors, such that tolerance develops to their effects. To cut to the chase, long-term overuse of salbutamol/albuterol is NOT a good idea.
 * If you required that much salbutamol, I'm curious as to why your doctor didn't prescribe a long-acting &beta;2-agonist (perhaps in a combination inhaler with your inhaled corticosteroids) to improve your maintenance therapy. One obvious question I want to ask is whether your pharmacist or doctor has checked your inhaler technique? It seems to me that if you need that many puffs you're either having an acute asthma attack (which doesn't appear to be the case), or you mightn't be using the inhaler correctly and therefore not receiving the full dose to your airways. -Techelf 11:43, 12 Jun 2005 (UTC)

Ten puffs at a time does sound a bit ridiculous, even when my asthma was severe and extremely distressing, two or maybe three puffs would be all I needed to get back to breathing almost perfectly again. Five to ten puffs to get breathing properly? At that rate I think you'd better be careful to have your inhaler within close reach at all times because without it you definitely wouldn't be still with us. Anonywiki 03:51, 29 July 2007 (UTC)

They cost twice as much and you need 3 times the dosage making them actually cost 6 times as much. This needs to be mentioned also. —Preceding unsigned comment added by 68.49.199.246 (talk) 13:54, 18 August 2008 (UTC)

Having several in the family under doctor's care for asthmatic conditions, my understanding from various conversations with medical personnel leads me to believe (unless you are not administering it properly as Techelf proposed above) your physician and you need to discuss this more. The first thing the doctor told us (and it is repeated at regular intervals) is that we should NEVER have to use an inhaler more than once or twice a day unless prescribed to do so; and only once in the past two decades have we been prescribed to use an inhaler up to 4 times per day as required. Techelf is right. In my layman's humble opinion (and in fact our doctor's prescriptive advice to our family members) you should be a on maintenance drug to control the chronic aspect and should carry the inhaler only in the event of an actual asthmatic attack (and maybe even an Epi pen??). Please review this advice with your physician. It may radically improve your quality of life (not to mention saving you a small fortune in inhaler charges which shortly will be a larger issue). Good luck and good health to you in the new year. 72.73.14.27 (talk) 16:15, 15 December 2008 (UTC)

question
what is the classification for this —Preceding unsigned comment added by 99.145.111.22 (talk) 22:32, 4 May 2010 (UTC)

minor synthesis error
I'm not sure how to add/edit images in Wikipedia, but for the sake of completeness the synthetic scheme should have "H2, Pd/C" as the last step instead of just "H2". The necessity of the catalyst is obvious to chemists, but less so to the general audience of the article. — Preceding unsigned comment added by 143.44.134.126 (talk) 18:51, 6 February 2012 (UTC)

Legal Status and History of use
I've been wondering why albuterol is regulated in the U.S. (and other countries) as prescription only. It doesn't have a high abuse potential and is completly safe if used in moderation. I haven't found any information on this and there is none in the article as to how it became under this legal status. There also is no section about the history of albuterol, which I think would make a good addition to the article. Would someone with knowledge on these areas be interested and adding this into the article? --Dr. WTF 23:12, 12 February 2007 (UTC)

A drug doesn't have to have a "high abuse potential" to be classified as prescriptions only. One reason I can think of that albuterol should remain prescription-only is that those with daily asthma attack will keep using/"abusing" albuterol instead of seeking a doctor. Albuterol is very effective for short-term relief but it's not recommended as maintenance therapy. Over-reliance to albuterol can be deadly. So to this end, such addition to the article doesn't seem necessary. Vandelay 06:05, 8 August 2007 (UTC)

Its so the doctors and pharmacies can keep making money, thats all. Albuterol is no more dangerous than aspirin or NyQuil or over-the-counter (OTC) diet pills. All could be dangerous if you abused them but 99.99% of the people using them have no problem and are properly educated and this would continue if OTC sale were legalised.

I read in the Los Angeles Times a few months ago of a proposal to let many current prescription drugs (like antibiotics and inhalers) be sold OTC. But the doctors' unions caused a ruckus and told congress a bunch of lies about the dangers of this. What a load. Its all about money. Adults should be able to put anything they want in their own bodies without anyone's approval if they so choose.

As for me, I need my albuterol but I do not have insurance. So when I visit Tijuana or elsewhere in Mexico, I pick up a 3-pack that costs me MX$180 pesos (US$20 dollars) and sneak them back into California. No prescription is required in Mexico for light pharmaceuticals, only drugs you could get high on like vicoden. Think about it - an American has to go to MEXICO to get his inhaler - not because its cheaper (although it is much cheaper) but because he can not afford an (unnecessary) doctor visit. Huge gains in the health of Americans could be realised if we just made prescriptions optional and it would save us a ton of money without the huge tax raise of Hillary-care nationalised health care. But for now, I have to visit a free, third-world country for my basic health care. --Jon in California 28 December 2007. —Preceding unsigned comment added by 208.127.73.9 (talk) 05:53, 29 December 2007 (UTC)

The second person who commented on this section obviously knows what they are talking about....I'm not sure about the rest of you. Antibiotics are prescription-only NOT so that doctor's can "make-money," but because their overuse needs to be controlled in order to cut down on the proliferation of drug-resistant bacteria. Antibiotics are over-prescribed in the U.S even as it is....just imagine if every idiot who had no idea how medicines actually work were able to walk into a CVS/Walgreens/Rite Aid and purchase some amoxicillin or cephalexin to treat their common cold (i.e a VIRAL INFECTION for which neither of these medications will EVER work - they will only destroy the good bacteria that is present in all of us and necessary for very vital functions of life such as digestion). These drugs are kept as prescriptions to ensure that our population doesn't die off from some super-resistant strain of bacteria that could have easily been killed by a simple penicillin if that person hadn't been needlessly ingesting so many antibiotics over the years that the bacteria from an ACTUAL infection became resistant to it. As for albuterol, any pharmacologist will tell you that there is some abuse potential due to a very mild euphoric effect that can come with its use. Not to mention the abuse that routinely occurs from athletes who are simply out of breath due to physical exertion (i.e the football player with true asthma who shares his inhaler with a teammate on the sidelines in order to help dilate his bronchioles and get a little bit more oxygen to his tissues). Also, if you are going to throw out statements including "99.99% of people" you should probably have some references to back it up. And if you would take the time to look up how many people actually die each year from OTC diet pills and seemingly harmless products like NyQuil you would be absolutely ASTOUNDED. I do understand the annoyance of having to pay to see a doctor for medications that seem to be so safe - but try to understand that it is for the greater good of society that some of these substances are only able to be acquired through these means. John December, 2009 —Preceding unsigned comment added by 24.125.239.209 (talk) 02:10, 27 December 2009 (UTC)


 * As a drug it's not that dangerous. In fact it's much less dangerous thatn the OTC stuff sold as Primatine and other equivilents. Albuterol is used for daily maintenence as well. Steroids for asthma are a last resort. The fear is that if the asthma worsens people won't go to the doctor but use more albuterol. A curious effect of albuterol and also of Primatine and the like is parodoxical bronichial spasm. In other words Albuterol can stop an asthma attack but too much of it can in fact trigger the attack it's suppose to be stopping.


 * If you are using it for daily maintenence your asthma is not well controlled. In australia at least needing to use it more than 2-3 times weekly is considered poorly controlled asthma.  — Preceding unsigned comment added by 121.222.119.57 (talk) 04:21, 24 September 2011 (UTC)

Over all it's ridiculous to allow Primatine as OTC and not albuterol when teh OTC has more abuse and side effects 99.21.161.175 (talk) 09:43, 28 January 2010 (UTC)Jean Mae

Although I find it annoying to have to wait 6 hours in the waiting area of my clinic to see my doctor(I don't have to pay for him since it's free in Canada), I get why it's not free for use. But concerning the article, I'm more concerned in the history of the drug. Who discovered it and when etc. I wanna know who I most praise for being able to breath today. Kamizushi (talk) 02:37, 7 May 2010 (UTC)

Finally, consider that Glaxo Smith Kline was perhaps the largest lobbyist for the CFC ban in Metered Dose Inhalers. The amount of CFC released annually is minimal from this use, so environmental effects were nearly non-existent. However, GSK had just built a US$1 Billion manufacturing facility in the USA for HFA (to replace CFC's) and the exception that allowed CFC's to continue to be used was costing GSK lots of money. Furthermore, when CFC's were banned, those who controlled the HFA alternatives (3M licensees, TEVA, GSK) were able to re-brand the formerly generic albuterol, increasing revenues by approximately $1B per year. This corporate-environmental group--government (EPA) collusion is another clear example of the increasingly fascistic tendencies of government in the United States. — Preceding unsigned comment added by 75.243.119.130 (talk) 22:13, 21 February 2012 (UTC)
 * Very few countries in the world have the regulatory and prescription control over medications that the United States employs. There is a public health reason to maintain antibiotics as prescription, but no public health reason for albuterol to be maintained as a prescription, or for cholesterol-lowering drugs or most other medications.  This represents the US system which tends to use regulatory control of the population and business, as opposed to outright government ownership of the population and businesses.  Certainly the American Medical Association and the pharmaceutical lobbies recognize the benefit from the prescription process for their constituents, although the doctors on the ground are too busy to even give the whole dysfunctional system any thought, but probably do NOT as a whole prefer to get their time wasted, unpaid, with having to call pharmacies to authorize refills for simple medications that patients have been on for years.

HFA inhaler info out of date?
To someone who would know: It seems we're already using a generic HFA albuterol inhaler, despite the article's contention that such inhalers won't be available in the U.S. till 2017.

216.175.116.145 (talk) 04:15, 13 January 2009 (UTC) mkmori

Did the ban on CFC-containing inhalers actually go into effect? All the references cited are from before the deadline. I removed the claim from the intro that generics are not available, because the reference did not support this claim. The reference only supported a claim that it was believed that generics would not be available after the deadline. Perhaps the government changed the policy? (The claim in the intro was also flawed because not all salbutamol is delivered by inhaler. The ban does not affect generic salbutamol for nebulizers, etc.)--Srleffler (talk) 01:36, 14 November 2009 (UTC)

I don't really think the rant about inhaler cost in the United States belongs on Wikipedia at all, even if it was entirely up to date (which it is not), so I'm going to remove it. 184.35.8.119 (talk) 07:11, 24 April 2012 (UTC)

Outside USA/Canada
I've just seen a prescription filled for a "Generic" CFC free salbutamol here in Australia. It's an Alphapharm brand, named ASMOL. Does that mean that the information on the so called patents on the HFA variants is wrong (listing availability 2012)? Is the section in the article North America specific - or does the CFC free section need to be globalised? Lantrix :: Talk :: Contrib :: 12:52, 14 December 2009 (UTC)

Costs and patents
Here's a story from the New York Times that explains how the drug companies keep the costs of Albuterol and generics so high, compared to other countries, by patents and other methods. The price went up from $15 to $50-100 per inhaler after a patent. It's worth working into the entry.

http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-simple-breath.html

The Soaring Cost of a Simple Breath

By ELISABETH ROSENTHAL October 12, 2013 --Nbauman (talk) 21:52, 12 October 2013 (UTC)


 * Hmmm, a bottle of salbutamol syrup cost $1.5 in Poland last time I checked, and a year's supply of salbutamol tablets in India cost $12. --Kashmiri (talk), 21 December 2015