What is Albuterol?
Albuterol is a prescription medication that prevents and treats reactive airway diseases such as asthma and chronic obstructive pulmonary disease (COPD) [1, 2]. It's classified as a beta2-adrenergic agonist bronchodilator, which stimulates the beta-2 adrenergic receptor on the surface of cells, causing smooth muscles in the airways to relax [1, 3].
Albuterol is a racemic mixture containing equal parts of the R- and S-isomers. The therapeutic benefits of Albuterol are due to the R-isomer, while the S-isomer may have adverse effects [2, 4]. The R-isomer, levalbuterol, has demonstrated therapeutic advantages over racemic Albuterol, such as decreased acute medical care and hospitalisation requirements.[2]
Albuterol is available in various forms, such as inhalation suspension, nebulizer solution, inhalation powder, immediate-release tablet, extended-release tablet, and oral syrup [3]. It is commonly used as a "rescue" medication because of its ability to bring quick symptom relief, such as wheezing and chest tightness [1].
The medication takes effect within a few minutes and can last several hours, helping to relax the airway muscles for 6–12 hours [1, 3]. However, if an albuterol inhaler is used three times a week or more, it may be necessary to speak with a healthcare professional about gaining better control of the condition [1].
Uses of Albuterol
As we previously discussed, Albuterol is primarily used to prevent and treat difficulty breathing, wheezing, shortness of breath, coughing, and chest tightness caused by lung diseases such as asthma and chronic obstructive pulmonary disease (COPD) [5].
In addition to its primary use, Albuterol is also used to prevent breathing difficulties during exercise [5]. It is a common rescue medication that people with COPD can use as an inhaler or nebulizer [1].
Albuterol has also been used to treat or improve muscle paralysis in patients with a condition that causes attacks of paralysis [5]. Furthermore, it has been used experimentally with exercise therapy in a few inherited neuromuscular disorders to increase muscle strength and volume [6].
Side effects of Albuterol
Common side effects: Albuterol can cause various side effects. The most common side effects include tremors and nervousness, which occur in about 1 in 5 people who take Albuterol [1]. Other common side effects include nausea, sore throat, dizziness, insomnia, chest pain, fast heart rate and shakiness [7, 8].
Uncommon side effects: Less common side effects include fever, vomiting, cough, dry mouth, chills, throat irritation, and muscle, back, or bone pain [1, 5]. Some people may also experience mood changes, nosebleeds, increased or decreased appetite, and difficulty falling asleep or staying asleep [7].
Severe side effects: Serious side effects of Albuterol can include fast heart rate, increased blood pressure, chest pain, tremor, abnormal heart rhythm, and severe allergic reactions [7, 8]. These severe allergic reactions can manifest as rash, hives, itching, swelling of the face, mouth, eyes, hands, feet, ankles, or legs, increased breathing difficulties, problems swallowing, and a hoarse voice [1, 7].
In rare cases, Albuterol can cause severe skin reactions, such as erythema multiforme and Stevens-Johnson syndrome, especially in children [3]. These reactions can include itching, burning, red lesions or a rash that spreads over your body, fever, and chills [3].
Advise caution: If you experience severe or persistent side effects, contact your doctor immediately. In case of life-threatening symptoms, seek immediate medical assistance [1, 3].
Expired Albuterol
Albuterol is typically issued with an expiration date of one year. However, it may still be effective for months after this date, depending on how it's stored [9].
The stability of Albuterol has been tested in various conditions. For instance, it was stable (greater than 90% of the initial concentration remaining) for at least seven days in different types of containers under refrigerated and room temperature conditions [10]. Another study found that both high and low concentrations of Albuterol were stable at room temperature for up to 168 hours(7 days) [11].
However, it should be noted that these studies do not confirm the therapeutic efficacy of expired Albuterol. While the chemical stability of the drug might be maintained, its effectiveness in treating asthma symptoms after the expiration date is not guaranteed.
Moreover, the storage conditions of the medication can significantly impact its stability. Albuterol should be kept at a temperature between 59°F and 77°F (15°C and 25°C) and away from extreme heat or cold. Temperatures above 120°F (49°C) may cause the canister to burst. It should also not be stored in moist or damp areas, such as bathrooms [3].
In conclusion, while Albuterol may not "go bad" immediately after its expiration date, its effectiveness cannot be guaranteed. If you have an expired albuterol inhaler, you should get a new one to ensure you get the full therapeutic benefits.
