ProAir HFA (albuterol sulfate)
ProAir HFA (albuterol sulfate) – a metered dose beta agonist inhaler commonly used to treat asthma. The pharmacologic effects of albuterol sulfate are attributable to activation of beta2-adrenergic receptors on airway smooth muscle. Activation of beta2-adrenergic receptors leads to the activation of adenylcyclase and to an increase in the intracellular concentration of cyclic-3′, 5’-adenosine monophosphate (cyclic AMP). This increase of cyclic AMP is associated with the activation of protein kinase A, which in turn inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentration, resulting in bronchial smooth muscle relaxation.
FDA approved uses: ProAir HFA is indicated for Treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease. Prevention of exercise-induced bronchospasm in patients 4 years of age and older.
Available dosage forms: Inhalation Aerosol – Each actuation delivers 108 mcg of albuterol sulfate from the actuator mouthpiece (equivalent to 90 mcg of albuterol base).
Usual dosage: Treatment or prevention of bronchospasm in adults and children 4 years of age and older – 2 inhalations every 4 to 6 hours. In some patients, one inhalation every 4 hours may be sufficient. Prevention of exercise-induced bronchospasm in adults and children 4 years of age and older – 2 inhalations 15 to 30 minutes before exercise.
Contraindications: Patients with known hypersensitivity to albuterol sulfate or to any excipients used in the ProAir HFA Inhalation Aerosol.
Special warnings: Life-threatening paradoxical bronchospasm may occur. Discontinue ProAir HFA immediately and treat with alternative therapy. Need for more doses of ProAir HFA than usual may be a sign of deterioration of asthma and requires reevaluation of treatment. ProAir HFA is not a substitute for corticosteroids. Cardiovascular effects may occur. Use with caution in patients sensitive to sympathomimetic drugs and patients with cardiovascular or convulsive disorders. Excessive use may be fatal. Do not exceed recommended dose. Immediate hypersensitivity reactions may occur. Discontinue ProAir HFA immediately. Hypokalemia (low blood potassium) has been reported with beta agonist inhalers.
Adverse reactions (side effects) of these medications: The most common side effects of ProAir HFA include headache, tachycardia, pain, dizziness, pharyngitis, and rhinitis. Other adverse events observed in postmarketing include urticaria, angioedema, rash, bronchospasm, hoarseness, oropharyngeal edema, and arrhythmias (including atrial fibrillation, supraventricular tachycardia, extrasystoles). In addition, albuterol, like other sympathomimetic agents, can cause adverse reactions such as: angina, hypertension or hypotension, palpitations, central nervous system stimulation, insomnia, headache, nervousness, tremor, muscle cramps, drying or irritation of the oropharynx, hypokalemia, hyperglycemia, and metabolic acidosis.
Common drug interactions: Other short acting beta agonist inhalers – Should not be used concomitantly with ProAir HFA. Monoamine oxidase inhibitors and tricyclic antidepressants – Use with extreme caution. May potentiate effects of albuterol on the vascular system. Beta blockers – may block bronchodilatory effects of beta-agonists and produce severe bronchospasm. Diuretics – Use with caution. EKG changes and/or hypokalemia associated with non-potassium sparing diuretics may worsen with concomitant beta agonist use.
Special instructions for patients: Use this medication exactly as directed by physician. Consult official Medication Guide before starting ProAir HFA and when you receive additional refills. Before using ProAir HFA, tell your doctor if you:
Full prescribing information may be found at the manufacturer‘s official website ProAir Website or at the U.S. Food and Drug Administration’s website at ProAir HFA Info at Drugs@FDA
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