Table 1. First-line Medications for Exercise-induced
Bronchoconstriction (EIB)
Generic
(Brand)
Dosage Dose Onset Duration
Short-acting beta agonists (Administer prior to exercise to prevent exercise-induced
bronchoconstriction and as-needed for relief of acute symptoms)
MDI
Albuterol
(ProAir HFA
®
,
Proventil HFA
®
,
Ventolin HFA
®
)
90 mcg/inh Prevention of EIB:
2 inh 15 min prior to
exercise
Relief of acute symptoms:
1-2 inh q4-6h prn
≤15 min 3-6 hrs
Pirbuterol
(Maxair
®
)
200 mcg/inh Prevention of EIB:
2 inh 15 min prior to
exercise
Relief of acute symptoms:
1-2 inh q4-6h prn
Max dose:
12 inh / 24 hrs
<5 min 5 hrs
Levalbuterol
(Xopenex
HFA
®
)
45 mcg/inh Prevention of EIB:
2 inh 15 min prior to
exercise
Relief of acute symptoms:
1-2 inh, q4-6h prn
(safety and efficacy not
established in children)
5-10 min 3-4 hrs
Nebulizer solution
Albuterol
(Proventil
®
)
0.021% (0.63
mg/3 mL),
0.042% (1.25
mg/3 mL),
0.083% (2.5
mg/3 mL), and
0.5% (2.5 mg/0.5
mL)
Prevention of EIB:
(15 min prior to exercise)
2-12 yrs: 0.63-1.25 mg
≥12 yrs: 1.25-2.5 mg
Relief of acute symptoms:
≥12 yrs: 2.5 mg, 3-4x daily
prn
2-12 yrs: 0.63-1.25, 3-4x
daily prn
5-15 min 3-4 hrs
Levalbuterol
(Xopenex
®
)
0.31 mg/3 mL,
0.63 mg/3 mL,
1.25 mg/3 mL,
and 1.25 mg/0.5
mL
Prevention of EIB:
(15 min prior to exercise)
≥ 12 yrs: 0.63-1.25 mg
6-11 years: 0.31 mg
Relief of acute symptoms:
≥12 years: 0.63-1.25 mg,
≤3x daily, q6-8h prn
6-11 yrs: 0.31 mg, up to
3-times daily, q6-8h prn
10-17 min 5-8 hrs.
