8
Treatment
Table 7. Quick Relief Medications
Generic
(Brand) Dosage Form Dose
a
Onset Duration
Short-acting β
2
-agonists (Use for relief of acute symptoms)
MDI
b
Albuterol
(ProAir HFA
®
,
Proventil HFA
®
,
Ventolin HFA
®
)
90 mcg/dose 2 inh q4–6h prn
In some patients 1 inh q4h
may be sufficient
≤15 min 3–6 h
Pirbuterol
(Maxair
®
)
200 mcg/dose 2 inh q4–6h prn
In some patients 1 inh q4h
may be sufficient
Max dose: 12 inh/q24h
<5 min 5 h
Levalbuterol
(Xopenex HFA
®
)
45 mcg/dose 2 inh q4-6h prn
In some patients 1 inh q4h
may be sufficient
(safety and efficacy not
established in children)
5–10 min 3–4 h
Nebulizer solution
c
Albuterol
(Proventil
®
)
0.021%
(0.63 mg/3 mL)
0.042%
(1.25 mg/3 mL)
0.083%
(2.5 mg/3 mL)
0.5%
(2.5mg/0.5 mL)
>12 years old:
2 .5 mg 3–4× daily prn
2-12 years old:
0.63–1.25 mg 3–4× daily prn
5–15 min 3–4 h
Salbutamol
(Ventolin Nebules
®
)
2.5 mg/2.5 mL
5 mg/2.5 mL
2.5–5 mg q6–8h prn 10–15
min
4–6 h
Levalbuterol
(Xopenex
®
)
0.31, 0.63, 1.25 mg
per 3 mL
1.25 mg/0.5 mL
≥12 years old: 0.63–1.25 mg
q6-8h prn Max: 3× daily
6–11 years old: 0.31mg
q6–8h prn Max: 3× daily
10–17
min
5–8 h
Anticholinergics (Use for acute bronchospasm in patients with β
2
-agonist intolerance.
erapy of choice for β-blocker-induced asthma.)
MDI
b
Ipratropium
(Atrovent HFA
®
)
17 mcg/dose 2 inh qid prn 15 min 2–4 h
Combinations (Use for acute bronchospasm. Some synergism with both agents.
Primary indication is COPD.)
Albuterol/
ipratropium
MDI
(Combivent
®
)
103 mcg
albuterol/18 mcg
ipratropium per
dose
2 inh qid prn
Max dose: 12 inh/d
5 min 3–4 h
Nebulizer Sol
(Duoneb
®
)
3 mg albuterol/0.5
mg ipratropium
per 3 mL vial
≥ 18 years old:
3 mL q4-6h prn;
Max dose: 18 mL/24 h
5 min 3–4 h
a
See product labeling for complete prescribing information.
b
For more information on FDA changes to MDIs containing CFC's please see
http://www.fda.gov/cder/mdi/consumer.htm and http://www.fda.gov/CDER/mdi/mdifaqs.htm.
c
Nebulizer medications are not therapy of choice for patients at home, but may be indicated under certain
circumstances.
