Albuterol: what it treats, how to use the inhaler, side effects
Last updated September 3, 2026.
Albuterol is a fast-acting bronchodilator that relaxes and opens the air passages to your lungs. It is the active ingredient in rescue inhalers like ProAir HFA, Proventil HFA, and Ventolin HFA, and it treats and prevents the wheezing, shortness of breath, coughing, and chest tightness of asthma and COPD.
What does it treat?
Albuterol relieves breathing difficulty, wheezing, shortness of breath, coughing, and chest tightness caused by asthma and chronic obstructive pulmonary disease (COPD). It is also used 15 to 30 minutes before exercise to prevent exercise-triggered breathing problems. The aerosol inhaler is approved for adults and children 4 and older. It controls symptoms - it does not cure the underlying condition, and it is not a maintenance anti-inflammatory inhaler.
How do you take it?
For an HFA inhaler like Proventil HFA, the label dose for adults and children 4 and older is 2 inhalations every 4 to 6 hours; some people do fine on 1 inhalation every 4 hours, and using more puffs or dosing more often is not recommended. Each actuation delivers 90 mcg of albuterol base, and each canister holds 200 inhalations - track them, because sprays past the count may not deliver a full dose. Prime a new inhaler, or one unused for more than 2 weeks, with 4 test sprays into the air away from your face. Shake well, breathe out fully, press once while breathing in slowly and deeply, then hold your breath about 10 seconds. Wash the mouthpiece in warm water at least once a week and air-dry it thoroughly - buildup can block the spray. If you need your inhaler more often than usual, that is a signal to call your doctor, not to keep puffing.
Side effects to know
- Common: shakiness or trembling, nervousness, headache, nausea, vomiting, cough, throat irritation, and muscle or back pain.
- Serious: a fast, pounding, or irregular heartbeat; chest pain; and paradoxical bronchospasm - wheezing or difficulty breathing that hits immediately after inhaling. If that happens, call your doctor right away and do not use the inhaler again until they say so. Allergic reactions (rash, hives, swelling of the face or throat) also need immediate care.
Who should not take it?
Anyone allergic to albuterol should not use it, and the powder inhaler (Respiclick) is off-limits for people allergic to milk proteins. Tell your doctor if you have heart disease, an irregular heartbeat, high blood pressure, hyperthyroidism, diabetes, or seizures, because albuterol can aggravate all of these. Interactions to flag include beta blockers, digoxin, diuretics, epinephrine, other inhaled bronchodilators, and - if taken now or within the last 2 weeks - tricyclic antidepressants or MAO inhibitors. If you are pregnant, planning pregnancy, or breastfeeding, talk to your doctor.
When is it an emergency?
If the inhaler stops relieving your breathing or your breathing gets worse right after a dose, treat it as an emergency - call 911 or get to an emergency room rather than stacking more puffs. Chest pain or a pounding, irregular heartbeat also warrants emergency care. Overdose signs include seizures, chest pain, and a fast or irregular heartbeat - call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Why do I have to prime the inhaler?
Priming loads the mechanism so the first real spray delivers a full dose. The Proventil HFA label says to prime before first use, and any time the inhaler has not been used for more than 2 weeks, by releasing 4 test sprays into the air away from your face. Skipping this can mean your first puff is under-dosed.
How many puffs are in my inhaler, and why should I count them?
The label counts 200 inhalations per canister. After that, each spray may deliver less medication than it should, even though it still sprays. Track the count on the built-in counter or by hand, and replace the inhaler at zero - never test it by floating the canister in water.
Why does my inhaler need weekly cleaning?
Medication builds up in the mouthpiece and can block the spray. The label instructs washing the mouthpiece in warm water at least once a week (canister removed), shaking off excess water, and air-drying it completely, overnight if needed. A blocked inhaler can stop delivering medication without looking different from the outside.
Is albuterol a steroid?
No. Albuterol is a bronchodilator - it relaxes the muscles squeezing your airways. Steroid inhalers (like fluticasone) work differently, reducing inflammation over time. Many asthma plans pair the two: the steroid daily for control, albuterol for flares and before exercise.
Why do my hands shake after using it?
Shakiness and nervousness are among the most common side effects listed by MedlinePlus, caused by the same stimulation that opens your airways. It usually fades quickly. A fast, pounding, or irregular heartbeat is different - that one goes on the call-your-doctor list.
What if my inhaler is not helping like it used to?
Call your doctor soon - do not just use it more. MedlinePlus flags needing albuterol more often than usual as a sign your condition is not controlled, and the label warns against more frequent administration or more puffs than directed. Poorly controlled asthma needs a plan change, not extra puffs.