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Albuterol side effects in kids: What's normal?

By Mayo Clinic staff

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  • With Mayo Clinic asthma and allergy specialist

    James T. Li, M.D.

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Mayo Clinic Health Manager

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Question

Albuterol side effects in kids: What's normal?

My 4-year-old daughter is taking albuterol for mild allergic asthma. Although the albuterol seems to help her asthma symptoms, it makes her cranky, withdrawn and unable to concentrate on activities she normally enjoys. Is there another medication she can switch to?

Answer

from James T. Li, M.D.

Albuterol is commonly used for short-term relief of asthma symptoms. A type of medication known as a short-acting bronchodilator, it eases symptoms by opening the airways during an asthma flare-up.

Albuterol is usually given with a metered dose inhaler (ProAir HFA, Ventolin HFA, others) and sometimes in tablet or liquid form. Albuterol side effects can include restlessness, irritability and nervousness. Albuterol side effects are worse with the liquid or tablet form than with the inhaled form. Also, the risk of albuterol side effects increases with higher doses.

To ease medication side effects, your child may need to try a metered dose inhaler if she is taking the liquid or tablet form. It may be worthwhile to try a different quick-relief medication, such as the short-acting bronchodilator levalbuterol (Xopenex) or pirbuterol (Maxair). Some children under 6 years don't have the coordination and dexterity to use a metered dose inhaler on their own. You may need to use an inhaler with a face mask to give your child the inhaled medication she needs.

If your child uses albuterol three or more times a week or has severe asthma symptoms, she probably needs to take a long-term asthma medication.

Examples of long-term control medications include inhaled corticosteroids such as fluticasone (Flovent), budesonide (Pulmicort), triamcinolone (Azmacort) and others; and leukotriene modifiers such as montelukast (Singulair) and zafirlukast (Accolate). With asthma under better control, your child won't need to use albuterol or another quick-relief medication as often.

Carefully track your child's asthma, and check with your child's doctor about any changes that may be needed. Help your child avoid any known asthma triggers. Work with the doctor to make sure you're using the right type and dose of medication to keep your child's symptoms — and medication side effects — under control.

Next question
Asthma triggers: Are hard flooring surfaces better than carpet?
References
  1. Expert Panel Report 3 (EPR-3): Guidelines for the diagnosis and management of asthma — Summary report 2007. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Accessed Sept. 30, 2009.
  2. Liu AH. Childhood asthma. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/162856992-6/0/1608/440.html?tocnode=54478148&fromURL=440.html#4-u1.0-B978-1-4160-2450-7..50145-6_3411 http://www.mdconsult.com/das/book/body/100024376-12/727446153/1608/440.html#4-u1.0-B978-1-4160-2450-7..50145-6--cesec11_3422. Accessed Sept. 29, 2009.
  3. Li JT (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 6, 2009.
  4. Guilbert T, et al. In: Adkinson NF, et al: Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia, Pa.: Mosby; 2008. http://www.mdconsult.com/das/book/body/100024376-7/727439687/1183/535.html#4-u1.0-B0-323-01425-9.50075-7_2434. Accessed Sept 29, 2009.

AN01065

Nov. 13, 2009

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