Alternatives to the Albuterol Inhaler for Asthma

Albuterol is a short acting beta agonist that helps provide short-term relief for symptoms of asthma. Sometimes patients cannot tolerate using an albuterol inhaler, though, which means a patient will need to work with his doctor to find an alternative. Understanding what alternatives are available usually relates to determining what other drugs are available within the class, as well as establishing what alternatives in other classes could help.

Other Short Acting Beta Agonists

• Because albuterol is a short acting beta agonist, patients should first talk with their doctors about whether other drugs in this class would be acceptable alternatives to the albuterol inhaler. If, for example, the patient has a specific problem with albuterol, but can tolerate short acting beta agonists, other drug options include pirbuterol (Maxair) or levalbuterol. Because clinical practice guidelines for the treatment of asthma still recommend use of a short term beta agonist as the gold standard of asthma therapy, patients should expect that their doctor will want to stay with this drug class unless there are issues with serious side effects or drug tolerance.

Long Acting Beta Agonists

• Another consideration when thinking about alternatives to albuterol is the long acting beta agonists. Although their mechanism of action is similar to the short acting beta agonists (like albuterol), long acting beta agonists will relieve symptoms for up to 12 hours, as opposed to only four to six hours on albuterol and other short term therapies. Drugs in the long acting beta agonist category include salmeterol (Advair), bambuterol (Bambec) and clanbuterol. Doctors will occasionally switch patients from short acting therapies to long acting therapies if circumstances are favorable for such a change. Treatment guidelines recommend that patients take a corticosteroid with a long acting therapy, however, so discussion about this switch with a doctor is important. Some companies also package long acting therapies with a corticosteroid included with the beta agonist--this is another reason to discuss a therapeutic switch with a doctor.

Other Alternatives

• Patients who cannot tolerate any short acting beta agonist do have a couple of options. Clinical guidelines recommend ipratropium bromide (Atrovent) as an effective therapy to provide short term relief for symptoms of asthma. Patients can also talk with their doctor about whether montelukast (Singulair) is an option--this drug helps treat exercise-induced asthma and works similarly to the long acting beta agonists, except it is in tablet form instead of inhaled aerosol or powder.