Breton
Generic Name
Salbutamol (as Sulfate)
Manufacturer
Amico Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| breton 1 mg syrup | ৳ 35.00 | N/A |
Description
Overview of the medicine
Breton 1 mg/5 ml Syrup contains Salbutamol (as Sulfate), a short-acting beta-2 adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles in the airways to improve breathing.
Uses & Indications
Dosage
Adults
Usual starting dose is 2-4 mg (10-20 ml) three or four times daily. Maximum single dose is 8 mg (40 ml).
Elderly
A lower initial dose may be considered, e.g., 2 mg (10 ml) three or four times daily. Adjust dose according to response and tolerance.
Children
Children 2-6 years: 1-2 mg (5-10 ml) three or four times daily. Children 6-12 years: 2 mg (10 ml) three or four times daily. Children over 12 years: 2-4 mg (10-20 ml) three or four times daily.
Renal_impairment
No specific dose adjustment is generally required, but caution is advised in severe impairment. Monitor for side effects.
How to Take
Breton syrup is for oral administration. It can be taken with or without food. Use a measuring spoon or cup to ensure accurate dosing.
Mechanism of Action
Salbutamol selectively stimulates beta-2 adrenergic receptors found in the smooth muscle of the bronchi, leading to relaxation of the bronchial smooth muscle. This results in bronchodilation, increased ciliary activity, and a decrease in mediator release from mast cells, thereby opening the airways and making breathing easier.
Pharmacokinetics
Onset
Bronchodilation typically occurs within 5-15 minutes after oral administration, with maximum effect at 1.5-2 hours.
Excretion
Approximately 75% of a dose is excreted in the urine within 24 hours, both as unchanged drug and as metabolites. Some is excreted in feces.
Half life
The plasma half-life of oral salbutamol is approximately 4-6 hours.
Absorption
Rapidly and well-absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are reached within 2-3 hours.
Metabolism
Partially metabolized in the liver to an inactive sulfate conjugate. Extensive first-pass metabolism occurs.
Side Effects
Contraindications
- Hypersensitivity to salbutamol or any component of the formulation.
- Severe milk protein allergy (for some formulations, check product specific information).
Drug Interactions
Digoxin
Salbutamol may decrease serum digoxin levels. Monitor digoxin levels if co-administered.
Other Sympathomimetics
Concurrent use with other sympathomimetic agents may increase the risk of cardiovascular adverse effects.
Diuretics (e.g., Furosemide)
May enhance the hypokalemic effect of salbutamol, particularly with high doses. Monitor serum potassium levels.
Non-selective Beta-blockers (e.g., Propranolol)
May antagonize the bronchodilatory effect of salbutamol and can produce severe bronchospasm in asthmatic patients. Concomitant use is generally contraindicated.
Monoamine Oxidase Inhibitors (MAOIs) and Tricyclic Antidepressants (TCAs)
May potentiate the cardiovascular effects of salbutamol, increasing the risk of arrhythmias and hypertension. Use with caution.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose include transient beta-agonist related effects such as tachycardia, tremor, palpitations, hypokalemia, and hyperglycemia. Paradoxical bronchospasm may also occur. Management is supportive and symptomatic.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Salbutamol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing mother. Consult your doctor before use.
Side Effects
Contraindications
- Hypersensitivity to salbutamol or any component of the formulation.
- Severe milk protein allergy (for some formulations, check product specific information).
Drug Interactions
Digoxin
Salbutamol may decrease serum digoxin levels. Monitor digoxin levels if co-administered.
Other Sympathomimetics
Concurrent use with other sympathomimetic agents may increase the risk of cardiovascular adverse effects.
Diuretics (e.g., Furosemide)
May enhance the hypokalemic effect of salbutamol, particularly with high doses. Monitor serum potassium levels.
Non-selective Beta-blockers (e.g., Propranolol)
May antagonize the bronchodilatory effect of salbutamol and can produce severe bronchospasm in asthmatic patients. Concomitant use is generally contraindicated.
Monoamine Oxidase Inhibitors (MAOIs) and Tricyclic Antidepressants (TCAs)
May potentiate the cardiovascular effects of salbutamol, increasing the risk of arrhythmias and hypertension. Use with caution.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose include transient beta-agonist related effects such as tachycardia, tremor, palpitations, hypokalemia, and hyperglycemia. Paradoxical bronchospasm may also occur. Management is supportive and symptomatic.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Salbutamol is excreted in breast milk; therefore, caution should be exercised when administered to a nursing mother. Consult your doctor before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to the product packaging for the exact expiry date.
Availability
Available in pharmacies nationwide.
Approval Status
Approved
Patent Status
Generic
WHO Essential Medicine
YesClinical Trials
Salbutamol has undergone extensive clinical trials over decades, establishing its efficacy and safety as a bronchodilator for respiratory conditions like asthma and COPD. Ongoing research focuses on optimizing delivery methods and combination therapies.
Lab Monitoring
- Serum potassium levels should be monitored, especially in patients receiving high doses, or concurrently with other drugs that can cause hypokalemia (e.g., diuretics).
- Blood glucose monitoring in diabetic patients.
Doctor Notes
- Emphasize to patients the difference between reliever (salbutamol) and controller medications, stressing that salbutamol is for symptom relief and not for long-term asthma control.
- Monitor patients for signs of hypokalemia, especially those with severe asthma or co-morbidities/medications that predispose to hypokalemia.
- Educate patients on proper syrup measurement and administration.
Patient Guidelines
- Do not exceed the recommended dose; overuse can lead to adverse effects.
- Seek medical advice immediately if your symptoms worsen or if the usual dose fails to provide relief.
- Use the provided measuring device for accurate dosing.
- Keep the bottle tightly closed when not in use.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Salbutamol may cause tremor or dizziness in some patients, particularly at the start of treatment or at higher doses. Patients should be advised to exercise caution when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Identify and avoid asthma triggers (e.g., allergens, irritants).
- Quit smoking and avoid exposure to second-hand smoke.
- Maintain a healthy lifestyle with regular exercise (if tolerated) and a balanced diet.
- Follow your asthma action plan as advised by your doctor.
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