The short answer is that albuterol is in Ventolin.
Ventolin is a brand name and albuterol is the medication that opens up the airways. Comparing brand-name products and their generic equivalents is similar to asking what is the difference between Tylenol and acetaminophen.
This does not mean all albuterol inhalers are the same, the medication may be the same, but the device in your hand can be different, and this can make a big difference.
What is albuterol?
Albuterol is a short acting beta₂ agonist, also known as a SABA. It is a rescue or reliever medication used to open up the airways by relaxing the muscles surrounding the airways. These muscles are often tight in diseases such as asthma, and when they relax it can relieve some of the symptoms associated with asthma within minutes of taking albuterol.
Outside the US, this medication is often referred to as salbutamol.
Albuterol is typically a reliever medication and is used when symptoms such as wheezing, chest tightness or shortness of breath develops. It may also be used before exercise if exercise is known to trigger symptoms.
However,
it does not address the underlying inflammation of the airways, which is why albuterol is often associated with other control medications for long term management.
Is Ventolin better than generic albuterol?
When comparing Ventolin HFA and an FDA approved generic albuterol HFA inhaler of the same strength, neither should be considered stronger than the other.
Ventolin HFA delivers 90 mcg of albuterol per each spray from the mouthpiece. A generic equivalent should provide the same clinical benefit when used as directed.
However, patients may note that one inhaler provides better relief than the other.
This is not always due to one inhaler being more effective than the other.
Patients may be noticing the difference in the device such as the firmness of the canister or how the mouthpiece feels in their hand or the amount or strength of the plume upon activation. The taste may be different, the dose counter may be different or even the number of actuations required before throwing away a new or unused inhaler.
There is also the factor of familiarity, a patient who has been using a blue ventolin inhaler for ten years will also be more familiar with that device, when a new generic inhaler is introduced, the timing of their breath may be slightly off since they are not as familiar with this new device. Their medication dose may end up going to their tongue instead of their lungs, and they will blame the new generic inhaler.
Albuterol can be more than an inhaler
Albuterol is available as more than just an inhaler. The more familiar metered dose inhaler or MDI is only one option.
There are also nebulizer solutions that are turned into a mist and inhaled over several minutes. This may be an option for children or when more severe symptoms develop, or for patients who are not able to coordinate the technique required for an MDI.
A nebulizer treatment and two puffs from an MDI are not interchangeable. Patients should check with their physician or pharmacist before trying to use a nebulizer solution or an MDI if they have been prescribed “albuterol”.
Technique can determine the success of either one
A rescue inhaler can have the exact dose, but if most of it ends up going down the back of the throat, it will not be effective.
For a typical MDI, the patient needs to shake it, breathe out away from the inhaler, place the mouthpiece in their mouth and begin to take a slow steady breath while pressing down on the canister. Then, continue to breathe in slowly and deeply and hold your breath for several seconds if possible.
This is a lot to ask, and that is why a spacer can be helpful, it often helps direct more medication into the lungs. Children or adults who have trouble with this technique should ask their pharmacist or doctor about a spacer.
The mouthpiece also needs to be cleaned, medication can build up and clog the opening, narrowing the stream of medication. The instructions usually provided with the inhaler are specific to that device, and should be followed, rather than what might be assumed.
The shaky feeling after taking a puff
Albuterol can cause tremors, an increased heart rate, or a feeling of restlessness or “wired” after taking a dose. Some patients can also get a headache or a sore throat.
These side effects tend to be short lived. However, repeated puffs can prolong these side effects, and chest pain that is severe, fainting, irregular heart rhythm or difficulty breathing just after the dose is reason to go to the emergency room.
If a patient takes the recommended number of puffs and it is not helping, they should not just continue to empty the canister in an attempt to get it to work. They need to seek emergency care, as this may be a severe asthma attack that requires more than a reliever medication.
Your rescue inhaler should not dictate your life
Using a Ventolin rescue inhaler occasionally is fine, but regular use and waking at night with asthma symptoms or needing to refill earlier than instructed may be an indication that your controller medication is not sufficient for your needs.
Modern asthma management tries to wean patients off of using a SABA inhaler as a primary medication and onto an inhaled corticosteroid with or without an additional bronchodilator to control the inflammation and reduce the risk of an attack.
Our asthma treatment guide goes into more detail about the difference between reliever and controller medications.
So, Ventolin vs. albuterol? Ventolin is just one brand of albuterol, and if one brand works better, is cheaper or is covered by your insurance, you will likely stick with it. The medication may even change based on how severe your symptoms are and the advice of your doctor or pharmacist.
The more interesting question is how often you need a reliever medication. That is a much better indicator of how well your current treatment plan is working than the name on the inhaler.
