Asmalin MDI Drug Interactions

Sympathomimetic agents: Salbutamol should not be administered concomitantly with other sympathomimetic agents or epinephrine since serious adverse cardiovascular effects may occur.
Beta-adrenergic blocking agents: Beta-adrenergic blocking agents (e.g., propanolol) may inhibit the effect of beta-agonists such as salbutamol. It may also produce severe bronchospasm in asthmatic patients.
Corticosteroids: Combination therapy of corticosteroids (e.g., prednisolone) and beta₂-agonists has been found to have beneficial effects on asthma control.
However, concurrent administration of corticosteroids and beta₂-agonists may exacerbate the decrease in potassium concentrations or enhance hyperglycemic effects. Thus, potassium and blood sugar levels should be monitored.
Diuretics: Administration of non-potassium-sparing diuretics (e.g., loop or thiazide diuretics) may result in electrocardiographic changes and/or hypokalemia and can be acutely worsened by administration of beta₂-agonists such as salbutamol, especially when the recommended dose of the beta₂-agonist is exceeded.
Digoxin: Following administration of single-dose intravenous or oral salbutamol to healthy individuals who had received digoxin for 10 days, a 16% to 22% decrease in serum digoxin concentration was observed. Although the clinical importance of these findings for patients who are receiving inhaled salbutamol and digoxin on a chronic basis is unclear, patients receiving such concomitant therapy should have their serum digoxin concentration carefully evaluated.
Monoamine oxidase inhibitors (MAOIs) or Tricyclic antidepressants (TCAs): Salbutamol should be used with caution in patients receiving MAOIs (e.g., rasagiline) or TCAs (e.g., clomipramine), or within 2 weeks of discontinuation of such agents, because the effect of salbutamol on the vascular system may be potentiated. Alternative therapy should be considered in patients taking MAOIs or TCAs.
Xanthines: An enhanced hypokalemic effect may occur when salbutamol is given with xanthines (e.g., theophylline).