Skip to Accessibility Tools Skip to Content Skip to Footer

6 Common Nebulizer Medicines

So, your doctor wants you to take breathing treatments. Or, perhaps you take breathing treatments already. Here are the 6 most common nebulized medicines used for COPD.

Normal Saline (Sodium Chloride)

It’s a solution that contains a 0.9% mixture of sodium chloride, or salt. The salt is needed to match the salt content of your body. Another name for it is salt water. It’s just salt water. It’s not prescribed on its own. But, about 0.3cc of normal saline is premixed with solutions of respiratory medicine to make breathing treatments last long enough to be effective. The solutions are stored in plastic amps. These amps have easy to remove twist-tops.

So, that said, here are your respiratory medicines.

1. Albuterol (Ventolin)

It’s a bronchodilator. It’s referred to as a beta-adrenergic medicine because the medicine binds to beta-adrenergic receptors lining airways. It relaxes smooth muscles that are wrapped around airways. In this way, it opens airways to allow air to flow easily through them. It starts working in a matter of seconds. So, it’s often called “rescue medicine.”

It lasts 4-6 hours. Some physicians prescribe it to be used as needed when you feel short of breath. However, some physicians prescribe it to be inhaled four times daily to prevent symptoms. For COPD, it is often combined with ipratropium bromide.

Side effects are generally considered negligible. The most common side effect is tremors.

2. Ipratropium Bromide (Atrovent)

It’s a different type of bronchodilator. It’s referred to as a muscarinic because the medicine binds with muscarinic receptors lining airways. Like albuterol, it relaxes the muscles that wrap around airways. This causes airways to open, thereby making breathing easier.

The medicine lasts 4-6 hours. So, it’s usually prescribed QID, or four times a day. It’s sometimes prescribed by itself. But, more often than not, it’s given with albuterol. This is done to keep your airways open long term and prevent symptoms.

3. Duoneb

As noted, COPDers are often prescribed both Ventolin and Atrovent together.  Because both are pre-mixed with normal saline, breathing treatments can last a long time. So, Duoneb is a mixture of Ventolin, Ipratropium Bromide, and 0.3cc of normal saline. This makes it so you can inhale both medicines at the same time with only one dose of saline. It makes for a nice, quick treatment.

4. Levalbuterol (Xopenex)

Like albuterol, it’s a bronchodilator and beta-adrenergic. It’s also a rescue medicine. Initial studies showed it was stronger and safer than albuterol. However, subsequent studies have not confirmed the initial expectations. In fact, a 2009 study showed there was no difference between albuterol and levalbuterol as far as efficacy.1 A 2011 study showed there was no difference as far as side effects.2 Still, it’s an alternative to albuterol that some doctors and COPDers find helpful.

5. Pulmicort (Budesonide)

It’s an inhaled steroid.  It’s the only inhaled steroid available as a solution. Some people with COPD have a hard time generating enough flow to actuate inhalers. For this reason, Pulmicort is a nice option for some people with COPD. The medicine lasts 12 hours, so the recommended dose is one treatment twice daily.

6. Brovana (arformoterol tartrate)

It’s a long-acting bronchodilator. It’s also referred to as a long-acting beta-adrenergic (LABA). It lasts for up to 12 hours. This makes it so you only need to use it two times a day. The goal is to help you obtain good COPD control. Most people using Brovana also have a PRN (as needed) prescription for albuterol. However, the goal is to not need your albuterol. Still, if you need to, it is considered safe to use albuterol in between Brovana breathing treatments.

Conclusion

So these are the most common respiratory solutions prescribed for COPD. These are medicines that are inhaled using a nebulizer breathing treatment.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Borkowski Jaime, Marsha Crader, "Nebulized albuterol versus levalbuterol in pediatric and adult patients: A review," Formulary Journal of Modern Medicine, April 1, 2009, http://formularyjournal.modernmedicine.com/formulary-journal/news/clinical/clinical-pharmacology/nebulized-albuterol-versus-levalbuterol-pediat, accessed 1/25/18
  2. Bio, et al., "Comparison of Levalbuterol and Racemic Albuterol Based on Cardiac Adverse Effects in Children," Journal of Pediatric Pharmacological therapy, 2011, Sept.- July , https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292530/, accessed 5/25/18

Comments

  • luvmylife1948
    5 months ago

    I Have Asthma and provided with a brown inhaler which is the Preventer and now stopped using salbutamol. When I use my inhalers I suffer more breathlessness and was wondering if this was a side effect. There is no way of me knowing if LECITHIN is used in any of these products, as lecithin is used in many food additives and I do have an allergic reaction to LECITHIN. I used it in in its 100% granular form to emulsify fats in the body since I suffer with lipodema. I immediately suffered severe breathlessness almost like anaphalactic. (Gasping for breath) A scary experience. I spoke to my G.P. about this and she didn’t reply so I have been left to do my own monitoring and not using an inhaler often. I am just trying to recover from bronchitis. Sharing here perhaps someone else has had the same experience, or not. But sharing does help me to feel less alone. I live in the U.K. with some bronchodilators being different in name from the U.S.A. but having the same function. I know the moderators can’t comment on medications but just sharing helps. To be heard.

  • Lyn Harper, RRT moderator
    5 months ago

    Hi again luvmylife48 – I want to be sure that you know about our sister site Asthma.net. Please take a minute and post your questions and comments there as well since sometimes a different group of people will see it and may respond. https://asthma.net/

    I’m not familiar with the nuances of the inhaler you describe. However, instead of making you feel breathless, your rescue inhaler should be having the opposite effect. You need to have a serious conversation with your doctor about your concerns. They may be unfounded, or not, but either way you deserve the time and attention from your doctor to get an answer.

    Regards,
    Lyn (site moderator)

  • Leon Lebowitz, BA, RRT moderator
    5 months ago

    Hi luvmylife1948 and thanks for your post. You are always welcome here! You’re also welcome to share and post – we’re all here to help. I’m in agreement with Lyn – you should not be dealing with this issue without medical guidance. Is there a way you can have your physician step in? That would be the most prudent approach. Please do keep us posted as to your progress.
    All the best, Leon (site moderator)

  • plum
    5 months ago

    Here in the U.K. instead of ventolin people get subscribed Salamol as a recuse inhaler. Salamol is cheaper than ventolin! Having lived in Australia for 16 years and also diagnosed with copd I was told to use my steroid inhaler as a rescue meds and could take up to 12 puffs a day. The names of meds are different and of course the costs are too. I am told to use Salamol as a rescue inhaler which I don’t fine very helpful, so now concentrate on breathing with the inhaler in my mouth! This site is brilliant btw

  • Leon Lebowitz, BA, RRT moderator
    5 months ago

    Hi plum and thanks for your post. While we cannot provide medical advice over the internet (for your own safety), your concern certainly warrants a reply. In the most general of terms, a medication that is considered to be an inhaled corticosteroid, should not be used as a ‘rescue’ inhaler. It looks (to me) like Salamol is the medication Salbutamol, which is considered to be a bronchodilator. I would suggest you speak about your medication regimen in detail with your prescribing physician. This will prevent any misunderstanding or confusion about what you should be taking. What do you think? Leon (site moderator)

  • Leon Lebowitz, BA, RRT moderator
    6 months ago

    Hi John and thanks for posting this. It’s a clear, concise presentation of the most commonly used medications for nebulization. It’s very helpful!
    Leon (site moderator)

  • Poll