Pulmicort Nebulizer and Tremor Association

Mechanism and Side Effects

Beta-agonists such as salbutamol and terbutaline are especially likely to cause tremor, particularly in elderly patients, and high doses should be avoided unless necessary 1
Bronchodilators like beta-agonists and ipratropium bromide are frequently mixed together in nebulizers with steroids 2, 3

Nebulized budesonide (Pulmicort Respules) is often administered in the same treatment session as bronchodilators 2, 3
The volume of fluid in nebulizer chambers is usually 2.0-4.5 ml, and bronchodilators are sometimes mixed together to make up this volume 2, 4
If a patient is experiencing tremor, they should verify whether their nebulizer treatment contains only budesonide or if it has been mixed with a beta-agonist bronchodilator 2

Patients experiencing tremor should contact their prescribing physician to clarify exactly what medications are in their nebulizer solution 2, 7
If a beta-agonist is included and causing problematic tremor, the patient should discuss dose reduction or alternative delivery methods with their doctor 1
In elderly patients with ischemic heart disease, high-dose beta-agonist treatment should be used with particular caution, as tremor is more common in this population 1