Salbutamol for Cough Management in Asthma and COPD

Indications for Salbutamol

The American Thoracic Society recommends salbutamol for cough associated with asthma or cough-predominant asthma, where bronchospasm is the underlying mechanism 2, 3
For acute asthma exacerbations with cough, the European Respiratory Society recommends nebulized salbutamol at doses equivalent to 2.5-5 mg 4
In children with asthma-related cough, the British Thoracic Society recommends salbutamol via nebulizer (5 mg or 0.15 mg/kg) or as an inhalational powder (400 μg) 5

The European Respiratory Society recommends nebulized salbutamol at doses of 2.5-5 mg for acute COPD exacerbations with cough 4
In chronic COPD management, the European Respiratory Society suggests salbutamol may be used up to 1 mg via hand-held inhalers before considering nebulized therapy 4, 6

The British Thoracic Society recommends spirometry in all patients with chronic cough to identify reversible airflow obstruction that might respond to salbutamol 2, 3
The British Thoracic Society suggests measuring FEV1 before and after inhalation of salbutamol to determine bronchodilator responsiveness 2, 3

The American College of Chest Physicians recommends inhaled ipratropium bromide as first-line treatment for cough suppression in patients without asthma or COPD 1
The American College of Chest Physicians suggests central-acting antitussives (codeine, dextromethorphan) for short-term symptomatic relief in chronic bronchitis 1

The American Thoracic Society warns that using salbutamol for non-asthmatic cough may delay appropriate diagnosis and treatment of the underlying cause 1
The British Thoracic Society advises against using single peak expiratory flow (PEF) measurements to assess bronchodilator response, instead recommending FEV1 2, 3