A shortage of the 2.5 mg/2.5 mL salbutamol inhalation solution ampoule is expected from mid next week until August 2024.

Asthmatic child using nebuliser

There will be a shortage of the salbutamol inhalation solution, which is used via a nebuliser, from 15 November.

The manufacturer of Ventolin nebules, GlaxoSmithKline, has reported an expected shortage of the salbutamol 2.5 mg/2.5 mL inhalation solution ampoule from next week.


An update to the Therapeutic Goods Administration (TGA) medicine shortage database indicates that the Ventolin nebules shortage is due from 15 November until 1 August 2024.


The shortage is not expected to affect the 5.0 mg/2.5 ml salbutamol solution, nor other inhaler devices using salbutamol.


Guidance has been developed by The Thoracic Society of Australia and New Zealand (TSANZ), the Lung Foundation and Asthma Australia to help health professionals to navigate the shortage.


‘Evidence suggests that the use of MDI and spacer is just as effective as using nebulisers in people with asthma and bronchodilation,’ the guidance states.


The PBS clinical criteria states that for both asthma and COPD prescriptions, patients must be unable to use the drug from an oral pressurised device via a spacer.


Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine, told newsGP the shortage could be used to reevaluate patients on existing prescriptions.


‘I would suggest GPs look to see who they have prescribed 2.5 mg nebules to and be proactive in changing them over to an MDI spacer,’ Dr Hancock said.


‘If a GP has a patient who they have been prescribing nebules, [they should] seriously consider changing the patient over to a puffer and spacer.’


Dr Hancock suggested that patients who have been prescribed the 2.5 mg ampoules should not automatically be prescribed the 5 mg inhalation solution, which will not be affected by the shortage.


‘Nebules are still quite tricky things to use and there should be an effort made to transfer them over,’ she said.


The guidance states that when initiating patients on salbutamol, it should be via MDI and spacer rather than nebulised salbutamol unless it is clinically necessary.


According to the product information, 2.5 mg is the approved dose of salbutamol nebules for children aged 4–12.


The salbutamol Cipla 2.5 mg/2.5 mL brand has been unavailable since last December.


An education event, Asthma Management and Practical Solutions, Ventolin 2.5 mg Nebule Outage, will take place at 6.00 pm on 14 December. For full details, see the TSANZ website.

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