Does albuterol raise blood pressure?

In this article:

• Does albuterol raise blood pressure?
• How long does albuterol raise blood pressure?
• Who is at risk for elevated blood pressure from albuterol?
• Can you take albuterol with high blood pressure?
• The bottom line

In this article

• Does albuterol raise blood pressure?
• How long does albuterol raise blood pressure?
• Who is at risk for elevated blood pressure from albuterol?
• Can you take albuterol with high blood pressure?
• The bottom line

Albuterol sulfate is a lifesaving treatment for people with lung conditions like chronic obstructive pulmonary disease (COPD), exercise-induced bronchospasm, and asthma. Also known by the brand names Ventolin HFA, Proair HFA, and Proventil HFA, this inhaler is a bronchodilator that works by rapidly opening the airways to relieve symptoms like trouble breathing, chest pain and tightness, wheezing, and coughing.

However, like any prescription drug, albuterol comes with potential side effects, such as increased blood pressure. It’s especially important to understand this potential risk for people with other preexisting medical conditions, including heart problems or hyperthyroidism. Luckily, a blood pressure increase is rare and usually temporary. Here’s what you need to know.

Does albuterol raise blood pressure?

An increase in blood pressure is a less common side effect of using an albuterol inhaler or nebulizer solution. Temporary increases in blood pressure are rare and typically mild, says Sazan Sylejmani, Pharm.D., owner and pharmacy manager of Westmont Pharmacy in Westmont, Illinois. “The benefits of controlling respiratory symptoms far outweigh these risks,” Dr. Sylejmani explains. “Patients should follow their prescribed treatment plan and schedule regular checkups to monitor side effects.”

Albuterol belongs to a class of medications called short-acting beta agonists (SABAs). “It works by relaxing the muscles around the airways in the lungs, making it easier to breathe and providing relief from symptoms like wheezing and shortness of breath,” says Raj Dasgupta, MD, a pulmonologist and program director at Huntington Health Hospital in California. However, research shows that beta agonists can change heart rhythms, especially in those who have pre-existing heart conditions. Changes in heart function can lead to high blood pressure (also known as hypertension).

Additionally, a study published in Scientific Reports found an association between asthma and high blood pressure—people with asthma have a higher risk of developing hypertension than those without asthma. 

How long does albuterol raise blood pressure?

High blood pressure after taking albuterol usually resolves in two to six hours, Dr. Dasgupta says.

A study found that when participants used an albuterol inhaler, they experienced an increase in systolic blood pressure as quickly as five minutes after inhalation. Systolic blood pressure is the top number in a blood pressure reading, representing the peak pressure in the arteries during the heartbeat. Researchers found that the peak change in systolic blood pressure occurred within 30 minutes after albuterol treatment. This indicates that albuterol has a rapid but short-lasting effect on blood pressure.

Inhaled albuterol is an aerosol medication, administered via a metered-dose inhaler (MDI) or a nebulizer treatment. This means its effects are concentrated in the lungs and don’t typically have long-lasting systemic effects throughout the body—except for people with certain risk factors.

“If you experience dizziness or feeling lightheaded and your blood pressure is high, you should contact your healthcare provider,” Dr. Dasgupta said. “Albuterol can cause a fast heart rate, also known as tachycardia, which is a more common side effect. Tachycardia can present as heart palpitations, which feel like a fluttering or pounding heart.”

Who is at risk for elevated blood pressure from albuterol?

Although albuterol is safe for many patients and effectively treats asthma symptoms, people with the following medical conditions should talk with their healthcare provider about the potential risk for blood pressure complications.

Heart problems

People with heart issues, particularly those with irregular heartbeats (arrhythmias), should talk to their healthcare provider before using albuterol. “This medication can temporarily raise blood pressure and heart rate, which could worsen existing heart problems,” Dr. Dasgupta explains. “Making sure that albuterol is appropriate for their condition is important to avoid any complications and to find out the alternatives to inhaled albuterol.” 

It’s important to note albuterol can interact with several drugs that heart patients are often prescribed, like non-potassium-sparing diuretics (such as hydrochlorothiazide), digoxin, and even certain dietary supplements. “Pharmacists can review your current medications to identify any potential drug interactions and ensure that your treatment plan is safe and effective,” Dr. Sylejmani says.

Hyperthyroidism

Certain chronic conditions like hyperthyroidism can put patients at risk for elevated blood pressure when taking albuterol, Dr. Sylejmani says. Hyperthyroidism is a condition in which the thyroid gland overproduces thyroid hormones, leading to an accelerated metabolism. This can cause a range of symptoms, including weight loss, rapid heartbeat, and nervousness. 

Can you take albuterol with high blood pressure?

Yes, taking albuterol when you have been diagnosed with high blood pressure can be safe. However, it’s important to work with your healthcare provider to manage your symptoms and ensure you are on the right medication for your condition.

“If someone’s blood pressure is well-controlled and they only use albuterol occasionally, the risk is extremely low,” Dr. Dasgupta explains. “However, if their blood pressure isn’t well-controlled or they experience significant increases after using albuterol, other medications might be a better fit.”

For example, some non-beta-agonist treatments, like cromolyn sodium, can help prevent asthma attacks without the risk of a blood pressure increase. However, cromolyn will not relieve an asthma or bronchospasm attack that has already begun.

Keep in mind that certain medications that are used to treat high blood pressure can interact with albuterol, potentially causing serious side effects. They include:

• Certain beta blockers like carvedilol, labetalol, and propranolol can reduce the effectiveness of albuterol by blocking the beta-2 receptors that albuterol targets to open the airways. This can lead to worsened asthma symptoms. Other beta blockers like atenolol and metoprolol are less likely to have this effect.
• Certain diuretics, such as furosemide, hydrochlorothiazide, and bumetanide, can increase the risk of hypokalemia.

Discuss all medications you are taking with your prescribing provider to avoid a drug interaction. Albuterol can interact with other medicines used to treat mental health conditions, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).

The bottom line

Taking albuterol can raise a person’s blood pressure, though this side effect is rare and usually ends within a few hours. You are more likely to experience other side effects of albuterol, like a feeling of nervousness or anxiety, shaking, headaches, and tachycardia, Dr. Dasgupta says.

Patients who have other pre-existing medical conditions, like heart problems or hyperthyroidism, should seek medical advice from a healthcare professional about whether albuterol is the right medication to treat breathing problems like asthma or COPD.

A personalized asthma action plan can help people with asthma and other chronic conditions manage their diseases. “The plan is developed in collaboration with the doctor—usually a pulmonologist or allergist—and is individualized to the patient’s needs,” Dr. Dasgupta says. It includes instructions on how to identify asthma triggers, how to recognize asthma symptoms, and what to do during an attack—like what medications to take and when to seek immediate medical attention or go to the emergency department.