drug or from underlying maternal conditionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Beta2 receptor agonist with some beta1 activity; relaxes bronchial smooth muscle with little effect on heart rate Absorption Onset: 25 min (Ventolin HFA); 0.5-2 hr (nebulization); 2-3 hr (PO) Duration: 4-6 hr (PO); Peak plasma time: Inhalation, 2-5 hr; PO, 2-2.5 hr Distribution Protein bound: 10% Metabolism Metabolized in liver Elimination Half-life: 3-8 hr (inhalation); 3.7-5 hr (PO) Excretion: Urine Oral Inhalation Administration For oral inhalation only Nebulizer solution Remove one vial from foil pouch Twist cap off vial and squeeze contents into nebulizer reservoir Attach mouthpiece/face mask and compressor to nebulizer Sit in a comfortable, upright position; place the mouthpiece in your mouth or put on mask, and turn on compressor Calmly breathe and evenly as possible through your mouth until no more mist is formed in the nebulizer chamber (~5-15 minutes) Clean nebulizer according to manufacturer instructions Aerosol metered-dose inhaler Prime inhaler (before first-time use or when inhaler has not been used for >2 weeks): Release 4 test sprays into the air, away from the face Shake well before each use Breathe out fully through the mouth; place mouthpiece fully into mouth, holding inhaler in its upright position and close lips around it While breathing in deeply and slowly through the mouth, fully depress the top of the metal canister with your index finger Hold your breath for ≤10 sec; before breathing out For additional puffs, wait 1 minute, shake inhaler again, and repeat steps listed above; replace cap after use Cleaning: To maintain proper use of this product, wash and dry mouthpiece thoroughly ≥1/week Powder metered-dose inhaler Does NOT require priming Do not use with a spacer or volume holding chamber Cleaning Keep clean and dry at all times Never wash or put any part of inhaler in water Routine maintenance not required Oral Administration Extended-release tablets: Do not chew, crush, or mix with food Storage Nebulizer solution Store between 2-25°C (36-77°F) Protect from light before use, therefore, keep unused vials in the foil pouch Aerosol metered-dose inhaler Store at room temperature (15-25°C [59-77°F]) Powder metered-dose inhaler Store at room temperature (15-25°C [59-77°F]) Avoid exposure to extreme heat, cold, or humidity Discard 13 months after opening the foil pouch, when the dose counter displays zero, or after the expiration date on the product, whichever comes first No images available for this drug. No images available for this drug.A Patient Handout is not currently available for this monograph.Print FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC NOT COVERED – Drugs that are not covered by the plan. Code Definition PA Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. QL Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered. ST Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription. OR Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription. 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