Why is oral albuterol rarely used in clinical practice?

The reason oral albuterol is rarely used in clinical practice is primarily due to the increased likelihood of significant adverse drug reactions when compared to inhaled versions. While both formulations act as bronchodilators, the inhaled administration allows for a targeted effect with fewer systemic side effects. Inhaled albuterol delivers medication straight to the airways, resulting in fewer systemic complications and a faster onset of action.

In contrast, oral administration of albuterol results in higher systemic exposure, increasing the risk of side effects such as tachycardia, nervousness, and tremors. These systemic side effects can be more pronounced when the medication is taken orally, which diminishes its attractiveness as a treatment option.

While effectiveness and cost are certainly important aspects of selecting a medication, the consideration of safety and tolerability significantly underscored the decision to favor inhaled formulations over oral albuterol. The longer duration of action does not contribute to the preference for inhaled forms since the inhaled versions typically provide effective symptom relief with manageable side effects.