Short-acting beta-agonists (SABAs) are a class of bronchodilators used to treat asthma symptoms quickly. They are primarily inhaled via a rescue inhaler or a nebulizer. You can take them at the first signs of an asthma attack.
While SABAs are an important part of any asthma treatment plan, they shouldn’t be relied on as your primary form of treatment.
Here’s what you need to know about SABAs, how they are used, and when you should consider other medications to help manage your asthma.
SABA medications belong to a class of drugs known as bronchodilators. They relax the small muscles in your bronchial tubes (airways) to help dilate, or open them, making it easier for you to breathe. Also, if you have excess mucus in your airways, SABAs can help you cough it up more freely.
SABA medications are one of the most effective ways to get immediate relief for airflow obstruction, especially in people with asthma.
A doctor may recommend a SABA medication to help prevent asthma attacks. During an asthma attack, your airways become inflamed and constrict, making it harder to breathe. Symptoms of an asthma attack include:
- wheezing
- coughing
- chest tightness
- quicker breathing
- difficulty taking in a full breath
Most asthma attacks are mild and can be treated with a SABA medication at home. However, how long they last can depend on what’s triggering them. Examples include:
- exercise
- allergies
- extreme weather changes
Do all people with asthma need SABAs?
Traditionally, SABAs are recommended for everyone who has asthma in case of emergency asthma attack symptoms. This usually comes in the form of a quick-relief (rescue) inhaler, which may also be used before exercising in the case of exercise-induced asthma.
However, in recent years, researchers have raised concerns over using SABAs in such a manner because of possible over-reliance.
Why is SABA-only treatment not recommended?
SABAs are meant to help provide quick relief from asthma symptoms only on an occasional basis. Overusing SABAs has been linked to worsening asthma symptoms and poor outcomes overall.
Also, if you find yourself needing a SABA medication more than twice per week, this could indicate your treatment plan is not working. You may need to talk with a doctor to make changes to your asthma treatment plan.
Possible side effects of SABA medications are typically mild but may include:
- nervousness
- trembling
- heart palpitations
- muscle cramps
- headaches
Rarely, SABAs can lead to a sudden tightening of your airways. This is known as paradoxical bronchospasm. At high doses, SABAs may also cause low potassium (hypokalemia) or heart attacks.
Another possible concern is a potentially reduced tolerance to SABA medications
SABA vs. LABA asthma treatments
Both SABAs and long-acting beta-agonists (LABAs) are bronchodilators. While SABAs are used to occasionally alleviate asthma symptoms quickly, LABAs are taken daily to help with asthma maintenance. Also, LABAs can only be used when combined with inhaled corticosteroids.
While SABAs are taken at the first sign of an asthma attack, LABAs are taken every day as preventive measures, even if you’re not currently experiencing symptoms of a flare-up.
SABA medications include the following:
| Drug name | Brand name(s) | Type | Dosage | Uses |
|---|---|---|---|---|
| albuterol sulfate | ProAir, Digihaler, Respiclick | inhaler | 2 puffs, taken every 4–6 hours | quick relief of asthma symptoms (ages 2+) |
| albuterol sulfate HFA | ProAir HFA, Proventil HFA, Ventolin HFA | inhaler; uses a | 2 puffs, taken every 4–6 hours | quick relief of asthma symptoms (ages 2+) |
| albuterol sulfate inhalation solution | generic versions only | unit-dose inhaler | 1 unit dose every 4–6 hours | quick relief of asthma symptoms (ages 2+) |
| albuterol sulfate nebulizer solution | AccuNeb | nebulizer | 0.63–1.25-mg dose vials | quick relief of asthma symptoms (ages 2+) |
| levalbuterol | Xopenex | nebulizer | varies; may be taken every 6–8 hours | quick relief of bronchospasm (ages 6+) |
| levalbuterol HFA | Xopenex HFA | inhaler | 2 inhalations, taken every 4–6 hours | treatment and prevention of bronchospasm (ages 4+) |
Is albuterol a SABA or LABA?
Albuterol sulfate is an active ingredient primarily found in SABAs. However, while you may see albuterol mostly in rescue inhalers, this active ingredient may also be in certain extended-release LABA tablets.
Albuterol sulfate is a bronchodilator available in different doses and brand names. SABA versions are intended for quick relief of asthma symptoms, while LABAs are taken twice daily regardless of symptoms. LABAs may be included as part of a preventive care style of treatment.
SABA medications — particularly generic versions — are typically covered by medical insurance as well as Medicare.
While the exact cost may vary by insurance, pharmacy, and region, you may be able to buy a generic SABA inhaler for as low as $8 per prescription.
Anyone with asthma should consider having a rescue inhaler on hand in case they encounter asthma triggers and need quick relief from symptoms.
In some cases, these medications can be lifesaving. Your doctor will prescribe the best SABA for you as part of your asthma treatment plan.
You may also be a good candidate for SABA medications if you:
- have exercise-induced asthma
- experience seasonal allergies
- currently have a cold, flu, or upper respiratory infection
- have sinusitis
In most cases, take your rescue inhaler as soon as you start experiencing symptoms of an asthma attack. SABA medications may also be taken to help prevent exercise-induced asthma 15 to 30 minutes before vigorous exercise.
While a SABA rescue inhaler can help alleviate symptoms of an asthma attack, it’s not meant for everyday use.
Talk with your doctor about other treatment options that may help prevent and manage asthma symptoms on a long-term basis. Also called long-term control medications, these options may include:
- inhaled corticosteroids
- LABAs, when combined with an inhaled corticosteroid
- oral medications, such as leukotriene modifiers
Biologics may be considered for severe asthma that doesn’t respond to medications, while immunotherapy (allergy shots) may help allergic asthma.
SABA medications may be used as part of an asthma treatment plan to help alleviate symptoms quickly in the case of an asthma attack. If you have exercise-induced asthma, a doctor may also recommend using a quick-relief inhaler before vigorous activities.
Still, SABAs aren’t the only asthma treatment option available, and they may cause adverse side effects when used regularly for asthma management.
If you’re having difficulty managing your asthma, talk with your doctor about your current asthma treatment plan and whether any modifications need to be made.