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Bronchodilators for Cystic Fibrosis

Bronchodilators are drugs that open or widen (dilate) the airways, specifically the bronchi and bronchioles in the lungs. These medicines make breathing easier by opening the airways so that more air can get in and mucus can be cleared out. Bronchodilators may begin working in 20 minutes and the effects can last from 4 to 6 hours.1

Types of bronchodilators

The type of bronchodilators used in people with cystic fibrosis (CF) are beta-agonists. The most commonly prescribed bronchodilators for CF are:

  • Albuterol (Ventolin®, Proventil®)
  • Levalbuterol hydrochloride (Xopenex®)

Anticholinergic bronchodilators do not seem to be effective in people with CF and are therefore not recommended.2,3

How are bronchodilators used to treat cystic fibrosis?

The CF Foundation recommends bronchodilators to be used first during daily breathing treatments so that other medications and airway clearance techniques work better. When finished with the bronchodilator, mucus thinners, airway clearance techniques, and then an inhaled antibiotic follow.2 Many people also use a bronchodilator before strenuous activities such as exercise and sex.4

Your doctor will give you specific instructions, but often a bronchodilator is used 15 to 30 minutes before daily airway clearance techniques are performed. This allows the mucus thinners and antibiotics to reach more deeply into the lungs.

How are bronchodilators administered?

Bronchodilators are inhaled through a device called a metered-dose inhaler. This device delivers a specific amount of medicine to the lungs. Less often, the medicine may be delivered through a nebulizer or a dry powder inhaler.5

Bronchodilators often come in an aerosol container, usually with a tube called a spacer, that attaches to the canister. The spacer helps more of the drug reach the lungs rather than getting sprayed on the mouth and throat. After using a bronchodilator, all equipment should be cleaned to prevent the spread of germs. Most people take two puffs off their bronchodilator, about 1 minute apart.4

What are common side effects of bronchodilators?

Most people tolerate bronchodilators well. With albuterol, less than 15% of those age 12 and older report tremor, nausea, rapid heart rate, palpitations, or nervousness. Children ages 4 to 11 also reported headache, nausea, vomiting, or throat irritation. Some parents report that bronchodilators make their child “hyper.”5

Levalbuterol hydrochloride’s side effects are slightly different. Common side effects include bronchitis (inflammation of the lining of the bronchial tubes), dizziness, pain, and vomiting.4

Written by: Jessica Johns Pool | Last reviewed: September 2019
  1. Smith S, Edward CT. Long‐acting inhaled bronchodilators for cystic fibrosis. 2017;12:1465-1858. doi.org/10.1002/14651858.CD012102.pub2.
  2. Mogayzel PJ, et al. Cystic Fibrosis Pulmonary Guidelines. Am J Respir Crit Care Med. 2013;187(7):680-689. doi:10.1164/reccm.201207-1160E.
  3. Flume PA, et al. Cystic Fibrosis Pulmonary Guidelines. Chronic Medications for Maintenance of Lung Health. Am J Respir Crit Care Med. 2007;176(10): 957-69. doi.org/10.1164/rccm.200705-664OC.
  4. Cystic Fibrosis Foundation. Bronchodilators. Available at: https://www.cff.org/Life-With-CF/Treatments-and-Therapies/Medications/Bronchodilators. Accessed 6/3/2019.
  5. U.S. National Library of Medicine Daily Med. Albuterol- albuterol aerosol, metered. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=808e2b04-9e84-440a-b00e-2cbe858041da. Accessed 6/2/2019.