Levosalbutamol

Short-Acting β₂-Agonist (SABA)

Generic Name

Levosalbutamol (Levalbuterol)

Drug Class

Short-acting beta-2 adrenergic agonist bronchodilator

Indications

Bronchial asthma
Acute bronchospasm
Chronic obstructive pulmonary disease (COPD)
Exercise-induced bronchospasm

Dosage

Nebulization (Adults): 1.25 mg every 6–8 hours
Nebulization (Children): 0.63–1.25 mg every 6–8 hours
MDI: 45 mcg per puff; 2 puffs every 4–6 hours

Note: Often preferred in patients with tachycardia or intolerance to racemic salbutamol.

Route of Administration

Inhalation (nebulizer, metered-dose inhaler)

Mechanism of Action

Levosalbutamol is the active (R)-enantiomer of salbutamol. It selectively stimulates β₂-adrenergic receptors in bronchial smooth muscle, producing bronchodilation with fewer β₁-mediated cardiac effects.

Common Adverse Effects

Tremor
Nervousness
Headache
Throat irritation

Serious Adverse Effects

Tachyarrhythmias
Hypokalemia
Paradoxical bronchospasm

Contraindications

Hypersensitivity to levosalbutamol or salbutamol

Precautions

Use cautiously in cardiac disease
Monitor potassium with frequent high-dose use
Overuse indicates poor asthma control

Drug Interactions

Beta-blockers – reduced bronchodilator effect
Diuretics – increased risk of hypokalemia
Other sympathomimetics – additive cardiac effects

Pregnancy & Lactation

Considered safe in pregnancy and breastfeeding when inhaled and used as prescribed.

Patient Counseling

Use correct inhalation technique
Do not exceed prescribed dose
Seek medical help if relief is short-lived
Not a substitute for controller medications