Introduction

Levosalbutamol, also known as levalbuterol, is a beta-2 adrenergic agonist used as a bronchodilator. It is the active R-enantiomer of albuterol, which means it is designed to have similar therapeutic effects but potentially fewer side effects. Levosalbutamol is used primarily to treat bronchospasm associated with asthma and chronic obstructive pulmonary disease (COPD).

Uses

Levosalbutamol is used for:

  • Relief of bronchospasm associated with asthma
  • Management of bronchospasm due to chronic obstructive pulmonary disease (COPD)
  • Prevention of exercise-induced bronchospasm
Brand Name Viscoryl
Type Syrup
Weight 1 mg/5 ml
Generic Levosalbutamol (Oral)
Manufacturer Albion Laboratories Limited
Available in English বাংলা

Mechanism of Action

Levosalbutamol works by stimulating beta-2 adrenergic receptors in the bronchial smooth muscle. This stimulation leads to relaxation of the smooth muscle, resulting in bronchodilation (widening of the airways). This helps to alleviate symptoms of bronchospasm such as wheezing, shortness of breath, and tightness in the chest.

How Long Does It Take to Work?

Levosalbutamol typically starts to work within 15 minutes of oral administration. The peak effect is usually observed within 30 to 60 minutes, and the bronchodilation effect can last for about 4 to 6 hours. The onset of action can vary based on individual response and the severity of bronchospasm.

Absorption

Levosalbutamol is well absorbed from the gastrointestinal tract after oral administration. However, systemic absorption may be influenced by factors such as food intake and individual variations in gastrointestinal function.

Route of Elimination

Levosalbutamol is primarily metabolized in the liver and excreted in the urine. The drug is partially metabolized to inactive metabolites, and the unchanged drug is also eliminated through renal excretion.

Dosage

Tablet-
  • Adults and adolescents above 12 years: 1-2 mg three times daily.
  • Children (6 -11 years): 1 mg three times daily.
Syrup-
  • Adults : 5-10 ml three times daily.
  • Childrn (6-11 years): 5 ml three times daily.

The recommended dosage for levosalbutamol oral tablets is typically:

  • For adults and children 12 years and older: 2 to 4 mg taken orally every 6 to 8 hours as needed.
  • For children 6 to 11 years old: 1.25 to 2.5 mg taken orally every 6 to 8 hours as needed.

Dosage may vary based on individual patient needs and response. Always follow the dosing instructions provided by a healthcare provider.

Administration

Levosalbutamol is administered orally, usually in the form of tablets. Take the tablets with or without food as directed by a healthcare provider. Swallow the tablet whole with a full glass of water; do not crush or chew the tablet.

Side Effects

Common side effects may include:

  • Headache
  • Dizziness
  • Tremors
  • Palpitations
  • Muscle cramps
  • Nausea

Serious side effects are rare but may include:

  • Chest pain or discomfort
  • Severe allergic reactions (e.g., rash, itching, swelling, severe dizziness, trouble breathing)
  • Severe or persistent headaches

Toxicity

Overdose of levosalbutamol can lead to symptoms such as severe tremors, rapid heartbeat, and hypertension. In case of suspected overdose, seek immediate medical attention. Treatment may involve supportive care and symptomatic management.

Precautions

Precautions include:

  • Monitoring for worsening symptoms or lack of improvement
  • Using with caution in patients with cardiovascular disorders, hypertension, or hyperthyroidism
  • Adjusting dose in patients with hepatic or renal impairment
  • Avoiding excessive use as it may lead to tolerance or adverse effects

Interaction

Drug Interactions

Levosalbutamol may interact with other medications such as:

  • Other beta-agonists (which may increase the risk of side effects)
  • Non-selective beta-blockers (which may reduce the effectiveness of levosalbutamol)
  • Diuretics (which may increase the risk of hypokalemia)

Consult a healthcare provider before using levosalbutamol with other medications.

Food Interactions

There are no significant food interactions with levosalbutamol. It can be taken with or without food.

Disease Interaction

Levosalbutamol should be used with caution in patients with:

  • Cardiovascular diseases, including arrhythmias and ischemic heart disease
  • Diabetes mellitus (due to potential impact on blood glucose levels)
  • Severe renal or hepatic impairment

Pregnancy Use

Levosalbutamol is categorized as a Category C drug for pregnancy. This means that risk to the fetus cannot be ruled out. It should be used during pregnancy only if the potential benefits justify the potential risks to the fetus.

Lactation Use

Levosalbutamol is excreted in breast milk in small amounts. Use during lactation should be approached with caution. Consult a healthcare provider to weigh the benefits and risks before using this medication while breastfeeding.

Acute Overdose

Acute overdose symptoms may include severe tremors, tachycardia, and hypertension. In case of overdose, seek immediate medical attention. Treatment typically involves supportive care and management of symptoms.

Contraindication

Levosalbutamol is contraindicated in individuals with:

  • Known hypersensitivity to levosalbutamol or other beta-agonists
  • Severe cardiovascular conditions where stimulation of beta-adrenergic receptors could be detrimental

Use Direction

Follow the prescribed dosage and administration instructions. Do not exceed the recommended dose. Consult a healthcare provider if symptoms persist or worsen despite treatment.

Storage Conditions

Store levosalbutamol tablets at room temperature, away from light and moisture. Keep the medication in its original container, tightly closed, and out of reach of children.

Volume of Distribution

The volume of distribution for levosalbutamol is not specifically defined for oral administration. Systemic distribution is limited as it is primarily used for local effects in the respiratory tract.

Half Life

The systemic half-life of levosalbutamol is approximately 5 to 6 hours. This may vary based on individual patient characteristics and the presence of other conditions affecting drug metabolism and clearance.

Clearance

Levosalbutamol is primarily cleared from the body through renal excretion. The rate of clearance can be influenced by factors such as kidney function and the presence of other medications.

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*** Taking medicines without doctor's advice can cause long-term problems.
Dr. Sheikh AHM Mesbahul Islam

Dr. Sheikh AHM Mesbahul Islam

Child Diseases & Asthma Specialist

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