Levalbuterol/Levosalbutamol

What Is Levalbuterol (Levosalbutamol)?

Levalbuterol and levosalbutamol are two names for the same medicine. The name levalbuterol is used in the United States, and levosalbutamol is used in many other countries. It is a purified form of albuterol (salbutamol) that contains only the active half of the albuterol molecule.

Drug class: Short-acting beta2-agonist (SABA), a type of bronchodilator.

Approved and Common Prescribed Uses

Depending on the country, product, and label, levalbuterol is approved for:

• Asthma and other reversible airway blockage: treatment or prevention of bronchospasm (tightening of the airway muscles) in people with reversible obstructive airway disease. It is commonly used as a quick-relief (“rescue”) medicine.
• Prevention of exercise-induced bronchospasm, where labeled.
• COPD symptom relief, as directed by a doctor, in some countries.

Levalbuterol is a reliever medicine. It does not control the underlying inflammation of asthma, so it is often used together with a daily controller medicine.

Available Formulations and Strengths

Formulation	Common Strengths	Notes
Inhalation aerosol (metered-dose inhaler)	45 mcg per puff	Common in the United States. Often used with a spacer, especially for children.
Nebulizer solution (liquid for a nebulizer machine)	About 0.31 mg, 0.63 mg, and 1.25 mg per vial, and a concentrated form	Used in a nebulizer machine. Strength depends on age and condition.
Tablets	Commonly 1 mg or 2 mg	Available in some countries, such as parts of Asia.
Oral liquid (syrup)	Commonly about 1 mg per 5 mL	Available in some countries.

Available products, strengths, and approved ages differ by country and brand. A prescriber or pharmacist can confirm what applies to a particular patient.

What Is the Recommended Dosage of Levalbuterol (Levosalbutamol)?

A licensed healthcare professional chooses the form, strength, and schedule. The dose depends on:

• The condition being treated and how severe it is.
• Age: children, teenagers, and adults use different strengths and forms, and approved ages vary by product.
• How the medicine is being used: as needed for quick relief, before exercise, or on a scheduled basis in some cases.
• Heart health and other conditions, such as thyroid disease, diabetes, or seizures.
• Other medicines being used.

Body weight is not usually used to set the dose for inhalers and nebulizers. Oral liquid forms may be dosed by age or weight in some countries. Dose adjustments for kidney or liver disease are not typically needed, but share any such conditions with your provider.

Dosage Forms

• Inhalation aerosol
• Nebulizer solution
• Tablets and oral liquid, in some countries

General Use Information

Levalbuterol is generally used as needed for symptoms or at intervals set by a doctor. It works quickly, usually within minutes, and the effect lasts about 4 to 6 hours. Use the smallest amount that controls symptoms.

Do not use it more often than directed. Needing it more often than usual is a warning sign that asthma or COPD is not well controlled. Contact a healthcare professional promptly if that happens. Follow your specialist’s instructions and the pharmacy label.

How Levalbuterol (Levosalbutamol) Works

The airways are surrounded by small muscles. During an asthma attack or flare-up, these muscles tighten and the airways narrow, which makes it hard to breathe.

Levalbuterol attaches to beta2 receptors on the airway muscles and signals them to relax. This opens the airways and helps air move in and out more easily. Because it contains only the active form of albuterol, it was developed to provide the same bronchodilating effect with a lower chance of some side effects, although studies show the differences are small in many people.

Levalbuterol relieves symptoms but does not cure asthma or COPD and does not treat airway inflammation. It is not a substitute for a daily controller medicine when one is prescribed.

Is a Prescription Required to Buy Levalbuterol (Levosalbutamol) Online?

Yes. In most countries, levalbuterol (levosalbutamol) is available by prescription only.

Which Specialist Can Help?

• A pulmonologist (lung specialist) commonly manages COPD and harder-to-control asthma.
• An allergist/immunologist often treats allergic asthma.
• A pediatrician or primary care provider may also prescribe it and follow the patient over time.

Buying Safely

• Buy only from licensed pharmacies that ask for a valid prescription.
• Be wary of sites that sell inhalers or nebulizer solutions without a prescription or at prices that seem too low. Such products may be counterfeit, expired, badly stored, or contain the wrong ingredients.
• Make sure the package is sealed, properly labeled, and has an expiration date. If anything looks odd, ask a pharmacist.

Side Effects of Levalbuterol (Levosalbutamol)

Many people tolerate levalbuterol well, but side effects can occur. Not everyone will have them.

Common Side Effects

• Shakiness or tremor
• Nervousness or restlessness
• Headache
• Fast or pounding heartbeat
• Dizziness
• Sore throat, cough, or stuffy nose
• Muscle cramps
• Nausea or upset stomach
• Trouble sleeping

Serious Side Effects

These are uncommon but important:

• Breathing that suddenly gets worse right after a dose (paradoxical bronchospasm)
• Allergic reactions: rash, hives, swelling of the face, lips, or tongue, or trouble breathing
• Rapid, pounding, or irregular heartbeat, chest pain, or high blood pressure
• Low blood potassium, which can cause muscle weakness, cramps, or heart rhythm problems
• High blood sugar
• Worsening asthma control if the medicine is overused

When to Get Medical Help Right Away

Seek emergency care if there is:

• Severe trouble breathing, or breathing that gets worse after using the medicine
• The medicine does not give relief, or relief lasts a shorter time than usual
• Swelling of the face, lips, tongue, or throat
• Chest pain or a very fast or irregular heartbeat
• Fainting or severe dizziness

Contact a healthcare professional soon if you need the medicine more often than usual, or if your symptoms are getting worse.

Drug Interactions

Some medicines can change how levalbuterol works or increase the chance of side effects. Give your specialist and pharmacist a full list of everything you use.

Prescription Medicine Categories

• Other beta-agonists and stimulant medicines, including other inhalers, oral products, and stimulants, which may add to heart and nervous system effects.
• Beta-blockers, including some eye drops, which can block the effect of levalbuterol and may trigger breathing problems in some people.
• Diuretics (“water pills”) and other medicines that lower potassium, which can add to potassium-lowering effects.
• Digoxin, a heart medicine, since levalbuterol may lower its blood levels.
• Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants, which may increase effects on the heart and blood vessels.
• Medicines that can affect heart rhythm (QT prolongation).

Over-the-Counter (OTC) Medicines

• Decongestants and some cold and allergy products may raise heart rate or blood pressure.
• Other OTC inhalers or asthma products should be used only with a healthcare professional’s approval.

Supplements and Herbal Products

• Stimulant-type supplements (for example, those with high caffeine, ephedra-like ingredients, or bitter orange) may add to heart-related effects.
• St. John’s wort and other herbal products can change how the body handles medicines. Ask before using them.

Do not start, stop, or change any medicine or supplement without telling your healthcare professional.

Safety & Important Considerations

Overuse Warning

Using levalbuterol more often than directed, or needing it more often than usual, can be a sign of worsening disease. Do not increase the dose or frequency on your own. Contact a healthcare professional right away.

Keep a Controller Plan

If you have asthma, your doctor may prescribe a daily controller medicine, such as an inhaled steroid. Do not stop it because you feel better or because levalbuterol seems to work.

Heart Disease

Levalbuterol can raise heart rate and blood pressure and may trigger rhythm problems. Tell your provider about any heart condition, high blood pressure, or irregular heartbeat.

Other Conditions

Use with caution if you have diabetes, an overactive thyroid, seizure disorders, or low potassium.

Liver and Kidney Disease

Dose changes are not usually needed, but share any liver or kidney conditions with your provider.

Pregnancy and Breastfeeding

• Tell your healthcare professional if you are pregnant, planning pregnancy, or breastfeeding.
• Uncontrolled asthma also poses risks in pregnancy, so decisions about treatment should be made with a specialist.
• It is not fully known whether levalbuterol passes into breast milk.

Children and Older Adults

• Children: Approved ages and forms vary by product. A spacer may help children use inhalers correctly.
• Older adults: Heart disease and other health problems may call for closer monitoring.

Conditions to Discuss Before Starting

Tell your healthcare professional if you have, or have had:

• Heart disease, high blood pressure, or an irregular heartbeat
• Seizures
• Thyroid disease or diabetes
• Low potassium levels
• An allergy to levalbuterol, albuterol (salbutamol), or ingredients in the product

Monitoring

Your care team may:

• Track symptoms, lung function tests, and how often you need quick-relief medicine
• Monitor heart rate, blood pressure, and potassium in some patients
• Check inhaler or nebulizer technique at follow-up visits

Safety Information From Regulators

Regulators note that overuse of short-acting beta-agonists can signal poorly controlled asthma and carries heart-related risks. Read the current prescribing information and patient leaflet that come with your medicine.

Who This Medication Is For

Levalbuterol (levosalbutamol) is intended for:

• Children, teenagers, and adults with asthma who need quick relief of airway tightening, as decided by their healthcare professional and within the label’s age limits.
• People who get airway tightening with exercise and need prevention, where labeled.
• People with other reversible airway conditions, as directed by a doctor.

It is used as a reliever medicine. A specialist or primary care provider decides if it is appropriate after reviewing symptoms, prior treatments, and overall health.

Who Should Not Take Levalbuterol (Levosalbutamol)

Do not use this medicine if:

• You are allergic to levalbuterol, albuterol (salbutamol), or any other ingredient in the product.

Important Precautions

Use extra caution and speak with your specialist if you have heart disease, high blood pressure, seizure disorders, thyroid problems, diabetes, or low potassium. Use extra caution in older adults and when using other stimulant or bronchodilator medicines.

What to Do If You Miss a Dose

• Levalbuterol is usually used as needed, so there is often no missed dose. Use it when symptoms occur, as directed.
• If your doctor has set a regular schedule, take the missed dose as soon as you remember, unless it is almost time for the next one. In that case, skip the missed dose.
• Never double up or take extra doses to catch up.
• If you are unsure what to do, contact a licensed healthcare professional or pharmacist.
• If symptoms worsen, follow your asthma action plan and get medical help if needed.

Related medications to Levalbuterol (Levosalbutamol)

Other medicines used for similar conditions include:

• Albuterol (salbutamol), the closely related and more widely used short-acting bronchodilator
• Other short-acting bronchodilators, such as ipratropium (a short-acting anticholinergic) and combination products
• Fast-acting combination inhalers used as both a controller and reliever in some countries
• Long-acting bronchodilators and inhaled steroids, used as daily controller medicines rather than rescue medicines
• Oral medicines, such as theophylline or montelukast, for some people with asthma

These options differ in how they are taken, how fast they work, and their side effects. Do not switch or stop treatment without guidance. Any change should be made after consulting a licensed medical specialist.

Storage Instructions

• Store at room temperature, usually about 68°F to 77°F (20°C to 25°C), unless the label says otherwise.
• Keep products dry and away from moisture, such as steamy bathrooms.
• Protect from light, heat, and freezing. Inhaler canisters are pressurized, so do not puncture them, burn them, or keep them near heat or open flame, even when empty.
• Nebulizer vials: keep them in the protective foil pouch until use, and follow the label for how long they can be used after opening the pouch (commonly about 2 weeks) and after removing from the pouch (commonly about 1 week). Do not use a solution that looks cloudy or discolored.
• Stop using an inhaler when the dose counter reads zero.
• Keep out of reach and sight of children and pets. Never share your inhaler or nebulizer solution with others.
• Dispose of expired or empty products as advised by your pharmacist or local disposal program.

Disclaimer:

This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Patients must consult a licensed pulmonologist, allergist, or other relevant medical specialist before starting, changing, or stopping treatment. Treatment decisions must be based on a full clinical evaluation by a qualified specialist. Always follow the prescribing information and patient leaflet provided with your medicine.