⚡ Quick Answer — What is Levolin?
Levolin contains levosalbutamol — the active R-isomer of salbutamol, a short-acting beta-2 agonist (SABA) that relaxes bronchial smooth muscle to relieve breathlessness, wheezing, and chest tightness in asthma and chronic obstructive pulmonary disease (COPD). Levolin is a tablets from Cipla. Onset of bronchodilation is 15–30 minutes and effect lasts 4–6 hours. Levosalbutamol delivers similar bronchodilation to salbutamol at half the dose, with potentially fewer cardiac side-effects (tremor, tachycardia) — useful for patients sensitive to standard salbutamol.
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What Is Levolin?
Levolin is a tablets manufactured by Cipla at WHO-GMP certified facilities. Each tablet delivers 1 mg or 2 mg of levosalbutamol. levosalbutamol is on the WHO List of Essential Medicines and is the world’s most-used reliever medication for asthma and reversible airflow obstruction.
Levosalbutamol is the pharmacologically active R-(−)-enantiomer of salbutamol. Standard salbutamol is a 50:50 racemic mixture of R and S isomers; the S-isomer contributes nothing to bronchodilation but may worsen airway hyperreactivity in some patients. By using only the R-isomer, levosalbutamol delivers the same therapeutic effect at half the milligram dose, with potentially less tremor and tachycardia in sensitive patients (especially children and those with cardiovascular comorbidities).
How Does Levolin Work?
levosalbutamol selectively activates beta-2 adrenergic receptors on the smooth muscle that rings the bronchial airways. Receptor activation raises intracellular cyclic AMP, smooth muscle relaxes, and the airway lumen widens — this is bronchodilation. Bronchodilation begins within 15–30 minutes, peaks at 30–90 minutes, and lasts 4–6 hours. levosalbutamol also modestly inhibits mast-cell mediator release, reduces plasma exudation from airway capillaries, and improves mucociliary clearance.
Selectivity is dose-dependent: at therapeutic doses, β2 effects predominate; at higher systemic doses (oral tablets, repeated nebulisation), spillover onto β1 receptors causes tachycardia and palpitations, and onto β2 receptors elsewhere causes tremor and hypokalaemia.
Uses and Indications
- Acute asthma exacerbations — first-line reliever (rescue) inhaler/nebulisation
- Chronic obstructive pulmonary disease (COPD) — symptomatic relief of acute breathlessness and exercise dyspnoea
- Exercise-induced bronchoconstriction — inhaled 15–30 minutes before exercise
- Bronchospasm with allergen, cold air, or viral exposure
- Anaphylaxis with bronchospasm — adjunct to adrenaline
- Hyperkalaemia (off-label) — nebulised salbutamol drives K⁺ intracellularly
Important: Levolin is a reliever, not a controller. It does not reduce underlying airway inflammation. Patients using more than the equivalent of one SABA canister per month, or needing a SABA more than three days per week outside of exercise pre-dosing, have poorly-controlled asthma and require step-up to inhaled corticosteroid (ICS) or ICS-LABA combination therapy.
Levolin Dosage
| Patient | Dose | Frequency |
|---|---|---|
| Adults & children >12 yr | 1–2 mg | Three to four times daily |
| Children 6–12 yr | 1 mg | Three times daily |
| Children 2–5 yr | 0.5 mg | Three times daily under medical supervision |
| Elderly / sensitive | Start at 1 mg TDS | Titrate to response |
How to Use Levolin Properly
- Swallow with water; food does not significantly affect absorption.
- Space doses at least 4 hours apart.
- Inhaled levosalbutamol is preferred for most patients — fewer systemic side effects.
- Never double up after a missed dose.
Side Effects of Levolin
Common (dose-related, settle within 30–60 minutes):
- Fine tremor, especially of the hands
- Palpitations or increased heart rate (typically 10–20 bpm rise)
- Headache
- Dry mouth, throat irritation
- Muscle cramps
- Hyperactivity or agitation in young children
Less common:
- Hypokalaemia — especially with high repeat doses, worsened by theophylline, steroids or loop diuretics
- Mild hyperglycaemia
- Insomnia if dosed late evening
- Possible paradoxical worsening with the R-isomer is rare
Serious (stop and seek emergency help):
- Severe allergic reaction / angio-oedema / anaphylaxis
- Paradoxical bronchospasm — worsening wheeze immediately after dose
- Cardiac arrhythmias (atrial fibrillation, supraventricular tachycardia)
- Severe hypokalaemia with arrhythmia or muscle weakness
Warnings and Precautions
- Frequent {$brand} use = poor asthma control. Needing a reliever more than 3 days per week (excluding exercise pre-dosing) means the underlying disease is not managed. Step up ICS-based controller therapy.
- Carry your reliever with you — many fatal asthma attacks happen when the inhaler is at home or expired.
- Cardiovascular disease: use cautiously in severe coronary artery disease, arrhythmias, hyperthyroidism, or severe heart failure.
- Diabetes: monitor glucose with repeat high doses.
- Pregnancy and breastfeeding: levosalbutamol is used at the lowest effective dose. Uncontrolled asthma is more dangerous to mother and fetus than the drug itself.
- Severe attack red flags (call emergency services): no relief 10 min after a full dose, peak flow <50% of personal best, difficulty speaking in full sentences, blue lips or drowsiness.
Contraindications
- Known hypersensitivity to levosalbutamol or any formulation excipient
- Tachyarrhythmias (uncontrolled) — relative contraindication
- Phaeochromocytoma — relative contraindication
- Hypertrophic obstructive cardiomyopathy — caution
Drug Interactions
| Interacting drug | Effect | What to do |
|---|---|---|
| Non-selective beta-blockers (propranolol, timolol drops) | Block β2 effect — can precipitate severe bronchospasm | Avoid; switch to cardioselective beta-blocker if essential |
| Loop or thiazide diuretics | Additive hypokalaemia | Monitor serum potassium with high doses |
| Systemic corticosteroids | Additive hypokalaemia + hyperglycaemia | Monitor electrolytes and glucose |
| Theophylline / aminophylline | Additive tachycardia and hypokalaemia | Monitor heart rate and potassium |
| MAOIs and tricyclic antidepressants | Potentiate cardiovascular effects | Caution — monitor BP/HR |
| Digoxin | Hypokalaemia increases digoxin toxicity risk | Monitor potassium; check digoxin level if symptomatic |
Storage
- Store below 25°C in a cool, dry place away from direct sunlight.
- Keep in original packaging until use to protect from moisture and light.
- Do not use after the expiry date printed on the strip.
- Keep out of reach of children.
Related Alternatives on MedsBase
- Asthalin Respules — salbutamol nebuliser solution
- Budecort Inhaler — budesonide ICS preventer
- Foracort Inhaler — budesonide + formoterol ICS-LABA
- Seretide Accuhaler — fluticasone + salmeterol ICS-LABA
- Duolin Inhaler — salbutamol + ipratropium combo reliever
Frequently Asked Questions
Why levosalbutamol tablets when inhalers exist?
Oral tablets are useful for patients who cannot use inhaler devices reliably. The systemic side-effect profile is heavier than inhaled, but lighter than racemic salbutamol tablets at equivalent bronchodilation.
Levolin tablet vs. Asthalin tablet — which is better?
Both work. Levolin (levosalbutamol) uses half the milligram dose for similar bronchodilation and may cause less tremor and palpitations. Asthalin (racemic salbutamol) is well-established and lower-cost.
Will Levolin make me jittery?
Fine tremor and increased heart rate are dose-dependent β2 effects — milder than with racemic salbutamol at equivalent doses, but still present in some people, especially at the 2 mg strength.
Can I take Levolin during pregnancy?
Levosalbutamol is considered low-risk in pregnancy; uncontrolled asthma is more dangerous than the drug. Inhaled is preferred.
How fast does Levolin tablet work?
Onset 15–30 minutes, peak 1–2 hours, duration 4–6 hours.
Can I take Levolin if I have heart disease?
Use with caution. Tachyarrhythmias, severe coronary artery disease, and severe heart failure are relative contraindications. Discuss with your cardiologist.
Is Levolin habit-forming?
No — there is no addiction or tolerance with levosalbutamol. However, frequent use is a marker of poor disease control, not dependence.
What if I miss a dose?
Take it as soon as you remember unless the next dose is due. Never double up.
Does food affect Levolin tablet?
Food slightly delays absorption but does not reduce total drug exposure.

































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