Levolin Respules
✅ Effective respiratory relief
✅ Convenient nebulizer solution
✅ Precise medication delivery
✅ COPD symptom management
contains Levosalbutamol
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Levolin Respules?
Levolin Respules 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 Respules is a preservative-free nebuliser respules from Cipla. Onset of bronchodilation is 1–5 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 Respules?
Levolin Respules is a preservative-free nebuliser respules manufactured by Cipla at WHO-GMP certified facilities. Each respules delivers 0.31 / 0.63 / 1.25 mg in 2.5 ml 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 Respules 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 1–5 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 Respules 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 Respules Dosage
| Patient | Dose | Frequency |
|---|---|---|
| Adults & children >12 yr | 0.63–1.25 mg (1 respule) | Every 6–8 hours, up to 4× daily |
| Children 6–12 yr | 0.31–0.63 mg (1 respule) | Every 6–8 hours |
| Children <6 yr | 0.31 mg (1 respule) | Every 6–8 hours under specialist supervision |
| Severe attack (adult) | 1.25 mg back-to-back | Every 20 minutes ×3, then reassess |
How to Use Levolin Respules Properly
- Wash hands and assemble a clean, dry nebuliser machine, cup, and mask or mouthpiece.
- Twist off the top of the respule and squeeze contents into the nebuliser cup. Do not dilute.
- Switch on the compressor — fine mist appears within seconds.
- Breathe normally through the mouthpiece with occasional deep breaths; for masks, ensure tight seal.
- Continue 5–10 minutes until the cup sputters and no more mist appears.
- Rinse cup and mouthpiece with clean water, shake dry, air-dry on a paper towel.
- Discard any unused respule — preservative-free.
Side Effects of Levolin Respules
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, protected from direct light.
- Keep respules in their original foil overwrap until immediately before use.
- Once a respule is opened, use immediately; discard any remainder.
- Do not refrigerate. 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 over salbutamol?
Levosalbutamol is the active R-isomer of salbutamol. At equivalent bronchodilation, the dose is half (1.25 mg vs 2.5 mg) and some patients report less tremor and palpitations. Some studies show no clinically significant difference; others favour levosalbutamol in children and cardiac-sensitive adults. Both are effective relievers.
What strength of Levolin Respules should I use?
Most adults use 0.63 mg or 1.25 mg per dose. Children 6–11 years use 0.31–0.63 mg. The 0.31 mg respule is for very young children under specialist guidance.
Can I mix Levolin with budesonide or ipratropium in the nebuliser?
Yes — co-nebulising levosalbutamol with budesonide (Budecort respules) or ipratropium (Ipravent respules) is common practice in acute severe asthma and COPD. Empty all respules into the same cup, then nebulise as one session.
How fast does Levolin Respules work?
Bronchodilation begins within 1–5 minutes of starting nebulisation, peaks at 30–90 minutes, and lasts 4–6 hours.
How often can I use Levolin Respules?
Routinely: every 6–8 hours. In severe attacks: back-to-back every 20 minutes ×3 doses under medical supervision. Outside acute attacks, more than 3 days a week of need = poorly-controlled disease.
Are Levolin Respules safe for children?
Yes, in age-appropriate doses (0.31 mg from infancy under specialist supervision; 0.31–0.63 mg in 6–11 year-olds; adult dose from 12 years).
What nebuliser machine works best?
Any jet (compressor) nebuliser rated 6–8 L/min — Omron, Philips, Pari, Flaem are common. Ultrasonic and mesh nebulisers also work; mesh are quietest.
Why are my hands shaky after a dose?
Tremor is the expected β2 effect, usually milder than with racemic salbutamol but still present at high doses. It settles in 30–60 minutes.
How long do Levolin Respules last on the shelf?
Sealed respules: 24 months from manufacture (check expiry). Once removed from the foil overwrap: use within 3 months. Once a respule is opened: use immediately.
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| Strength | 0.31 Mg, 0.63 mg, 1.25 mg |
|---|---|
| Quantity | 20 Respule/s, 40 Respule/s, 60 Respules/s |
| Pharma Form | Respules |
| Manufacturer | Cipla Inc |
| Treatment | Asthma, Chronic obstructive pulmonary disorder (COPD) |
| Generic Brand | Levosalbutamol |
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