When should I use my levosalbutamol (albuterol) inhaler?

When to Use Levosalbutamol (Levalbuterol) Inhaler

Use your levosalbutamol inhaler for quick relief of acute asthma or COPD symptoms (wheezing, shortness of breath, chest tightness) at a dose of 2 puffs every 4-6 hours as needed, or 15-30 minutes before exercise to prevent exercise-induced bronchospasm. 1, 2

Primary Indications for Use

Acute Symptom Relief (Rescue Therapy)

• Take 2 puffs (45 mcg/puff) when you experience sudden breathing difficulty, wheezing, chest tightness, or cough 1, 3
• The medication should provide relief within minutes and last 4-6 hours 4
• You may repeat dosing every 4-6 hours as needed, but do not exceed 8 puffs in 24 hours 3

Exercise-Induced Bronchospasm Prevention

• Take 2 puffs 15-30 minutes before planned physical activity 1, 2, 3
• This provides protection for approximately 4-5 hours, though duration may decrease with chronic regular use 1

Acute Exacerbations (Severe Symptoms)

• For moderate to severe breathing difficulty, take 4-8 puffs via MDI with spacer every 20 minutes for up to 3 doses 2, 3
• If symptoms persist after this initial treatment, seek immediate medical attention 5

Critical Warning Signs Requiring Medical Attention

Seek emergency care immediately if: 5

• You need to use your inhaler more frequently than every 4 hours
• Your symptoms worsen despite using the inhaler
• You experience no relief within 15-20 minutes of use
• You develop difficulty speaking in full sentences, altered mental status, or extreme fatigue

Important Usage Guidelines

Proper Technique

• Shake the inhaler well before each use 4
• Prime with 4 test sprays if using for the first time or if not used for more than 3 days 4
• Inhale slowly and deeply during actuation, then hold breath for 10 seconds 1
• Clean the plastic actuator weekly by running warm water through it for 30 seconds, then air-dry thoroughly overnight 4

Monitoring Your Asthma Control

• If you need levosalbutamol more than 2 days per week for symptom relief (excluding exercise prevention), your asthma is poorly controlled 1, 3
• This signals the need to start or adjust daily controller medications (inhaled corticosteroids) 1, 2
• Increasing frequency of use indicates worsening disease and requires physician evaluation 1, 4

Levosalbutamol vs. Racemic Albuterol

Levosalbutamol is the R-enantiomer of albuterol and provides comparable bronchodilation at half the milligram dose of racemic albuterol 2, 6, 7:

• 100 mcg levosalbutamol ≈ 200 mcg racemic albuterol in effectiveness 7
• Both have similar onset, duration, and peak effect 7, 8
• Levosalbutamol may have fewer beta-mediated side effects (tremor, tachycardia) at equivalent doses, though clinical significance remains debated 6, 9, 8

Common Side Effects to Expect

You may experience 1, 2, 3:

• Rapid heartbeat (tachycardia)
• Tremor or shakiness
• Headache
• Nervousness

These effects are generally mild with inhaled use and typically resolve as your body adjusts to the medication 1

Special Precautions

Use with caution if you have 4:

• Heart disease, high blood pressure, or irregular heart rhythms
• Diabetes (can raise blood sugar)
• Thyroid disorders
• Seizure disorders

Never use levosalbutamol as your only asthma medication if you have persistent symptoms - it is a rescue inhaler, not a controller medication 1, 3