Purisal100 ml

Purisal 100 ml is a fast-acting bronchodilator used for the treatment and prevention of bronchospasm (narrowing of the airways) in adults, adolescents, and children 6 years of age and older who have reversible obstructive airway disease.

It is commonly prescribed for conditions in which the airways constrict and restrict airflow, including:

• Bronchial asthma – to relieve wheezing, breathlessness, chest tightness, and coughing during acute episodes.
• Chronic obstructive pulmonary disease (COPD) – including chronic bronchitis and associated reversible airway obstruction.
• Exercise-induced bronchospasm – to prevent airway narrowing triggered by physical activity.
• Other conditions associated with reversible airway obstruction, as determined by a physician.

Purisal 100 ml works by relaxing the smooth muscles surrounding the airways, making breathing easier. Medication should always be taken under the guidance of a registered physician.

Short-acting selective & β2-adrenoceptor stimulants

Purisal 100 ml (also known as levalbuterol) is the pharmacologically active (R)-enantiomer of racemic salbutamol. It is a short-acting, selective beta₂-adrenoceptor agonist that differs from conventional racemic salbutamol by the elimination of the largely inactive (S)-salbutamol isomer.

By stimulating beta₂-adrenergic receptors in the smooth muscle of the bronchi, Purisal 100 ml activates adenylyl cyclase, increasing intracellular cyclic adenosine monophosphate (cAMP). Elevated cAMP levels relax bronchial smooth muscle and inhibit the release of inflammatory mediators from mast cells, producing effective bronchodilation.

Because its primary mechanism of action is not impeded by the (S)-isomer, clinically comparable bronchodilation can be achieved at lower doses than with racemic salbutamol. This may substantially reduce beta-mediated side effects such as tremor and palpitations, while maintaining therapeutic efficacy.

After oral administration, Purisal 100 ml is absorbed from the gastrointestinal tract, with the onset of bronchodilator effect typically occurring within minutes and a duration of action lasting several hours.

Purisal 100 ml may interact with several medicines, potentially altering its effect or increasing the risk of adverse reactions. Caution is advised when it is used together with:

• Other short-acting sympathomimetic bronchodilators or epinephrine – concurrent use may increase the risk of cardiovascular side effects and should be undertaken with caution.
• Additional adrenergic drugs – if given by any route, they should be used cautiously to avoid deleterious cardiovascular effects.
• Beta-blockers – may block the bronchodilating action of Purisal 100 ml and can provoke severe bronchospasm in asthmatic patients.
• Diuretics and xanthine derivatives (e.g., theophylline) – may potentiate the potassium-lowering effect, increasing the risk of hypokalaemia.
• Digoxin – low potassium levels caused by beta₂-agonists may increase susceptibility to digoxin-related cardiac arrhythmias.
• Monoamine oxidase (MAO) inhibitors and tricyclic antidepressants – may enhance the cardiovascular effects of Purisal 100 ml.

Patients should inform their physician of all prescription drugs, over-the-counter medicines, and supplements they are taking.

Like all medicines, Purisal 100 ml can cause side effects, although not everyone experiences them. Most effects are related to its beta-adrenergic stimulating action and are usually mild and transient.

Commonly reported side effects include:

• Palpitations and increased heart rate
• Fine tremor of the skeletal muscle, particularly in the hands
• Muscle cramps
• Hypocalcaemia (low blood calcium)
• Nausea and vomiting
• Burning substernal or epigastric pain
• Diarrhoea
• Headache, nervousness, or restlessness

Rarely, high doses may cause hypokalaemia (low potassium), dizziness, or cardiac rhythm disturbances. Patients should seek prompt medical attention if they experience severe palpitations, chest pain, or signs of an allergic reaction.

Pregnancy: The safety of Purisal 100 ml during pregnancy has not been fully established. It should be used during pregnancy only if the potential benefit to the mother clearly justifies the potential risk to the fetus. A physician should assess the risk-benefit balance before prescribing.

Lactation: It is not known whether Purisal 100 ml is excreted in human breast milk. Because many drugs pass into breast milk, caution should be exercised when oral Purisal 100 ml is administered to a nursing mother. A physician should be consulted before use during breastfeeding.

Purisal 100 ml should be used with caution in patients with certain underlying conditions. A physician should be informed of any pre-existing medical problems before starting treatment.

Particular caution is advised in the following situations:

• Acute severe asthma – the potassium-lowering effect may be potentiated by hypoxia and by concomitant treatment with xanthine derivatives, steroids, and diuretics. Serum potassium levels should be monitored in such situations.
• Cardiovascular disorders – including ischaemic heart disease, cardiac arrhythmias, and hypertension, as beta₂-agonists may increase heart rate and blood pressure.
• Hyperthyroidism – symptoms may be aggravated by sympathomimetic drugs.
• Diabetes mellitus – monitoring of blood glucose may be advisable, as beta₂-agonists can affect blood sugar levels.

Patients whose symptoms are not adequately controlled, or who need increasing doses, should be reassessed by a physician, as this may indicate worsening of the underlying condition requiring a change in therapy.

Overdosage of Purisal 100 ml typically produces symptoms of excessive beta-adrenergic stimulation, which are an exaggeration of the usual side effects. These may include marked palpitations, rapid heartbeat, pronounced tremor, headache, agitation, hypokalaemia (low potassium), and hyperglycaemia (raised blood sugar).

In the event of suspected overdose, medical help should be sought immediately. Management is generally supportive. In cases of serious poisoning, the stomach may be emptied, and if necessary a cardioselective beta-blocker may be administered — but with caution in patients with a history of bronchospasm, as it may provoke airway narrowing. Serum potassium levels should be monitored.

Store in a cool, dry place, protected from light, below 30°C. Keep the medicine in its original container, tightly closed. Do not use after the expiry date printed on the packaging.

Keep all medicines out of the reach of children.

Paediatric use: Purisal 100 ml is not recommended for children under 6 years of age, as safety and efficacy have not been established in this group. In children 6 years and older, the dose should be adjusted according to age and monitored by a physician.

Elderly patients: Older adults may be more sensitive to the cardiovascular and metabolic effects of beta₂-agonists. A lower starting dose and careful monitoring are advisable.

Hepatic and renal impairment: Caution is advised in patients with significant liver or kidney impairment, and dosing should be supervised by a physician.