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Levalbuterol (Xopenex®) is the R-enantiomer of the short-acting β2-adrenergic receptor agonist albuterol. As a bronchodilator, it is used to treat asthma and COPD. In general, levalbuterol has similar effects, pharmacokinetics, and pharmacodynamics to albuterol. However, its manufacturer, Sepracor, has implied (although not directly claimed) that the presence of only the R-enantiomer produces fewer side-effects. Physicians sometimes elect to use levalbuterol in patients with a history of supraventricular tachycardia or other arrhythmias because it is thought that levalbuterol may produce less direct effects on β1 adrenergic receptors in the heart. For similar reasons some pediatricians also use levalbuterol for patients who experience hyperactivity or jitteriness from racemic albuterol.

The use of levalbuterol over the more traditionally used racemic albuterol is controversial among health care professionals. That using levalbuterol instead of albuterol produces less direct effect on β1 adrenergic receptors and/or less cardiac side effects has been suggested, but not consistently proven by long term, well designed clinical trials. There are differing opinions on whether there is sufficient therapeutic benefit to using levalbuterol that outweighs the 5-10 times higher price tag. In general, it appears that if a clinician and patient feel that a low dose of racemic mixture is causing undesirable side effects, levalbuterol may be a viable alternative.

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High-dose continuous nebulized levalbuterol for pediatric status asthmaticus: a randomized trial http://bit.ly/3EyW3L
CharlieNeck (Carlos Cuello) Tue, 27 Oct 2009 00:48:57 -0000
High-dose continuous nebulized levalbuterol for pediatric status asthmaticus: a randomized trial http://bit.ly/3EyW3L

 
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Drugs.com: Xopenex ( Levalbuterol ) - Provides brief summary for patient.

Levalbuterol - Familydoctor.org - Information for patients in English and Spanish.

Xopenex - Official pharmaceutical website by Sepracor.

Xopenex - Consumer information sheet provided by the U.S. Food and Drug Administration Center for Drug Evaluation and Research.

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