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Levalbuterol

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Levalbuterol, Xopenex, Levalbuterol Nebulizer, Nebulized Xopenex

  • See Also
  1. Short-acting Beta Agonist
  2. Albuterol
  3. Long Acting Beta Agonist
  4. Nebulized Albuterol
  • Indications
  1. Short acting agents for rescue use only for symptomatic COPD or Asthma
  • Mechanism
  1. Levalbuterol (Xoponex) is the active R-isomer of Albuterol
  2. Inhaled Bronchodilators target Beta 2 Adrenergic Receptors
    1. Adverse effects (e.g. Tachycardia) are related to Beta 1 Adrenergic Receptor activity
  • Dosing
  1. Levalbuterol Inhaler (age 4 years and older)
    1. See Hydrofluoroalkane Inhaler (HFA Inhaler) for technique
    2. Take 2 puffs up to every 4 to 6 hours
    3. Generic in 2016
  2. Levalbuterol (Xopenex) Nebulizer
    1. Indicated for Age over 12 years
    2. Age >=12 years: 0.63 (up to maximum of 1.25 mg) nebulized every 6 to 8 hours as needed
    3. Age 6 to 11 years: 0.31 mg nebulized every 8 hours as needed
  • Adverse Effects
  1. See Short-acting Beta Agonist
  2. Dyspepsia
  • Efficacy
  1. Levalbuterol was initially reported to cause less Tachycardia and less FEV1 decline with chronic use than Albuterol
  2. In further study, Levalbuterol appears to have no advantage over Albuterol for most patients
  • Safety
  1. Pregnancy Category C
  2. Unknown safety in Lactation
  • Resources
  1. Levalbuterol Nebulizer Solution (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5f1c4f22-d420-495c-8f64-33532638215f
  2. Levalbuterol MDI (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=218ab3f0-4d1e-4c33-a7e8-27807f029d83
  • References
  1. Bio (2011) J Pediatr Pharmacol Ther 16(3): 191-8 +PMID:22479161 [PubMed]
  2. Hilaire (2007) Am fam Physician 75:247-8 [PubMed]
  3. Lam (2003) Am J Health Syst Pharm 60(19):1971-5 +PMID:14531242 [PubMed]
  4. (1999) Med Lett Drugs Ther 41(1054):51-3 [PubMed]