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HWN Suggests

Xopenex: Is it worth the money?

Levalbuterol costs 5 to 25 times more than albuterol. Many studies reporting greater efficacy or therapeutic index with levalbuterol treatment over albuterol are of questionable quality funded by the pharmaceutical company. The claim that levalbuterol has a relatively lower cardioaccelerating effect compared to albuterol does not appear to be clinically supported in studies of the general population or in patients with baseline tachycardia. Furthermore, despite preclinical studies suggesting a theoretical clinical benefit, any therapeutic advantage of levalbuterol over albuterol on pulmonary function is still debated and requires further research. So before you write that nonformulary Xopenex…

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Articles of Interest

Comparison of Levalbuterol and Racemic Albuterol Based on Cardiac Adverse Effects in Children

Levalbuterol and racemic albuterol bronchodilator therapies produced similar effects on HR. No clinically significant differences were detected in HR changes between the two treatment groups, despite administration of a larger equipotent albuterol dose in the racemic albuterol group than in the levalbuterol group.

Levalbuterol versus albuterol for acute asthma: A systematic review and meta-analysis

Levalbuterol was not superior to albuterol regarding efficacy and safety in subjects with acute asthma. We suggest that levalbuterol should not be used over albuterol for acute asthma.

Levalbuterol vs Albuterol: What’s the Difference?

If you’ve ever been treated for asthma attacks, you may be familiar with the medications albuterol (ProAir) and levalbuterol (Xopenex). Whereas albuterol has been used for decades in rapid inhalers and nebulizer to treat asthma attacks, levalbuterol was introduced later alongside marketing that sold it as an innovative new treatment option.

Love it or Lev it: Levalbuterol for Severe Acute Asthma—for Now, Leave It

Although there remains controversy over the preferred dose and delivery method of SABA, a more recent addition to the debate has been the choice of which SABA: levalbuterol or racemic albuterol.

Resources

Xopenex

XOPENEX HFA Inhalation Aerosol is a pressurized metered-dose inhaler that produces an aerosol for oral inhalation. It contains a suspension of micronized levalbuterol tartrate, propellant HFA-134a (1,1,1,2-tetrafluoroethane), Dehydrated Alcohol USP, and Oleic Acid NF.