III. Mechanism
- Levalbuterol (Xoponex) is the active R-isomer of Albuterol
-
Inhaled Bronchodilators target Beta 2 Adrenergic Receptors
- Adverse effects (e.g. Tachycardia) are related to Beta 1 Adrenergic Receptor activity
IV. Dosing
- Levalbuterol Inhaler (age 4 years and older)
- See Hydrofluoroalkane Inhaler (HFA Inhaler) for technique
- Take 2 puffs up to every 4 to 6 hours
- Generic in 2016
- Levalbuterol (Xopenex) Nebulizer
- Indicated for Age over 12 years
- Age >=12 years: 0.63 (up to maximum of 1.25 mg) nebulized every 6 to 8 hours as needed
- Age 6 to 11 years: 0.31 mg nebulized every 8 hours as needed
V. Adverse Effects
VI. Efficacy
- Levalbuterol was initially reported to cause less Tachycardia and less FEV1 decline with chronic use than Albuterol
- In further study, Levalbuterol appears to have no advantage over Albuterol for most patients
VII. Safety
- Pregnancy Category C
- Unknown safety in Lactation
VIII. Resources
- Levalbuterol Nebulizer Solution (DailyMed)
- Levalbuterol MDI (DailyMed)
Images: Related links to external sites (from Bing)
Related Studies
| levalbuterol (on 2/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LEVALBUTEROL 0.31 MG/3 ML SOL | Generic | $0.34 per ml |
| LEVALBUTEROL 0.63 MG/3 ML SOL | Generic | $0.37 per ml |
| LEVALBUTEROL 1.25 MG/3 ML SOL | Generic | $0.35 per ml |
| LEVALBUTEROL TAR HFA 45 MCG INH | Generic | $3.58 per gram |
| xopenex (on 12/20/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| XOPENEX HFA 45 MCG INHALER | Generic | $3.65 per gram |
Ontology: Levalbuterol (C0772501)
| Definition (NCI) | A short-acting sympathomimetic beta-2 adrenergic receptor agonist with bronchodilator activity. Levalbuterol binds to beta-2 adrenergic receptors in bronchial smooth muscle and activates intracellular adenyl cyclase, an enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3',5'-adenosine monophosphate (cAMP). Increased cAMP levels lead to the activation of protein kinase A, which inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrations, resulting in relaxation of bronchial smooth muscles. The increased cAMP concentrations also inhibit the release of inflammatory mediators, especially from mast cells. |
| Definition (MSH) | The R-isomer of albuterol. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D064412 |
| SnomedCT | 116090007, 398965008 |
| LNC | LP171617-6 |
| English | Levalbuterol [Chemical/Ingredient], Levalbuterol, LEVALBUTEROL, levalbuterol, Levalbuterol (product), Levalbuterol (substance) |
| Czech | levalbuterol |
| French | Levalbutérol, Lévosalbutamol |
| German | Levosalbutamol, Levalbuterol |
| Italian | Levalbuterolo |
| Russian | КСОПЕНЕКС, LEVALBUTEROL, ЛЕВАЛЬБУТЕРОЛ, ЛЕВАЛБУТЕРОЛ, LEVAL'BUTEROL, KSOPENEKS |
| Spanish | levalbuterol (producto), levalbuterol (sustancia), levalbuterol, levo-salbutamol |
Ontology: Xopenex (C0876218)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D064412 |
| English | xopenex, Xopenex |
| Czech | Xopenex |
| French | Xopenex |
| German | Xopenex |
