Levalbuterol (Xopenex)

Indications

Bronchospasm (see Obstructive Lung Disease, [[Obstructive Lung Disease]])
- Asthma (see Asthma, [[Asthma]])
- Chronic Obstructive Pulmonary Disease (COPD) (see Chronic Obstructive Pulmonary Disease, [[Chronic Obstructive Pulmonary Disease]])

Short-Acting β2-Adrenergic Receptor Agonist (SABA) (see β2-Adrenergic Receptor Agonists, [[β2-Adrenergic Receptor Agonists]])
- Note: albuterol is a racemic mixture of (S)-albuterol and (R)-albuterol, while levalbuterol is solely the (R)-albuterol enantiomer ((R)-albuterol is the therapeutically active component of albuterol, whereas (S)-albuterol is considered therapeutically inactive but contributes to the development of side effects)
- Sysyematic review has found no clinical benefit (in terms of efficacy or safety) of levalbuterol over albuterol [MEDLINE]

QT Prolongation without Definite Association with Torsade (see Torsade, [[Torsade]])
Sinus Tachycardia (see Sinus Tachycardia, [[Sinus Tachycardia]])

Paradoxical Bronchospasm (see Obstructive Lung Disease, [[Obstructive Lung Disease]])

Levalbuterol compared to racemic albuterol: efficacy and outcomes in patients hospitalized with COPD or asthma. Chest. 2003 Jan;123(1):128-35 [MEDLINE]
Comparison of racemic albuterol and levalbuterol in the treatment of acute asthma in the ED. Am J Emerg Med. 2005 Nov;23(7):842-7 [MEDLINE]
Paradoxical bronchospasm: a potentially life threatening adverse effect of albuterol. South Med J. 2006 Mar;99(3):288-9 [MEDLINE]
Levalbuterol versus albuterol for acute asthma: a systematic review and meta-analysis. Pulm Pharmacol Ther. 2013 Apr;26(2):239-48 [MEDLINE]