Levalbuterol (Xopenex)



  • 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]


  • INH:

Adverse Effects

Cardiovascular Adverse Effects

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

Pulmonary Adverse Effects

Other Adverse Effects

  • xxx


  • 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]