What is the difference between levalbuterol and albuterol

Low serum potassium levels, or hypokalemia, has been observed with levalbuterol and albuterol. This may be caused by intracellular shunting. While these drugs are sometimes used off-label to lower potassium levels intentionally, this effect should be monitored.

Levalbuterol is a prescription drug that is a short-acting beta-agonist, also known as a bronchodilator. It is used to treat bronchospasm related to asthma and COPD. It is also used off-label to help prevent exercise-induced bronchospasm. It is available in the form of a metered-dose inhaler as well as solutions to be used in a nebulizer. Albuterol is also a prescription drug that is a short-acting beta-agonist.

It is also known as a bronchodilator and is used to treat bronchospasm related to asthma and COPD as well as to prevent exercise-induced bronchospasm. It is available in various forms including oral tablets, oral solutions, metered-dose inhalers, and solutions to be used in a nebulizer. Levalbuterol and albuterol are chemically similar, but they are not exactly the same.

Albuterol is a racemic mixture of two chemical enantiomers, R-albuterol and S-albuterol. It is sometimes referred to as racemic albuterol. Levalbuterol is composed of just R-albuterol, the more active of the two compounds. Retrospective comparison studies overall have shown that levalbuterol and albuterol have similar clinical outcomes.

Prescribers may consider characteristics such a cost and potential adverse effects when selecting one over the other. Levalbuterol and albuterol are both considered pregnancy category C by the FDA. This means there are no good clinical studies to show safety in pregnancy.

These drugs should only be used when the benefits clearly outweigh the risks. In these cases, albuterol may be preferred due to the presence of more historical data on its use in pregnancy. There are no direct contraindications with albuterol and alcohol. However, alcohol can slow respiratory rate and affect pulmonary function, which is counterproductive to treating bronchospasm.

Yes, levalbuterol HFA is a rescue inhaler indicated for use in the treatment of acute asthma exacerbations or bronchospasms due to COPD.

Levalbuterol is not a steroid or anti-inflammatory and should not be used in place of a steroid when steroid use is indicated, such as in asthma destabilization. On average, the effects of a single dose of levalbuterol may last five to six hours.

Levalbuterol begins working about 15 minutes after administration. Skip to main content Search for a topic or drug. Levalbuterol vs. Albuterol: Differences, similarities, and which is better for you. By Kristi C. Torres, Pharm. Updated on May. Top Reads in Drug vs. Toujeo vs Lantus: Main Differences and S Dulera vs Advair: Main Differences and S Suboxone vs Methadone: Main Differences Studies have compared the efficacy and side effect profiles of these 2 agents in the clinical setting.

Randomized, controlled trials with adequate sample size generally have demonstrated no significant differences between LEV and ALB on the outcomes of efficacy, occurrence of adverse effects, and hospital admissions for adults and children.

During the same time frame, 1. The S -isomer is considered the inactive isomer because of its limited binding to beta 2 -receptors, lack of bronchodilation production, and augmentation of inflammatory stimuli. The R -isomer is considered the active isomer because it binds to beta 2 -receptor sites, produces bronchodilation, and has no effect or possibly reduces inflammatory stimuli.

S -albuterol promotes contractility through increases in intracellular calcium in airway smooth muscle cells. S -albuterol also enhances airway hyperresponsiveness and promotes eosinophil recruitment and activation in vitro.

The R -isomer has been associated with adverse effects that may preclude its use in certain patients. Because beta 2 -receptors are also found outside the lungs, beta 2 -adrenergic agonists can cause tremor, headache, increased heart rate, hypokalemia, and hyperglycemia. Beta 2 -agonists are only available as inhaled medications, therefore reducing systemic absorption, but these side effects are concentration-dependent and so may still occur at higher doses.

Lam et al 17 investigated the heart rate effects of these 2 agents with a prospective, randomized, crossover study. Patients who required a bronchodilator more often than every 4 hours, required a vasopressor or inotropic therapy, or were maintained on a beta-blocker were excluded from the study. Heart rate was recorded at the end of the second dose and at 5, 10, 15, 30, 60, 90, , , and minutes after the final dose.

The authors concluded that there was no clinically significant difference between groups in maximum heart rate increases and that use of LEV was not justified in their population. Another retrospective chart review performed by Truitt et al 18 investigated the total number of nebulizer treatments required with ALB and LEV. The investigators assessed patient charts from a 6-month period at 1 institution. The only patients excluded were those with a diagnosis of cognitive disturbances or cancer.

ALB 2. The mean hospital length of stay LOS was 5. Regression analysis controlling for diagnosis, baseline forced expiratory volume in 1 second FEV 1 , and ipratropium use indicated that LEV was associated with a shorter LOS decreased by 0. Because this was a retrospective review, the investigators did not consider sample size calculation and power test to be necessary. Patients received 1 of 5 doses of LEV or 1 of 2 doses of ALB every 20 minutes for 3 doses plus prednisone 60 mg or equivalent ; this was followed by a minute observation period.

Patients were excluded if they had been hospitalized for asthma within 2 months, had fixed airway disease, or had received ALB in the ED before enrollment. Patients treated with LEV 0. Patients treated with ALB 2. A comparison of equivalent amounts of the R -isomer in the 2 beta 2 -agonists demonstrated that there were statistically significant differences.

LEV 1. LEV 2. Changes in glucose, potassium, and heart rate were proportional to the dose of the R -isomer. Potential limitations of this study included its open-label design and the cohort sizes 12—14 patients each. Differences in age were also statistically significant among groups. Patients received either LEV 1. A number of major limitations were associated with this study.

First, the study was retrospective and uncontrolled. Comparisons of postdosing efficacy were not made. There were twice as many patients in the ALB group as in the LEV group, and the use of other therapy eg, corticosteroids was not accounted for in the study.

The admission rate for patients in the ALB group was also higher than the rate observed in similar studies. In another study by Nowak et al, 21 the investigators assessed the time to ED discharge in adults presenting with an acute asthma exacerbation who received either LEV or ALB. This study was a prospective, multicenter, double-blind, parallel-group trial.

Patients could receive additional asthma therapy if this was considered necessary by the investigator. All patients were treated with prednisone 40 mg, and during the initial 3-hour treatment period, certain medications were not permitted, including ipratropium, long-acting beta 2 -agonists LABAs , leukotriene modifiers, methylxanthines, corticosteroids other than prednisone 40 mg, and magnesium.

There were 2 evaluation periods in this study: an acute period and a 7- and day follow-up period. The median time to discharge primary outcome was similar for both groups LEV, Subgroup analysis demonstrated a benefit of LEV compared with ALB on FEV 1 and hospital admission rate in patients who were not taking corticosteroids at home, but no difference was observed among patients taking corticosteroids.

No difference was observed between groups for the incidence of adverse effects, including tachycardia. The authors concluded that there is a benefit in using systemic corticosteroids early in therapy and scheduled dosing of beta 2 -agonists in patients with acute exacerbations.

A multicenter, randomized, double-blind study published by Milgrom et al 23 compared the efficacy and safety of LEV and ALB in stable asthmatic children. Patients who had a lower respiratory tract infection within 2 weeks of randomization or had a clinically significant abnormality in electrocardiogram were not included in the study. Patients were treated with LEV 0. The investigators observed no significant difference in the primary outcome of peak percent change from baseline in FEV 1 at 21 days between LEV 0.

No differences were observed among treatment groups on the outcomes of asthma symptom assessment score, symptom-free days, quality-of-life score, rescue medication use, and time to peak improvement in FEV 1. Albuterol has long been used for asthma but has also been found to induce some side effects like shakiness, tachycardia increased heart rate and jitters.

Conversely, although Levalbuterol also generates the same type of side effects, many say that they are only minimal. This is probably one of the most significant differences between the two drugs. And so, nurses and other health practitioners have observed that there is less shakiness and jitters. The other key differences between the two is that Albuterol has a shorter duration of action hours compared to Levalbuterol hours.

Because of such, it does not come as a surprise that Levalbuterol is priced much higher than Albuterol. Levalbuterol has purely the R-albuterol which is the one responsible for the bronchodilation effect. Because of this disparity in drug composition, many researches have been conducted to find proof that Levalbuterol has better efficacy than Albuterol.

Yet still up to this day, there is no solid proof yet to backup this claim. Despite these several differences, the two drugs are similar in many other aspects like: same half-life, same onset and peak of drug action, and same effect on blood potassium hypokalemia and glucose levels hyperglycemia. Albuterol has a shorter duration of drug action compared to Levalbuterol.

Albuterol is said to produce more side effects than Levalbuterol. Cite APA 7 ,. Difference Between Albuterol and Levalbuterol.

Difference Between Similar Terms and Objects. MLA 8 ,. Question: My patient feels his albuterol MDI works faster and stronger than xopenex. It does not work! I could go on and on at my dismay….