Levalbuterol vs. Albuterol: How Do They Differ?
Medically reviewed by Lindsay Cook, PharmDMedically reviewed by Lindsay Cook, PharmDAbout one out of 12 people in the United States has asthma. Asthma is a chronic (long-term) lung condition in which airways can become inflamed and narrowed. This makes it difficult to get air in and out of your lungs and harder to breathe.Asthma symptoms, such as wheezing and shortness of breath, may be mild or severe. More severe symptoms may lead to an asthma attack in which your airways become very narrow, making breathing extremely difficult. An asthma attack can be life-threatening and requires emergency treatment.Medications that help open your airways, such as levalbuterol and albuterol, are commonly taken to treat an asthma attack. If you have asthma, your healthcare provider may prescribe levalbuterol or albuterol to help prevent or treat asthma symptoms.
Key Similarities and DifferencesAlbuterol is made of a mixture of two chemicals called (S)-albuterol and (R)-albuterol. (R)-albuterol is also called levalbuterol, and it's the active form of the drug. (S)-albuterol has been thought to contribute to side effects of the medication.Levalbuterol only contains (R)-albuterol and was initially expected to work better and have fewer side effects than albuterol. However, a review of studies found that the medications worked equally well and had similar side effects when taken to treat immediate asthma symptoms.Levalbuterol can sometimes cost more than albuterol and is not always the first choice for treating asthma symptoms. However, some people may have gradually worsening asthma symptoms after long-term albuterol use. In this case, healthcare professionals may change the treatment to levalbuterol.
Levalbuterol
Albuterol
Short-acting beta-agonists
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Used as rescue treatment
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Approved for children 2 years of age and older
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Available as a metered dose inhaler
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Available in oral tablet and syrup forms
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Taken to prevent asthma symptoms during exercise
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What Is Levalbuterol?Levalbuterol belongs to the group of drugs called beta-agonists. It's also called a bronchodilator. Bronchodilators are medications that help open your airways.Levalbuterol is a short-acting beta-agonist that works by relaxing the smooth muscles along your airways, which helps the airways open up. Short-acting beta agonists work right away and are typically taken to quickly relieve symptoms of an asthma attack.Levalbuterol is available as a generic and brand-name version called Xopenex HFA. The generic version comes as a liquid to be inhaled through your mouth using a nebulizer. Xopenex HFA is available as an aerosol that you inhale by mouth using a metered dose inhaler.Uses of LevalbuterolThe U.S. Food and Drug Administration (FDA) has approved levalbuterol to prevent and treat bronchospasm (airway narrowing) in adults and children ages 6 years and older. Xopenex HFA is FDA-approved to prevent and treat bronchospasm in adults and children as young as 4 years of age.Bronchospasm may be due to breathing conditions such as asthma or chronic obstructive pulmonary disease (COPD).Because levalbuterol is a short-acting medication, it's typically used as a rescue treatment. This means that you can use it to treat an asthma attack as it happens. You can also use levalbuterol as soon as you feel asthma symptoms to help prevent an asthma attack. Asthma symptoms can include:Shortness of breathWheezingCoughingChest tightnessThe levalbuterol liquid for the nebulizer and the Xopenex HFA inhaler both work the same way. However, the inhaler is more convenient to carry with you in case you have asthma symptoms while you're away from home.It's important to note that using an inhaler can require some hand-breath coordination and may be more challenging for younger children to use. In this case, the levalbuterol liquid for nebulizer might be a better option.Side Effects of LevalbuterolLevalbuterol may cause side effects in some people. They can include:HeadacheDizzinessTremorNervousnessIrregular or rapid heartbeatChest painSore throat (with metered dose inhaler)Runny nose (with metered dose inhaler)In rare cases, levalbuterol may cause more serious side effects, such as:Low blood potassium levelWorsening bronchospasm when first using levalbuterolSerious heart problemsSerious allergic reactionLevalbuterol and PregnancyWhether levalbuterol is safe to use during pregnancy is unknown. However, untreated asthma may lead to pregnancy complications, including preeclampsia. Untreated asthma during pregnancy may also lead to premature birth and low birth weight in the newborn baby.Let your healthcare provider know if you're pregnant or planning on becoming pregnant. If they prescribe levalbuterol, they'll monitor your medication doses closely to ensure they are managing your asthma symptoms.Other Levalbuterol PrecautionsLevalbuterol can cause irregular or rapid heartbeat and other heart problems. If you already have a heart condition, such as heart rhythm problems or high blood pressure, taking levalbuterol may worsen it. Make sure you tell your healthcare provider if you have a heart condition before taking levalbuterol. They may recommend a different treatment for your asthma symptoms.What Is Albuterol?Like levalbuterol, albuterol is also a short-acting beta-agonist bronchodilator. It works right away to open your airways by relaxing the muscles along your airways.Albuterol is available in brand and generic versions. Generic albuterol is available in the following forms:Liquid to inhale through a nebulizerAerosol to inhale by mouth through a metered dose inhalerOral tabletOral syrupThe brand versions of albuterol are called ProAir RespiClick and Ventolin HFA. ProAir RespiClick is a powder form of albuterol that's inhaled by mouth using a metered dose inhaler. Ventolin HFA is an aerosol form of albuterol that's also inhaled by mouth through a metered dose inhaler.Both inhalers work the same way. However, with the aerosol form, you need to inhale through the mouthpiece and press the canister at the same time to get a dose. With the powder form, you can get a dose just by inhaling. This makes taking it easier for young children and people with coordination problems.Uses of AlbuterolThe FDA has approved all forms of albuterol for preventing and treating bronchospasm caused by lung conditions such as asthma and COPD. The brand and generic metered dose inhalers are also approved to prevent symptoms of bronchospasm during exercise.Albuterol liquid for use with a nebulizer and oral syrup are approved for use in adults and children as young as 2 years and older. The metered dose inhalers may be used by adults and children ages 4 years and older, and the oral tablets are approved for use by adults and children ages 6 years and older.Like levalbuterol, albuterol is a short-acting bronchodilator that is typically used as a rescue treatment.Side Effects of AlbuterolIt's possible to have some side effects from albuterol. They can include:HeadacheTremorDizzinessNervousnessRapid heartbeatSore throat (with metered dose inhaler)Runny nose (with metered dose inhaler)Although rare, albuterol may also cause more serious side effects, such as:Gradual worsening of asthma symptomsWorsening bronchospasm when first using albuterolLow blood potassium levelSerious heart problemsSerious allergic reactionAlbuterol and PregnancyThere aren't enough studies of albuterol use during pregnancy to determine whether taking albuterol while pregnant is safe. There have been some reports of birth defects in babies born to people who took albuterol during pregnancy. However, whether these effects were due to albuterol or other medications is unknown.Before you start taking albuterol, talk with your healthcare professional if you're pregnant or planning on becoming pregnant. They can recommend safe ways to manage your asthma symptoms during pregnancy.Other Albuterol PrecautionsAlbuterol can cause rapid heartbeat and other heart problems. If you already have a heart condition, such as high blood pressure or heart rhythm problems, taking albuterol may worsen it. Make sure you tell your healthcare provider if you have a heart condition before taking albuterol. They may recommend a different treatment for your asthma symptoms.Potential for InteractionsIf your healthcare professional prescribes levalbuterol or albuterol, they'll talk with you about other medications you take. This is because some medications may negatively interact with levalbuterol or albuterol. They may increase your risk of side effects or affect how the medications work.Medications that may interact with levalbuterol or albuterol include:Other short-acting beta-agonists, such as EpiPen (epinephrine)Beta-blockers, such as metoprolol (Toprol XL)Diuretics (water pills), such as Lasix (furosemide)Lanoxin (digoxin)Monoamine oxidase inhibitors (MAOIs), such as Nardil (phenelzine)Keep in mind that levalbuterol and albuterol are both short-acting beta-agonists. You should not take these medications together.SummaryLevalbuterol and albuterol are both prescription medications taken to treat and prevent bronchospasm (airway narrowing) due to asthma and COPD. Albuterol can also prevent bronchospasm during exercise. Both medications work quickly to relax the muscles along your airways and make breathing easier.Levalbuterol is available as a liquid that you inhale using a nebulizer and an aerosol that you inhale through a metered dose inhaler. Albuterol is also available in these forms as well as a tablet and syrup that you swallow by mouth. Both medications are approved for use in adults and young children. Levalbuterol may be taken by children 4 years and older, and albuterol syrup may be taken by children as young as 2 years of age.The side effects of levalbuterol and albuterol are similar and can include rapid heartbeat and headache. Both medications can interact with other drugs and may worsen heart conditions. Because of this, it's important to talk with your healthcare provider about your health history and other medications you take before you take levalbuterol or albuterol. Read the original article on Verywell Health.
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