The use of this medication amkes biological sense. Racemic
albuterol consists of equal amounts of R- and S- isomers.
R-albuterol is the active agent, interacting with Beta-2 receptors
in airways. It is believed that the non-specific interactions
with Beta-1 receptors (seen with albuterol) cause some side effects.
Another study examined 362 patients 12 years or older. In
this study, children were treated with treatments TID for 1 month
with levalbuterol or albuterol and found little differences in effects
or side effects.4
The studies1,4 were sponsored by manufacturer of Xopenex
Other studies need to be performed, including looking at children with
co-morbidity, those receiving continuous or frequent treatments, with
exacerbations, or cotreatment with other medications (i.e. prophylaxis).
Further study on the role of S-albuterol is also needed.
- Gawchick SM, Sacca CL, Noonan M, Reasner DS, DeGraw SS. The
safety and efficacy of nebulized levalbuterol compared with racemic
albuterol and placebo in the treatment of asthma in pediatric patients.
Journal of Allergy and Clinical Immunology, 1999; 103(4):615-21.
- Personal communication, UM Pharmacy, 1/2000.
- Levalbuterol for Asthma. The Medical Letter, 1999; 41:51-3.
- Nelson HS, Bensch G, Pleskow WW, DiSantostefano R, DeGraw S, Reasner
DS, Rollins TE, RobinPD. Improved bronchodilation with levalbuterol
compared with racemic albuterol in patients with asthma. Journal
of Allergy and Clincial Immunology, 1999; 102(6):943-52.