Levalbuterol

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

North America

USA: Levalbuterol, Xopenex.

Latin America

Argentina: Albulair.

Drug combinations

Chemistry

Levalbuterol Hydrochloride: C~13~H~21~NO~3~ HCl. Mw: 275.77. (R) – α^1^-[(tert-Butylamino)methyl]-4-hydroxy-m-xylene – α, α’-diol hydrochloride. CAS-50293-90-8 (1997).

Levalbuterol Tartrate: 2(C~13~H~21~NO~3~) C~4~H~6~O~6~. Mw: 628.71. 1,3-Benzenedimethanol, α^1^-[[(1,1-dimethylethyl)amino]methyl]-4-hydroxy-, (α^1^R)-, (2R,3R)-2,3-dihydroxybutanedioate (2:1). CAS-661464-94-4 (2004).

Pharmacologic Category

Bronchodilators; Selective β~2~-Adrenergic Agonists. (ATC-Code: R03AC).

Mechanism of action

Relaxes bronchial smooth muscle by action on β~2~-receptors with little effect on heart rate.

Therapeutic use

Treatment or prevention of bronchospasm in children and adults with reversible obstructive airway disease.

Pregnancy and lactiation implications

Racemic albuterol teratogenic in some species. This drug should be used during pregnancy only if benefit exceeds risk. Has potential to interfere with uterine contractions. Excretion in breast milk unknown (use caution).

Unlabeled use

Contraindications

Hypersensitivity to levalbuterol, albuterol, or any component of the formulation.

Warnings and precautions

Rarely, paradoxical bronchospasm might occur with use of inhaled bronchodilating agents. Immediate hypersensitivity reactions (urticaria, angioedema, rash, bronchospasm) reported. Avoid use as component of chronic therapy without an anti-inflammatory agent. Might cause elevation in blood pressure, heart rate, and increase risk of arrhythmias (use with caution in cardiovascular disease). Use with caution in diabetes mellitus (might increase serum glucose), glaucoma (might elevate intraocular pressure), hyperthyroidism (might stimulate thyroid activity), hypokalemia (might decrease serum potassium), seizure disorders (risk of CNS stimulation/excitation).

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