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Levalbuterol vs. Albuterol: How Do They Differ?

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Levalbuterol vs. Albuterol: How They Compare
Levalbuterol Albuterol
Short-acting beta-agonists ✔ ✔
Used as rescue treatment ✔ ✔
Approved for children 2 years of age and older ✔
Available as a metered dose inhaler ✔ ✔
Available in oral tablet and syrup forms ✔ ✔
Taken to prevent asthma symptoms during exercise ✔

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 Levalbuterol

The 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:

The 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 Levalbuterol

Levalbuterol may cause side effects in some people. They can include:

In rare cases, levalbuterol may cause more serious side effects, such as:

Levalbuterol and Pregnancy

Whether 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 Precautions

Levalbuterol 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 nebulizer
  • Aerosol to inhale by mouth through a metered dose inhaler
  • Oral tablet
  • Oral syrup

The 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 Albuterol

The 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 Albuterol

It’s possible to have some side effects from albuterol. They can include:

Although rare, albuterol may also cause more serious side effects, such as:

  • Gradual worsening of asthma symptoms
  • Worsening bronchospasm when first using albuterol
  • Low blood potassium level
  • Serious heart problems
  • Serious allergic reaction

Albuterol and Pregnancy

There 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 Precautions

Albuterol 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 Interactions

If 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:

Keep in mind that levalbuterol and albuterol are both short-acting beta-agonists. You should not take these medications together.

Summary

Levalbuterol 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.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. National Heart, Lung, and Blood Institute. What is asthma?

  3. National Heart, Lung, and Blood Institute. Asthma: symptoms.

  4. Jat KR, Khairwa A. Levalbuterol versus albuterol for acute asthma: a systematic review and meta-analysis. Pulmonary Pharmacology & Therapeutics. 2013;26(2):239-248. doi: doi.org/10.1016/j.pupt.2012.11.003

  5. Ameredes BT, Calhoun WJ. Levalbuterol versus albuterol. Curr Allergy Asthma Rep. 2009;9(5):401-409. doi:10.1007/s11882-009-0058-6

  6. American Academy of Allergy, Asthma & Immunology. Short-acting beta-agonists (SABAs).

  7. MedlinePlus. Levalbuterol oral inhalation.

  8. DailyMed. Label: Xopenex HFA- levalbuterol tartrate aerosol, metered.

  9. DailyMed. Label: Levalbuterol- levalbuterol hydrochloride solution.

  10. U.S. Food and Drug Administration. Orange Book: approved drug products with therapeutic equivalence evaluations.

  11. DailyMed. Label: ProAir RespiClick- albuterol sulfate powder, metered.

  12. DailyMed. Label: Ventolin HFA- albuterol sulfate aerosol, metered.

  13. MedlinePlus. Albuterol oral inhalation.

  14. DailyMed: Label. Albuterol sulfate solution.

  15. DailyMed. Label: Albuterol sulfate syrup.

  16. DailyMed. Label: Albuterol sulfate HFA- albuterol sulfate aerosol, metered.

  17. DailyMed. Label: Albuterol- albuterol sulfate tablet.

By Rosanna Sutherby, PharmD

Sutherby is a community pharmacist with over 20 years of experience in medication review, counseling, and immunization.

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