What is the role of levalbuterol in the treatment of status asthmaticus?

Updated: Jun 17, 2020
  • Author: Constantine K Saadeh, MD; Chief Editor: John J Oppenheimer, MD  more...
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Answer

The US Food and Drug Administration (FDA) approved the use of the R isomer of albuterol, known as levalbuterol, for treating patients with acute asthma. This isomer has fewer effects on the heart rhythm (ie, tachyarrhythmia) and is associated with fewer occurrences of tremors, while having the same or greater clinical bronchodilator effects as racemic albuterol. The decreased prevalence of adverse effects with this single isomer medication may allow physicians to use nebulizer therapy in patients with acute asthma more frequently, with less concern over the adverse effects that occur with other bronchodilators (eg, albuterol, metaproterenol). The dose of levalbuterol is either a 0.63-mg vial for children or a 1.26-mg vial for adults. A study in 2009 documented that although a slight decrease may have occurred in the duration of continuous nebulizer treatment with levalbuterol compared with albuterol, the difference was not statistically significant. [23]


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