Levalbuterol or Xopenex is the R isomer of salbutamol and is used for the prevention and treatment of bronchospasm. Salbutamol (albuterol) is a mixture of two isomers - R and S. It is thought that the R isomer is the more active compound and that the S isomer contributes to some of salbutamol's side effects.
Levalbuterol or Xopenex is a beta 2 adrenergic agonist which targets beta 2 sites in the bronchial tissue to produce relaxation of the bronchial tubes opening air ways.
Nervousness and tremor are the most commonly reported side effects. Others reported include headache, leg cramps, anxiety, dizziness, chest pain, and heart palpitations.
Levalbuterol or Xopenex is available only for use with a nebulizer, and thus people must be familiar with the technique for nebulizer use.
Levalbuterol or Xopenex like salbutamol has the potential to reduce potassium levels when given in combination with non potassium sparing diuretics or oral corticosteroids. Beta blockers reduce its effectiveness and it can reduce digoxin's effectiveness.
Medical Letter 1999;41(1054):51
The relevant product monographs must be regarded as the appropriate sources of prescribing information.