Single-isomer levalbuterol: a review of the acute data

Levalbuterol, the pure (R)-isomer of racemic albuterol, is a new therapeutic option for patients with asthma. Racemic albuterol comprises a 50:50 mixture of (R)- and (S)-albuterol, with (R)-albuterol conferring all of the bronchodilator effects of the racemate. Numerous preclinical and in vitro studies have indicated that (S)-albuterol is not an inert isomer, but may have proinflammatory effects. Results from clinical trials in adults and children with asthma have demonstrated that 0.63 mg levalbuterol provides effective bronchodilation with lower b-mediated side effects compared with 2.5 mg racemic albuterol. In the emergency department, levalbuterol provided greater bronchodilation and significantly reduced hospital admissions compared with racemic albuterol. Recent studies have supported that levalbuterol use in acute settings may reduce the cost of asthma treatment by decreasing the total treatments and subsequent respiratory therapy resources. Levalbuterol provides heath care professionals with a safe, effective, and potentially cost-saving alternative to racemic albuterol for the treatment of patients with asthma.