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Difference Between Albuterol and Levalbuterol

Albuterol vs Levalbuterol

Albuterol and Levalbuterol are two drugs that are often confused with each other because of their very similar action and classification. They are classified as bronchodilators.

So what is Albuterol? Well, Albuterol is one of the most used bronchodilators nowadays. As such, it serves to minimize the airway resistance by increasing the diameter of the air passages or bronchi. In doing such, the drug improves overall airflow into and out of the lungs. Albuterol is mainly used to treat or alleviate several conditions involving the lungs like asthma and emphysema.

How about Levalbuterol? This drug is more known by its trade name Xopenex. It is used alongside standard asthma inhalers. Both Levalbuterol and Albuterol have similar properties in the sense that they target the Beta-2 receptors which results in the relaxation of the pulmonary (airway) smooth muscles.

Albuterol has long been used for asthma but has also been found to induce some side effects like shakiness, tachycardia (increased heart rate) and jitters. Conversely, although Levalbuterol also generates the same type of side effects, many say that they are only minimal. This is probably one of the most significant differences between the two drugs. And so, nurses and other health practitioners have observed that there is less shakiness and jitters.

Image by Flickr.com, courtesy of Christian Guthier

The other key differences between the two is that Albuterol has a shorter duration of action (4-6 hours) compared to Levalbuterol (5-8 hours). Because of such, it does not come as a surprise that Levalbuterol is priced much higher than Albuterol. A 0.83 mg of Albuterol costs about $17.59 compared to Levalbuterol of only 0.63 mg but is still costlier at $101.99.

With regard to the specific drug composition of the two bronchodilators, Albuterol is said to contain 50% each of S-albuterol and R-albuterol. Levalbuterol has purely the R-albuterol which is the one responsible for the bronchodilation effect. Because of this disparity in drug composition, many researches have been conducted to find proof that Levalbuterol has better efficacy than Albuterol. Yet still up to this day, there is no solid proof yet to backup this claim.

Despite these several differences, the two drugs are similar in many other aspects like: same half-life, same onset and peak of drug action, and same effect on blood potassium (hypokalemia) and glucose levels (hyperglycemia).

1. Albuterol has a shorter duration of drug action compared to Levalbuterol.

2. Albuterol is cheaper than Levalbuterol.

3. Albuterol is said to produce more side effects than Levalbuterol.

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  1. Question: My patient feels his albuterol MDI works faster and stronger than xopenex. Could the ‘S’ isomer in Albuterol (with the increase in circulation) be contributing to a faster onset?

    • As an asthma patient (moderate) who struggles terribly when getting a cold (as many do) I’m shocked that Levabuterol seems to be the only thing I can get prescribed. It does not work! Due to it’s price, I can see why the drug companies say it’s (regular, wonderful, blessed albuterol) not as good.

      This is horrible and I’m in shock. I don’t care what is said about R-albuterol. It isn’t true. I ‘ve gone through several prescriptions with my nebulizer, thinking I might have gotten “bad” medicine—it just doesn’t work well at all, hardly noticable. I could go on and on at my dismay…

  2. I take levalbuterol 2 times a day ,,,ipratropium bramide 3times a day .they are both vials.

  3. I had to discontinue use of albuterol because I causes my airway to constrict, causing me to be unable to breath, raises my heart rate and blood pressure. After a trip to the emergency room in extreme distress my doctor prescribed levabuterol and I have had no further problems. My medicare agree to pay for it after my doctor wrote them explaining my reaction to the albuterol.

  4. I have been on albuterol for many years and then got the levalbuterol and I can feel much of a difference for the better. I was told the levalbuterol is much easier on the heart which I can tell and it does last longer. It’s unfortunate that there is such a price difference but I do feel the levalbuterol is the best chouce for me.

  5. The cost of Levabuterol is outrageous and my husband can’t tell any difference in using it over doing nothing. An India pharmacy has it for 1/3 the price if anyone really needs it. We are stuck with a $1,000.00 bill for the vials delivered to us that we can’t possibly use before the expiration date. Is it any wonder that we Americans know that we are being ripped off by the pharmaceutical companies? Our insurer has already paid it’s share of these vials which is six times what we are being billed for. Our doctor is being duped along with the insurance company and now us also.

  6. My wife has had asthma for years. She once had a severe reaction to albuterol so the doctor prescribed Levalbuterol (Xopenex) . Because the Xopenex is more expensive, insurance wants her to use the less expensive albuterol. We have to be very careful that the doctor/ drugstore both go to the extra effort to get the right prescription. Even her emergency inhaler has to be Xopenex because she has had the same adverse reaction in the doctors office when they did the lung capacity test after giving her albuterol instead of Xopenex.

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