From the Guidelines
AirSupra and Xopenex are distinct asthma medications, with AirSupra containing albuterol and budesonide for both immediate relief and anti-inflammatory effects, and Xopenex containing levalbuterol, the active R-isomer of albuterol, for quick symptom relief with potentially fewer side effects. The key difference between these medications lies in their active ingredients and mechanisms of action. AirSupra combines a rescue bronchodilator (albuterol) with an inhaled corticosteroid (budesonide) to address both bronchospasm and inflammation simultaneously, making it a suitable option for patients requiring both quick relief and long-term control of asthma symptoms 1. On the other hand, Xopenex (levalbuterol) is a single-ingredient rescue bronchodilator that provides rapid relief of asthmatic symptoms with potentially fewer side effects like tremors and increased heart rate compared to regular albuterol 1.
Some key points to consider when choosing between AirSupra and Xopenex include:
- The specific asthma pattern and symptom frequency of the patient
- The patient's response to different bronchodilators
- The need for both immediate relief and anti-inflammatory effects
- The potential for side effects with regular albuterol use
It's also important to note that according to the guidelines, inhaled corticosteroids are the most potent and consistently effective long-term control medication for asthma, and short-acting beta2 agonists like albuterol and levalbuterol are recommended for rapid reversal of airflow obstruction and prompt relief of asthmatic symptoms 1.
In terms of dosing, AirSupra is typically prescribed as 2 inhalations as needed for asthma symptoms, with a maximum of 6 inhalations in 24 hours, while Xopenex is usually dosed as 1-2 inhalations every 4-6 hours as needed. The choice between these medications should be based on the individual patient's needs and response to treatment, and should be guided by the most recent and highest quality evidence available 1.
From the Research
Differences between Airsupra and Xopenex
- Airsupra is a brand name for levalbuterol, which is the (R)-enantiomer of albuterol 2, 3, 4
- Xopenex is also a brand name for levalbuterol, indicating that Airsupra and Xopenex are the same medication 2, 4
- The key difference lies in the fact that Xopenex was introduced in 1999 as a single-enantiomer formulation of levalbuterol, whereas Airsupra is a more recent brand name for the same active ingredient 2
- Both Airsupra and Xopenex provide greater bronchodilation than racemic albuterol and offer the possibility of improving clinical outcomes in patients with asthma and other obstructive airway diseases 2, 4
Comparison of Levalbuterol and Racemic Albuterol
- Levalbuterol, the active ingredient in Airsupra and Xopenex, binds to the beta2-adrenergic receptor with high affinity, whereas the (S)-enantiomer of albuterol binds with 100-fold less affinity 2, 3
- Levalbuterol possesses the bronchodilatory, bronchoprotective, and ciliary-stimulatory properties of racemic albuterol, while the (S)-enantiomer does not contribute beneficially to the therapeutic effects of the racemate 2, 3
- The use of levalbuterol, such as Airsupra or Xopenex, may reduce the risk of beta-mediated adverse effects compared to racemic albuterol 2, 3, 4