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Forum Name: Pharmacy & Drug Topics

Question: Xopenex versus Albuteral


 dacubster - Tue Dec 11, 2007 12:08 am

Hi there,

I am a 24 year old female with a history of severe asthma, bronchitis, allergies, hyperthyroidism, IST and depression.

When I am sick my doctor usually has me do nebulizer treatments of albuteral (or occassionally Pulmicort). Now I usually get the usual side affects from it, jittery and shaking.

My primary care doctor suggested taking Xopenex through the neb. instead since it does not have the same jittery effect. However a friend of mine who also takes this medicine said it is not recommended in someone who has heart problems (I am being treating with Toprol for an unexplained rapid heart beat). Would this apply to my condition? And is this drug considered safe in that retrospect?

I would like to take something that doesn't make me as jittery but not if the risks are increased.

Thanks you.
 Dr. Chan Lowe - Tue Dec 11, 2007 10:43 pm

User avatar Hi Dacubster,

If you can take albuterol you can take xopenex. Most medicines have two isomers (forms) of the medicine molecule (termed R and S, basically right and left hand forms). With many medications it is thought that the S form gives the benefits and the R form gives the side effects. So, Xopenex is only the S form of the albuterol while regular albuterol contains both.

If xopenex is contraindicated for a heart condition, albuterol should be as well.

There are some studies showing that Xopenex gives less elevations in heart rate and "jittery feelings" when used every four to six hours compared to albuterol. However, if the medicine is being used more frequently than every four hours the benefit goes away.

Xopenex comes in both a nebulizer form and a "puffer" form, as does albuterol. If you're having a lot of problems with jittery feelings and fast heart rates it is reasonable to try the Xopenex. Some people notice a big difference and others do not.

One other thing to consider is that, for a while, Xopenex was about 8 times more expensive than albuterol so most insurance plans would not cover it or would cover it at the highest copay. You may want to check into this since in many cases this has now changed.

Best wishes.

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