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What are the Differences Between Xopenex® and Albuterol?

By D. Nelson
Updated: Feb 23, 2024
Views: 15,510
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Xopenex® and albuterol are two prescription drugs used to treat asthma. Known as beta-2 agonists, they are part of a class of drugs that help increase the air passing into the lungs. Both drugs have similar indications, but they can affect patients differently. Because of variations in access to prescription drugs, healthcare or insurance regulations, and drug approvals, some people may only have access to one or the other.

Beta-2 agonists are used to treat various states of pulmonary disease. They work by calming spasms of the bronchial muscles, which sometimes occur during asthma attacks and emphysema or COPD exacerbations. Xopenex® and albuterol lessen the severity of the symptoms of these diseases, although they do not have a longterm effect on disease progression.

To understand the difference in the chemistry of these drugs, it is necessary to understand what an enantiomer is. Some molecules have mirror images; they contain the same types of atoms in the same number, but some are "left-handed" (S-enantiomers) and others "right-handed" (R-enantiomers), depending on their orientation. Albuterol contains both S- and R-enantiomers, while Xopenex® contains only the R molecules. It has been suggested that this may lead to fewer side effects, although there is some debate about this.

In addition to their different formulas, the names of Xopenex® and albuterol reveal a difference in their legal status. Xopenex® is the trade name for the drug levosalbutamol, while albuterol is a generic name. Xopenex® is marketed by the pharmaceutical company Sunovion. Albuterol, also known as salbutamol, is also included in other drugs as well as being marketed under a variety of brand names.

There are some differences between the side effects of Xopenex® and those of albuterol. Some users of Xopenex® have reported that they experience unwarranted anxiety, headaches, and an overall sense of nervousness. In some rare cases, users have reported have reported shakiness or jitters.

Reports of shakiness have been much more prevalent among users of albuterol. In some cases, users also report experiencing tachycardia, or excessively rapid heartbeat, a distressing symptom. While the side effects of Xopenex® and albuterol are not uncommon, they do not occur in the majority of patients. Side effects are often times mild when they are experienced.

As far as price goes, most users find that albuterol is the cheaper drug. This respiratory treatment came to the market earlier. While Xopenex® is the more expensive of the two, it is favored by many consumers who believe that they experience fewer side effects. Because it is a newer drug, many asthma patients see it as being an improvement over albuterol.

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Discussion Comments
By anon1006051 — On Jan 22, 2022

I care for my disabled brother. As he is almost totally non-verbal, it took me a little while to determine that albuterol was causing his distressing symptoms. After the breathing treatment with albuterol, I noticed his face became red, he was breathing more rapidly, sweating, his heart rate increased, and began what I refer to as tics. He would start by beating his face, biting his lips, pulling his hair, rocking back and forth, wringing his hands as if plagued with uncontrollable anxieties.

After doing much research, I asked the doctor if we could try Xopenex. Wow, what a difference. So that is our experience with albuterol and xopenex.

By ZipLine — On Dec 15, 2013

@literally45-- When Xopenex first came out, it was believed to be a better drug than albuterol. But now, studies show that they are not much different.

Both medications essentially have the same ingredient. The only difference is that Xopenex has R-albuterol and albuterol has S-albuterol. One is not better than the other at treating asthma. Less Xopenex is needed than albuterol to get the same effects, but this doesn't mean that Xopenex works better.

In terms of side effects, everyone reacts differently to drugs. So one person might do better on Xopenex and the other might do better on albuterol.

By literally45 — On Dec 14, 2013

@SarahGen-- You should definitely talk to your doctor about this. My doctor switched me to Xopenex and I'm happy with the change. I used to have rapid heart rate and jitters with albuterol. I have less of these symptoms with Xopenex.

Also, I've read that albuterol leads to more asthma in the long term because it causes inflammation in the lungs. So it's better to use Xopenex, if you have to use an asthma medication regularly.

By SarahGen — On Dec 13, 2013

My doctor put me on albuterol a few weeks ago for asthma. I've been experiencing some side effects like nausea, dizziness, headaches and sore throat. I don't know if these symptoms will go away in time, but I'm having a hard time living with them now. Should I ask my doctor to switch me to Xopenex?

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