Evidence behind use of levosalbutamol over salbutamol to prevent cardiac side effects

Authors

  • Subhrajit Lahiri Department of Pediatrics, Nicklaus Children’s Hospital, Florida International University, Miami, USA

DOI:

https://doi.org/10.18203/2349-3291.ijcp20171682

Keywords:

Heart disease, Levosalbutamol, Salbutamol, Tachycardia

Abstract

Salbutamol and levosalbutamol are the two most frequently used medications for asthma in pediatrics. Levosalbutamol is more expensive than salbutamol and is usually considered safer option for patients with existing cardiac condition and, to reduce tachycardia in otherwise healthy patients. In this article, we reviewed the literature which included randomized controlled trials, retrospective studies and case reports and compared the cardiac side effects of these two medications with primary emphasis on tachycardia

References

Hänsel R. Pharmazeutische Biologie: Allgemeiner Teil. 2nd ed. Ahrens W, Pigeot I, eds. United States: Springer-Verlag New York; 2013.

Jat KR, Khairwa A. Levsalbutamol versus salbutamol for acute asthma: A systematic review and meta-analysis. Pulm Pharmacolo Therapeut. 2013;26(2):239-48.

Uspal NG, Agrawal D. Misconceptions regarding levsalbutamol in the treatment of acute asthma exacerbations in children. Am J Emer Med. 2009;27(1):117-9.

Johnston SL, Edwards MR. Mechanisms of adverse effects of - agonists in asthma. Thorax. 2009;64(9):739-41.

Beasley R. A historical perspective of the New Zealand asthma mortality epidemics. J Aller Clin Immunol. 2006;117(1):225-8.

Kroesen M, Maseland M, Smal J, Van Setten P. Probable association of tachyarrhythmia with nebulized salbutamol in a child with previously subclinical wolff Parkinson white syndrome. J Pediatr Pharmacol Ther. 2012;17(1):93-7.

Gautam NK, Rafique MB, Numan MT. Impact of isoproterenol infusion on BIS and metabolic values in pediatric patients undergoing electrophysiology studies. J Clin Anesth. 2014;26(8):611-5.

Nelson HS, Bensch G, Pleskow WW. Improved bronchodilation with levsalbutamol compared with racemic salbutamol in patients with asthma. J Aller Clin Immunol. 1998;102(6):943-52.

Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS. The safety and efficacy of nebulized levsalbutamol compared with racemic salbutamol and placebo in the treatment of asthma in pediatric patients. J Aller Clin Immunol. 1999;103(4):615-21.

Rahman A. Levosalbutamol versus Salbutamol for treatment of acute exacerbation of asthma in Bangladesh children. J Aller Ther. 2012;3(3).

Mujeeb M, Mutha A. Comparative efficacy and safety of salbutamol versus levosalbutamol for treatment of acute exacerbation of bronchial asthma. J Evolut Res Med Pharmacol. 2015;1(1):7-10.

Ralston S, Hartenberger C, Anaya T, Qualls C, Kelly HW. Randomized, placebo-controlled trial of salbutamol and epinephrine at equipotent beta-2 agonist doses in acute bronchiolitis. Pediatr Pulmonol. 2005;40(4):292-9.

Milgrom H, Skoner DP, Bensch G, Kim KT, Claus R, Baumgartner RA. Low-dose levsalbutamol in children with asthma: safety and efficacy in comparison with placebo and racemic salbutamol. J Aller Clin Immunol. 2001;108(6):938-45.

Skoner DP, Greos LS, Kim KT, Roach JM, Parsey M, Baumgartner RA. Evaluation of the safety and efficacy of Levsalbutamol in 2-5-year-Old patients with asthma. Pediatr Pulmonol. 2005;40(6):477-86.

Qureshi F, Zaritsky A, Welch C, Meadows T, Burke BL. Clinical efficacy of Racemic Salbutamol versus Levsalbutamol for the treatment of acute pediatric asthma. Anna Emerg Med. 2005;46(1):29-36.

Wilkinson M, Bulloch B, Garcia-Filion P, Keahey L. Efficacy of Racemic Salbutamol versus Levsalbutamol used as a continuous Nebulization for the treatment of acute asthma exacerbations: A Randomized, double-blind, clinical trial. J Asthma. 2011;48(2):188-93.

Hamilos DL, D’Urzo A, Levy RJ. Long-term safety study of levsalbutamol administered via metered-dose inhaler in patients with asthma. Anna Aller Asthma Immunol. 2007;99(6):540-8.

Andrews T, McGintee E, Mittal MK. High-dose continuous Nebulized Levsalbutamol for pediatric status asthmaticus: a randomized trial. J Pediatr. 2009;155(2):205-10.

Carl JC, Myers TR, Kirchner HL, Kercsmar CM. Comparison of racemic salbutamol and levsalbutamol for treatment of acute asthma. J Pediatr. 2003;143(6):731-6.

Bio L, Willey V, Poon C. Comparison of levsalbutamol and racemic salbutamol based on cardiac adverse effects in children. Journal Pediatr Pharmacol Therapeut. JPPT. 2011;16(3):191.

Kelly A, Kennedy A, John BM, Duane B, Lemanowicz J, Little J. A comparison of heart rate changes associated with Levsalbutamol and Racemic Salbutamol in pediatric Cardiology patients. Ann Pharmacother. 2013;47(5):644-50.

Berger WE, Ames D. A patient satisfaction survey comparing levsalbutamol to racemic salbutamol in children. J Aller Clin Immunol. 2003;111(2):S214.

Andrews W. Impact of racemic salbutamol compared to levsalbutamol on objective measures of hyperactivity and inattentiveness in children with asthma. J Aller Clin Immunol. 2004;113(2):S32.

Ch HH, Oh HN. Xopenex® (levsalbutamol HCl) inhalation solution concentrate, 1.25 mg, 2012. Available from: http://www.accessdata. fda. gov/drugsatfda_docs/label/2012/020837s036lbl.pdf. Accessed 29 October 2016.

Verkleeren N, Lipstick K. Prescribing Trends with Levsalbutamol (Xopenex) At a Community Hospital. Pharm Therapeut. 2009;34(10):550-3.

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Published

2017-04-25

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Section

Review Articles