Albuterol vs Levalbuterol HFA Inhalers: What’s the Difference?

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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Albuterol and levalbuterol can be confusing right off the bat due to the sound-alike active ingredient names. Both are available as various brand name inhalers, though there are no generic albuterol or levalbuterol HFA inhalers at the moment. Both types of inhaler treat asthma and in some cases COPD, but they have different strengths and side effects and can vary in price.

Are albuterol and levalbuterol considered rescue or maintenance inhalers?

Both albuterol and levalbuterol are rescue inhalers. These inhalers are fast-acting and to be used for short-term breathing problems such as an asthma attack. Albuterol and levalbuterol will assist in quickly opening the airways to help improve your breathing.

What are the brand names of the albuterol and levalbuterol HFA inhalers?

Albuterol HFA inhalers include ProAir HFAVentolin HFA, and Proventil HFA. Xopenex HFA is the levalbuterol HFA inhaler.

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What is the difference in strength between the albuterol inhalers and Xopenex HFA?

All Albuterol HFAs (ProAir, Ventolin, and Proventil) have a strength of 108 mcg/actuation, where Xopenex HFA is 45 mcg/actuation.

Is there an advantage to using levalbuterol instead of albuterol?

Even though these medications are inhaled there is still some bodily (or systemic) absorption which can result in unfavorable side effects. Levalbuterol tends to have fewer systemic side effects compared to albuterol.

For example, albuterol can cause an increased heart rate. Therefore, patients who have a history of heart problems such as arrhythmias or heart disease may benefit from using Xopenex HFA (levalbuterol) instead of the ProAir, Ventolin, or Proventil HFAs.

Is there a price advantage to use Xopenex HFA compared to ProAir, Ventolin, or Proventil HFAs?

Depending on which pharmacy you use, you may be able to get levalbuterol and albuterol HFAs at the following discounted prices:
Xopenex HFA (levalbuterol): $58-$63
ProAir HFA (albuterol): $51-$59
Ventolin HFA (albuterol): $49-$54
Proventil HFA (albuterol): $65-$70

Ventolin HFA appears to be the least expensive option, by about $20 at the most. However, the price of Xopenex HFA is comparable to the albuterol inhalers, and less expensive than Proventil HFA.

These prices DO NOT reflect what the copayment if using your prescription insurance may be; therefore, it is always best to check with your insurance first to see if your medication is covered and if so what the copayment will be.

Only your doctor can determine which medication is right for you, but keep in mind that if you have a pre-existing heart condition using Xopenex HFA may be more favorable due its side effect profile.

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