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xopenex and albuterol are almost the same drug, the original albuterol had two isomers, put together in the same drug. One was thought to be inactive, and one was thought to be the active drug, but they've found this supposedly 'inactive' compound can produce side effects, such as refractory bronchoconstriction (a side effect I've experienced on occasion)

Xopenex is simply only the active isomer -- it's more expensive because it's more difficult to make, and because it's only available in nebulizer solution, but it doesn't last longer. It may seem like it does because there is no refractory bronchoconstriction from it, so you don't notice when it quits working right away, but it is almost the same molecule and it's broken down the same way ... sorry to contradict, but I learned this at an inservice for respiratory therapists, which covered all kinds of new drugs, only one of them being xopenex.

The thing that sucks about most rescue meds is they only come in one strength -- except for the ventolin diskhaler, which comes in 100 and 200 per actuation, which doesn't really help (considering the aerosol is 100 per actuation anyway.)

Oxeze takes effect as quickly as ventolin does (though you can't just keep taking it because it DOES stay in your body for 12 hours and it WILL build up if you take lots of doses like you would take ventolin) and also comes in two strengths, the standard strength of 12ug which made me a little shaky and then the reduced strength of 6ug which I have found works almost as good and doesn't make me shaky at all.

The nice thing about taking nebulizer solutions like ventolin is that you can get them in bottle format (I think you could ask your doctor to prescribe the bottle instead of the nebules) and then dilute them yourself in sterile .45 normal saline. (Mostly just so they'll run well in the nebulizer -- dial out a proper dose with a 1cc syringe, say, half the normal dose, and then add an arbitrary amount of saline to increase the volume to 2.5 mL.)

I don't think Xopenex comes in bottles -- which sucks, because the bottles are a little cheaper. (You can get atrovent in bottles.)

It's a little more work but if you're sensitive enough to medication that a reduced dose would work wonderfully for you, it's a great alternative.

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