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Thursday, January 30, 2014

Off label use of beta adrenergic medicine

This isn't really said much, but albuterol is only approved by the Food and Drug Administration (FDA) for the treatment of asthma and the prophylaxis of exercise induced asthma.  

However, it's often used off label for many other things, some of which I will list here: 
  • Bronchospasm as a complication of anesthesia
  • Chronic obstructive pulmonary disease (COPD
  • Cough cough
  • Hyperkalemia
  • Pulmonary emphysema
  • Respiratory distress in a premature newborn
  • Adjunct to respiratory treatment of syncytial viral infection. 
  • LEV is approved for use in asthma and is also used off-label in patients with COPD.
Levalbuterol is only approved for the treatment of asthma, but is often used for COPD.  

While the FDA does not recommend the off label use of any medicine it approves, it is not illegal.  This is a good thing in that it allows physicians the opportunity to be creative in treating their patients, and this does work to the advantage of the patient in many cases.  

However, there are many instances in the hospital setting where both albuterol and levalbuterol are misused and abused. You can see some more examples here at the RT Cave here and here and here

  1. Borkowski Jaime, Marsha Crader, "Nebulized albuterol versus levalbuterol in pediatric and adult patients: A review," Formulary Journal of Modern Medicine, April 1, 2009,, accessed 1/28/2014

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