Prescribing trends with levalbuterol (xopenex) at a community hospital.

The committee developed these guidelines to reflect its stance that levalbuterol should be considered a second-line therapy to albuterol and that it should be reserved for patients who experience intolerable side effects from albuterol. The guidelines did not impose restrictions on dose or frequency of levalbuterol use in patients who met these criteria; however, the pharmacists were asked to send a pharmacist-tophysician communication sheet to the chart for all orders that exceeded the FDA’s approved frequency of three doses per day. As a result of the increase in usage and the subsequent increase in expenditures, an audit of levalbuterol use was conducted.