WASHINGTON - February 1 - Levalbuterol HFA (Xopenex HFA) inhalers are no more effective than older, less expensive drugs used to treat asthma and other diseases and should not be used by consumers, Public Citizen writes in a new February posting on its WorstPills.org Web site. The consumer advocacy organization cited information published in the March 2006 issue of Medical Letter on Drugs and Therapeutics.

In 2005, Americans filled more than 2.2 million prescriptions for levalbuterol at a cost of more than $293 million. Marketed by Sepracor Inc., levalbuterol has the same atomic components as the asthma drug albuterol, which has been on the market longer and costs less. The difference is that, while albuterol has both of the two mirror images of the molecule, levalbuterol has only one. Levalbuterol is available in two forms, Xenopex HFA, a pocket-sized inhaler approved by the Food and Drug Administration (FDA) in March 2005, and Xenopex, a liquid drug approved in 1999 that is converted to a fine mist when passed through a device called a nebulizer. Levalbuterol is short-acting and is used to relieve symptoms experienced during an asthma attack. In 1999, Public Citizen placed levalbuterol on its “Do Not Use” list of drugs because there was – and still is not – any compelling evidence that levalbuterol is safer or more effective than albuterol.

“Creating a drug that is nearly identical in nature to a drug that is already in existence and then marketing it as a ‘new’ or ‘breakthrough’ drug is a strategy that neither helps consumers nor produces better drugs,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group. “In marketing levalbuterol as such, the manufacturer is manipulating patients into unnecessarily paying hefty prices.”

Albuterol, first marketed in the United States in 1981, no longer has patent protection and therefore can be made by generic manufacturers and sold at a reduced price. Since levalbuterol is a “new” drug, it is patented and can be sold at brand-name prices. A patient using albuterol pays about $10.99 per inhaler, whereas one using levalbuterol HFA pays about $48.99 for each inhaler.

The February updates to the WorstPills.org Web site also discuss life-threatening adverse affects reported by patients using methadone (dolophine) for pain relief and quinine to prevent nocturnal leg cramps.

Worst Pills, Best Pills is a monthly newsletter available in print and electronic formats through Public Citizen’s Web site, www.WorstPills.org. The site has other searchable information about the uses, risks and adverse effects associated with prescription medications, including all the information contained in Public Citizen’s best-selling book, Worst Pills, Best Pills.

Worst Pills is an unbiased analysis of information from a variety of sources, including well-regarded medical journals and unpublished data obtained from the FDA that allow Public Citizen to sound the alarm about potentially dangerous drugs long before they are banned by the federal government. For example, Public Citizen warned consumers about the dangers of Vioxx, ephedra, Baycol and Propulsid years before they were pulled from the market.

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