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@cwal

Not sure I understand what you mean. I was referring to the inhaler being a lesser dosage strength than the nebulizer and how could they act with the same effectiveness for opening the airways if one is a lesser dosage amount.

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Replies to "Not sure I understand what you mean. I was referring to the inhaler being a lesser..."

I looked into this and you are correct about the significant differences in amount per dose.

Levalbuterol via neb delivers 0.63 mg per dose (3 mL nebulized) and Albuterol sulfate HFA inhaler delivers 0.09 mg of albuterol per dose. According to literature levalbuterol is for patients with severe asthma or COPD. Albuterol for those with mild or moderate disease. Plus, albuterol puffer is quick, portable and less expensive than levalbuterol.

Don't know for sure but since levalbuterol is longer acting than albuterol it might impact the lower esophageal sphincter leading to possibility of GERD. I prefer albuterol for the reasons stated above.