Indacaterol is an ultra long acting beta-adrenoceptor agonist currently undergoing research. It needs only be taken once a day, unlike the currently available Formoterol and Salmeterol. Such drugs are used in the treatment of chronic obstructive pulmonary disease and asthma.
Indacaterol by Novartis is an effective and well-tolerated treatment of asthma and chronic obstructive pulmonary disease (COPD) over 24 hours with a rapid onset of action. The combination of 24-hour efficacy and a reassuring safety profile suggests that in time, a once-daily dose of indacaterol could become a new standard of care for bronchodilation in asthma and COPD. Indacaterol could be the first beta2-agonist to be taken only once-daily providing full 24 hour symptom control with a single administration, in contrast to currently-available long-acting beta2-agonists (LABAs) such as salmeterol and formoterol which have to be taken twice-daily.

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Xopenex as a bronchodilator is used to treat asthma and COPD. In general, xopenex has similar pharmacokinetic and pharmacodynamic properties to albuterol; however, its manufacturer, Sepracor, has implied (although not directly claimed) that the presence of only the R-enantiomer produces fewer side effects.
Physicians sometimes elect to use xopenex in patients with a history of supraventricular tachycardia or other arrhythmias because it is thought that xopenex may produce less direct effects on beta-adrenergic receptors in the heart. For similar reasons, some pediatricians also use xopenex for patients who experience hyperactivity or jitteriness from racemic albuterol.
The use of xopenex over the more traditionally used racemic albuterol is controversial among health care professionals. That using xopenex instead of albuterol produces less direct effect on beta adrenergic receptors and/or fewer cardiac side effects has been suggested, but not consistently demonstrated by long term, well-designed clinical trials.
There are differing opinions on whether there is sufficient therapeutic benefit to using xopenex that outweighs the 5-10 times higher price tag. In general, it appears that if a clinician and patient feel that a low dose of racemic mixture is causing undesirable side effects, xopenex may be a viable alternative. xopenex was originally available only as a solution for nebulizer and eventually become available as a CFC-free metered dose inhaler under the trade name Xopenex HFA (xopenex tartrate) Inhalation Aerosol.

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