Levalbuterol Aerosol Delivery With a Nonelectrostatic Versus a Nonconducting Valved Holding Chamber

Abstract

BACKGROUND:

Hydrofluoroalkane-propelled levalbuterol (Xopenex) aerosol is a recently approved formulation for delivery via metered-dose inhaler for the treatment or prevention of bronchospasm in adults, adolescents, and children ≥ 4 years of age who have reversible obstructive airway disease. Valved holding chambers (VHCs) made from conventional polymers are susceptible to accumulation of electrostatic charge, which can be minimized by prewashing with ionic detergent, but it may be desirable to be able to use the product straight from the package, without pretreatment, especially during an exacerbation.

METHODS:

We studied the performance of the AeroChamber Plus and AeroChamber Max VHCs in delivering hydrofluoroalkane-propelled levalbuterol. Both VHCs were prewashed, rinsed, and drip-dried before testing. The AeroChamber Max is manufactured from charge-dissipative material and was therefore also evaluated without prewashing. Aerosol samples were collected at 28.3 L/min with an Andersen 8-stage cascade impactor, per the procedure specified in Chapter 601 of the United States Pharmacopeia.

RESULTS:

The mean ± SD fine-particle mass (mass of aerosol particles < 4.7 μm aerodynamic diameter) values were 33.5 ± 1.4 μg and 36.3 ± 1.1 μg with the AeroChamber Max, without and with wash/rinse pretreatment, respectively, and 28.5 ± 2.4 μg with the prewashed AeroChamber Plus.

CONCLUSIONS:

We think the small differences we observed are unlikely to be of clinical importance, given the inter-patient variability seen with inhaled drug delivery. The performance of the AeroChamber Max was substantially comparable whether or not it was prewashed.