Xopenex is not that much more selective for beta 2 receptors. You should be fine with both - you'll experience beta 2 effects on the heart before beta 1 either way (tachycardia and maybe tremors).

I, for years, had to use albuterol inhalers before riding. I have both exercise and cold induced asthma. I've been hospitalized for asthma.

My pharmacist recommended that I discuss Advair with my doctor. I did, he didn't want to prescribe it since he said it was no more effective than the albuterol inhalers and more expensive ($100/month vs $20 per month or so). Well, he was way, way wrong. Since using the Advair for the last 5 years, I no longer even own an albuterol inhaler (or any rescue inhaler for that matter). A single dose twice a day of the Advair and I am completely symptom free.

Sometimes, it's better to talk to the medications experts or at least to get the docs talking to the pharmacists. Getting them to collaborate on solving your problem is likely the best way to go.

J.

I currently use ProAir inhalers, which is essentially albuterol. Thankfully the asthma only affects physical activity for me when it is really cold, but I rarely have any issues in the summer. Spring and fall can be tough due to allergy seasons, though. My asthma has gotten better over the years: I went from needing a nebulizer 3+ times per day when I was younger to now using an inhaler only as needed (and I can often go weeks at a time without it in warm months).

The fact that you don't have any issues until after your ride is quite odd, and I think I'm going to join the others and say try new treatments. I've been on Singulair before and don't think it did much for me, though, and inhalers have been the best route the last few years.

this thread has answered a lingering question for the past few weeks. I have never been subject to asthma, and worked for many years in dusty contaminate environments. I just thought it was from finally expelling more of the garbage lodged in my lungs over the years. My coughing fits don't last long, but they are there after an intense climb.