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Spiriva Handihaler vs. Xopenex

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Spiriva (tiotropium) and levalbuterol (Xopenex) are both inhaled medications used to help with breathing problems, but they work differently and are used for different purposes. Spiriva is a long-acting muscarinic antagonist (LAMA) that helps control chronic obstructive pulmonary disease (COPD) and asthma by relaxing the muscles in your airways. Spiriva Respimat is a metered-dose inhaler, while Spiriva Handihaler is an inhaler that requires you to place a capsule of the medication into the device before using it. Both are typically used once a day, but only Spiriva HandiHaler is available in a generic form. On the other hand, levalbuterol is a short-acting beta agonist (SABA) that treats sudden wheezing or shortness of breath in people with asthma. It works quickly, usually within minutes, and is used three times a day with a nebulizer. Levalbuterol is also available as a lower-cost generic. While Spiriva is not a rescue inhaler and takes time to show effects, levalbuterol acts fast to relieve acute symptoms. Both medications have side effects, but they differ; for example, Spiriva can cause dry mouth and upper respiratory infections, while levalbuterol can cause headaches and runny nose.

Spiriva

(tiotropium)

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Levalbuterol

(Xopenex)

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Summary for Spiriva Handihaler

Prescription only

Spiriva (tiotropium) is a medication used to help control chronic obstructive pulmonary disease (COPD) and asthma. There are two different Spiriva inhalers: Spiriva Respimat is a metered-dose inhaler, and Spiriva HandiHaler is a device that you place a capsule of medication into before you take the medication. The typical dosage for Spiriva (tiotropium) is two inhalations once a day, but the dose depends on the reason you're using it. Side effects include dry mouth, cough, and upper respiratory tract infections. Only Spiriva HandiHaler is also available as a generic version.

Indications for Spiriva Handihaler

  • Chronic obstructive pulmonary disease (COPD)
  • Asthma in people age 6 years and older - Spiriva Respimat only

Pros and Cons for Spiriva Handihaler

Pros

  • Helps prevent attacks or flare-ups
  • Has few side effects
  • Used once daily
  • Doesn't commonly cause a fast heart rate like some other bronchodilators
  • Available as a lower-cost generic (Spiriva HandiHaler only)

Cons

  • Doesn't work fast enough to be used as a rescue inhaler for attacks
  • Can be difficult for some people to use
  • Can cause dry mouth as a side effect
  • Only Spiriva Respimat can be used for asthma in children 6 years and older
  • Spiriva Respimat is currently only available as brand name

Common Side Effects for Spiriva Handihaler

Spiriva HandiHaler and generic

Spiriva Respimat

  • Sore throat (12%)
  • Cough (6%)
  • Dry mouth (4%)
  • Sinus inflammation (3%)

Warnings for Spiriva Handihaler

  • Not a rescue inhaler
  • Allergic reaction
  • Sudden airway tightening (paradoxical bronchospasm)
  • Worsening glaucoma
  • Urination problems
  • Higher risk for side effects in people with kidney problems

Summary for Xopenex

Prescription only

Levalbuterol inhalation solution (also known by its brand name, Xopenex) is a short-acting beta agonist (SABA). It's used to treat and prevent sudden wheezing or shortness of breath in people with certain breathing problems, such as asthma. This medication is for adults and children ages 6 years and older. Levalbuterol (Xopenex) inhalation solution is inhaled through the mouth with a nebulizer machine. Side effects of this medication include headache, sore throat, and runny nose. It's available as a lower-cost generic.

Indications for Xopenex

  • Treatment or prevention of wheezing or tightening of airways in people ages 6 years and older with certain types of lung problems (e.g., asthma)

Pros and Cons for Xopenex

Pros

  • Works well for relieving wheezing or shortness of breath
  • Quickly opens up the airways
  • Can use for children as young as 6 years old

Cons

  • Takes about 5 to 15 minutes to take the whole dose
  • Need to use with a nebulizer machine, which isn't ideal for someone who is traveling
  • Need to inhale 3 times daily, so not a long-acting medication

Common Side Effects for Xopenex

Ages 12 years and older:

  • Viral infection (7-12%)
  • Runny nose (3-11%)
  • Nervousness (3-10%)

Ages 6 to 11 years:

  • Headache (8-12%)
  • Runny nose (6-10%)
  • Sore throat (3-10%)
  • Asthma (6-9%)
  • Viral infection (8-9%)
  • Rash (up to 8%)
  • Diarrhea (2-6%)

Warnings for Xopenex

  • Breathing problems
  • Heart problems
  • Allergic reactions
  • Low potassium in the blood
  • Only take as directed

Prices with our coupons for Spiriva Handihaler vs. Xopenex

Price Card Drug Icon
Tiotropium1 inhaler / 30 capsules of 18mcg per capsule
$76.57$369.84
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Levalbuterol25 vials / 3ml of 1.25mg/3ml
$31.50$70.36
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