levalbuterol
Levalbuterol (also known by its brand name, Xopenex HFA) is a rescue inhaler used for the treatment or prevention of sudden wheezing or shortness of breath in people with certain breathing problems, such as asthma. This medication is for adults and children ages 4 years and older. It's inhaled through the mouth and the typical dose is 1 to 2 puffs every 4 to 6 hours. Levalbuterol (Xopenex HFA) can cause side effects such as sore throat and runny nose. It's available as a lower-cost generic.
What is Levalbuterol (Xopenex HFA)?
What is Levalbuterol (Xopenex HFA) used for?
- Treatment or prevention of wheezing or tightening of airways in people with certain types of lung problems (e.g., asthma)
How Levalbuterol (Xopenex HFA) works
Levalbuterol (Xopenex HFA) is a short-acting beta-agonist (SABA). It relaxes the muscles in your lungs to open up your airways, making it easier to breathe.
Drug facts
More on Levalbuterol (Xopenex HFA) essentials
Side effects of Levalbuterol (Xopenex HFA)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
-
People ages 12 years and older:
- Asthma (9%)
- Sore throat (8%)
- Runny nose (7%)
- Body pain (4%)
- Dizziness (3%)
-
Children ages 4 to 11 years old:
- Vomiting (11%)
- Sore throat (7%)
- Bronchitis (3%)
Less Common Side Effects
- Nervousness
- Tremor
- Chest pain
- Dizziness
- Cough
- Hoarseness
Levalbuterol (Xopenex HFA) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reaction: hives, swelling of your face or tongue, difficulty breathing
- Sudden narrowing of your airways: difficulty breathing, wheezing, chest pain or tightness, cough
- Heart problems: dizziness, fatigue, weakness, tremor, irregular heartbeat, worsening symptoms of heart problem you already have
The following Levalbuterol (Xopenex HFA) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Fast heartbeat
Incidence not known
Confusion
difficult or labored breathing
difficulty swallowing
drowsiness
extra heartbeat
fainting
fast, pounding, slow, or irregular heartbeat or pulse
hives, welts, itching, or rash
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
noisy breathing
rapid, deep breathing
redness of the skin
restlessness
stomach cramps
unusual tiredness or weakness
vomiting
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
dizziness
general feeling of discomfort or illness
headache
impaired consciousness
irregular or fast heartbeat
lightheadedness
nervousness
seizures
sweating
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Accidental injury (in children 4 to 11 years of age)
body aches or pain
chills
congestion
dryness or soreness of the throat
general aches and pains
headache
hoarseness
increased cough
leg cramps
loss of appetite
migraines or other headaches
muscle tightness
nervousness
runny or stuffy nose
Less common
Abnormal growth filled with fluid or semisolid material
blemishes on the skin
blood in the urine
bloody nose
burning, dry, or itching eyes
burning or stinging of the skin
cough producing mucus
cramps
difficulty having a bowel movement
discharge from the eye
dry mouth or throat
ear pain
excessive tearing
eye itch
night sweats
numbness or decreased sensitivity of the hand
painful cold sores or blisters on the lips, nose, eyes, or genitals
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
stomach pain
tingling sensation in the arms or legs
vaginal yeast infection
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Levalbuterol (Xopenex HFA)
Pros
- Works within minutes to help you breathe easier
- Only used as needed
- Safe for children as young as 4 years old
Cons
- Not a long-acting treatment for asthma
- Some people might find the inhaler difficult to use
- Not the best choice if you have a history of an allergic reaction to albuterol
Pharmacist tips for Levalbuterol (Xopenex HFA)
- Carefully read the instructions on how to use your levalbuterol (Xopenex HFA) inhaler and ask your provider or pharmacist if you have any questions.
- If you're using a new levalbuterol (Xopenex HFA) inhaler for the first time or if you haven't used it in more than 3 days, you'll need to prime your inhaler to make sure you get the full dose. To prime the levalbuterol (Xopenex HFA) inhaler, shake the inhaler well, hold it upright and away from your face, and spray 4 times.
- Shake levalbuterol (Xopenex HFA) well for about 5 seconds before each dose. This makes sure the medication is mixed well so you receive the correct dose.
- When you're ready to use levalbuterol (Xopenex HFA), place your lips firmly around the mouthpiece. Then, take a slow and deep breath while pushing the button on the top of the canister to deliver the medication. Try to hold your breath for up to 10 seconds or for as long as you comfortably can. This allows time for levalbuterol (Xopenex HFA) to reach deep into your lungs.
- If you need to inhale more than one puff of levalbuterol (Xopenex HFA), wait at least 1 minute between inhalations.
- Clean the mouthpiece of levalbuterol (Xopenex HFA) at least once a week. To do so, remove the cap and canister and set them aside. Then rinse the mouthpiece with warm running water for at least 30 seconds. Shake it and let it air dry fully before reassembling your inhaler.
- If you're having a hard time using your levalbuterol (Xopenex HFA), ask your provider about a spacer. Spacers are devices that you can attach to your levalbuterol (Xopenex HFA) inhaler to make it easier for you to inhale the medication.
- Call your provider if your breathing worsens or you're not responding to levalbuterol (Xopenex HFA). Also contact your provider if you're using your rescue inhaler more often than usual. These could be signs you need a change in your breathing medications.
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Common questions about Levalbuterol (Xopenex HFA)
Studies show levalbuterol (Xopenex HFA) and albuterol (Proair, Ventolin) both work similarly well at controlling sudden breathing problems. In addition, they both cause similar side effects, such as throat irritation and fast heart rate. Healthcare providers typically choose between both medications based on factors like risk of fast heart rate, preference, availability, cost, and what your insurance covers.
No, levalbuterol (Xopenex HFA) isn't a steroid; it's a short-acting beta-agonist (SABA). But your provider might prescribe an inhaled steroid for you to use in addition to levalbuterol (Xopenex HFA) inhaler. The inhaled steroid should be used every day to help keep your airways open, while levalbuterol (Xopenex HFA) inhaler is only as needed to treat sudden trouble breathing.
Yes, levalbuterol (Xopenex HFA) is a rescue inhaler that's used as needed to treat sudden shortness of breath in people with breathing problems. It's not a maintenance inhaler that needs to be taken every day. But, if you're needing to use levalbuterol (Xopenex HFA) multiple times per day, talk with your provider. They might need to make changes to your other breathing medications to better control your symptoms.
Levalbuterol (Xopenex HFA) is a short-acting bronchodilator. It starts to work within minutes and can last for up to 6 hours.
Levalbuterol (Xopenex HFA) rescue inhaler can be used every 4 to 6 hours, if needed. And if you need to use 2 puffs, wait 60 seconds between puffs.
Each brand new levalbuterol (Xopenex HFA) inhaler contains 200 puffs. There's a dose indicator window on the top of the inhaler that has the number of remaining puffs and a pointer. The dose indicator will count down after every 20 puffs. When there are only 20 puffs left, the display window will change to a red color. This means you should refill your inhaler prescription so you have a new levalbuterol (Xopenex HFA) inhaler ready.
Yes, it's possible for levalbuterol (Xopenex HFA) to raise your heart rate. But this side effect is rare if you only use this inhaler as prescribed by your provider at the recommended doses. Make sure to tell your provider if you have heart rate problems (e.g., atrial fibrillation (or afib)) before starting levalbuterol (Xopenex HFA). If you do experience a fast heart rate from using levalbuterol (Xopenex HFA), your provider might need to consider other medication options for you.
Levalbuterol (Xopenex HFA) might affect your blood pressure, but this side effect is very unlikely. A small study in children using levalbuterol (Xopenex HFA) found no notable changes to blood pressure. But there isn't a lot of research on how levalbuterol (Xopenex HFA) affects blood pressure. To be safe, if you have high blood pressure, tell your provider before starting levalbuterol (Xopenex HFA).
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Risks and warnings for Levalbuterol (Xopenex HFA)
Levalbuterol (Xopenex HFA) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Breathing problems
Although rare, levalbuterol (Xopenex HFA) can sometimes cause a muscle spasm in your lungs (bronchospasm). This can lead to difficulty breathing, wheezing, cough, and chest discomfort. If you still have trouble breathing right after using levalbuterol (Xopenex HFA), get medical help right away.
For some people, their asthma can worsen over time. If you find yourself needing to use more doses of levalbuterol (Xopenex HFA) than usual, let your provider know. They'll examine you to see if they need to make any changes to your asthma medications to better help you control symptoms.
Heart problems
- Risk factors: High blood pressure | Heart failure | Heart rate or rhythm problems | Using more levalbuterol (Xopenex HFA) than recommended
Levalbuterol (Xopenex HFA) might cause changes in your blood pressure, heart rate, and heart rhythm. But these side effects are extremely unlikely if you're only taking the recommended dose of levalbuterol (Xopenex HFA). If you have high blood pressure or other heart problems, your provider might ask you to check your blood pressure and heart rate regularly at home. Don't use levalbuterol (Xopenex HFA) more often than recommended. If so, let your provider know so they can see if they need to make changes to your breathing medications. Tell your provider if you feel dizziness, tiredness, tremor, fast heartbeat, or weakness after using levalbuterol (Xopenex HFA).
Allergic reactions
Allergic reactions to levalbuterol (Xopenex HFA) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using levalbuterol (Xopenex HFA).
Low potassium in the blood
- Risk factors: Using levalbuterol (Xopenex HFA) too much
Levalbuterol (Xopenex HFA) can cause the potassium levels in your blood to drop too low if you use more levalbuterol (Xopenex HFA) than recommended. Symptoms of low potassium include tiredness, weakness, muscle cramps or spasms, a racing heart, and a "pins and needles" feeling in your hands and feet. Typically, this is mild and your potassium level should return to your typical range on its own with time. If you find yourself needing to use levalbuterol (Xopenex HFA) more often than recommended, talk with your provider. They can let you know if they need to make changes to your asthma medications to better control your symptoms.
Levalbuterol (Xopenex HFA) dosage
Typical dosage for Levalbuterol (Xopenex HFA)
Each inhalation delivers 45 mcg of levalbuterol into the lungs.
- People ages 4 years and older: The typical dose is 1 to 2 inhalations through the mouth every 4 to 6 hours as instructed by your healthcare provider.
Interactions between Levalbuterol (Xopenex HFA) and other drugs
More on Levalbuterol (Xopenex HFA) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Albuterol
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Arotinolol
- Atenolol
- Befunolol
- Betaxolol
- Bevantolol
- Bisoprolol
- Bopindolol
- Bucindolol
- Bupranolol
- Butriptyline
- Carteolol
- Carvedilol
- Celiprolol
- Clomipramine
- Desipramine
- Dibenzepin
- Dilevalol
- Dothiepin
- Doxepin
- Epinephrine
- Esmolol
- Fenoterol
- Hexoprenaline
- Imipramine
- Iprindole
- Labetalol
- Landiolol
- Levobunolol
- Lofepramine
- Melitracen
- Mepindolol
- Methacholine
- Metipranolol
- Metoprolol
- Nadolol
- Nebivolol
- Nortriptyline
- Opipramol
- Oxprenolol
- Penbutolol
- Pindolol
- Practolol
- Propizepine
- Propranolol
- Protriptyline
- Sotalol
- Talinolol
- Tertatolol
- Tianeptine
- Timolol
- Trimipramine
- Tulobuterol
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Levalbuterol (Xopenex HFA) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Levalbuterol (Xopenex HFA) will not be safe for you to take.
- Allergy to levalbuterol (Xopenex HFA) or albuterol
What are alternatives to Levalbuterol (Xopenex HFA)?
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