How to Use A Xopenex Inhaler, Plus 3 More Pharmacist-Backed Tips for Best Results

It’s easy to take breathing for granted. We breathe all day, and you may not notice or think about it until it becomes difficult. For people with asthma, chronic obstructive pulmonary disease (COPD), and other breathing conditions, this might be an everyday reality. 

Thankfully, inhaler medications can be used to open up your airways and make breathing easier. Xopenex (levalbuterol) is one example of an inhaler that treats symptoms of asthma and COPD. Knowing when and how to use a Xopenex inhaler is important to getting the most out of this medication. Here, we’ll review five tips for how to use this rescue inhaler.

Levalbuterol is available as an inhaler (Xopenex HFA) and an inhaled solution to use with a nebulizer. Here, we’ll focus on the inhaler, and simply refer to it as Xopenex.

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1. Knowing how to use the Xopenex inhaler will help you get the most out of your medication

To effectively use the Xopenex inhaler to relieve breathing problems, it’s important to know how to use it. Your pharmacist can show you in person how to use Xopenex when you pick it up from the pharmacy, but we’ll go through the general steps below.

Step 1: Priming

Before using a Xopenex inhaler, you may need to prime it. There are two situations where this is necessary: The first time you use a new Xopenex inhaler, and if you haven’t used your inhaler in 3 days or more.

To prime Xopenex, take the cap off the inhaler mouthpiece. Look to confirm that the mouthpiece is free of any objects or debris. Then, with the inhaler upright (the canister at the top) and the mouthpiece pointing away from your face, shake the inhaler a few times. Then spray it into the air four times. Now, your inhaler is ready to use.

Step 2: Using the inhaler

First, take the cap off the inhaler mouthpiece. Shake the inhaler for 5 seconds, then hold it upright. This means the mouthpiece is pointing towards your face. Then, follow the steps below:

1. Breathe out through your mouth, pushing out as much air from your lungs as possible. 

2. Put the mouthpiece in your mouth and create a seal with your lips. 

3. Press down on the canister, then breathe in slowly and deeply. After taking this breath, release the canister and remove the inhaler from your mouth. 

4. Hold your breath for 10 seconds. Then, breathe out gently. 

If you need a second dose, wait one minute in between doses. Always put the cap back on the mouthpiece once you’re done using the Xopenex inhaler.

If you’re struggling to use your Xopenex inhaler, or you’re administering the inhaler to your child, a device called a spacer may be useful. A spacer attaches to the mouthpiece and makes it easier for you to breathe in a dose.

Step 3: Cleaning

Be sure to clean your Xopenex inhaler at least once per week. To do so, remove the medication canister out of the actuator and take the cap off the mouthpiece. Using a faucet, run warm water through the actuator for at least 30 seconds. Then, flip the actuator upside down and rinse it again, this time running the water through the mouthpiece for at least 30 seconds. Check to make sure the actuator is clean and that there’s no medication build-up inside.

EXPERT PICKS: WHAT TO READ NEXT

• How are Xopenex and albuterol different? These two rescue inhalers have many similarities, but they also have a few differences. 

• What should you know about your rescue inhaler? Learn several facts about rescue inhalers, including whether they have side effects and drug interactions.

• How are rescue inhalers and long-acting inhalers different? Though these inhalers can treat the same health conditions, they’re used differently.

Shake off any excess water from the actuator and let it air dry overnight. Don’t put the medication canister back into the actuator, or the cap back on the mouthpiece, until it’s completely dry. 

However, if you need to use a dose before the actuator is dry, shake off as much water as you can. Then put the inhaler back together and give yourself a dose. Repeat the cleaning process again, letting the actuator dry completely before assembling the inhaler again.

If at any point you notice that little or no medication is coming out of the mouthpiece when you use the Xopenex inhaler, the actuator might be blocked. Repeat the cleaning steps discussed above to clear the actuator. 

2. You can use the Xopenex inhaler when you need it

The Xopenex inhaler is part of a group of inhalers called rescue inhalers. These inhalers work quickly to relieve breathing problems in people with asthma and COPD. This means you’ll use Xopenex as needed when asthma or COPD symptoms appear — such as coughing, wheezing, or difficulty breathing.

So how often you’ll use Xopenex depends on how severe your asthma is. This is different from the way maintenance inhalers are dosed. Maintenance inhalers are used every day and they’re meant to prevent asthma or COPD symptoms from starting. If you use Xopenex and a maintenance inhaler, make sure you can clearly tell which inhaler is which. If they look similar, consider labeling each inhaler.

Typically, the recommended Xopenex dosage is 2 inhalations when you feel asthma symptoms coming on, up to every 4 to 6 hours. Remember to wait at least 1 minute in between inhalations. Some people may only need to administer 1 inhalation per dose, so talk to your prescriber about the best dose for you.

If your Xopenex use has increased, or you find yourself needing Xopenex more often than every 4 to 6 hours, let your prescriber know. You may need changes to your medication regimen to better manage your asthma or COPD.

3. Xopenex and albuterol aren’t the same medication, and they shouldn’t be used together

Xopenex isn’t the only rescue inhaler on the market. Albuterol is another commonly used rescue inhaler. It comes as both a generic and as brand-name products, such as ProAir HFA and Ventolin HFA.

Albuterol contains a mixture of inactive and active forms of albuterol. Levalbuterol, the medication in the Xopenex inhaler, is the active form of albuterol. Both medications are considered similarly effective and safe. So what would make someone use levalbuterol over albuterol?

Levalbuterol and albuterol both come as a metered-dose inhaler (MDI) and inhalation solution. But albuterol also comes as a dry powder inhaler (ProAir Digihaler, ProAir RespiClick). Some people may prefer a dry powder inhaler because you don’t have to coordinate when you inhale the way you do with an MDI. In this case, albuterol may be a better option for you. Albuterol also tends to cost less and is more likely to be covered by insurance plans.

When it comes to side effects, both Xopenex and albuterol are known to increase heart rate and cause tachycardia (fast heart rate). Some research shows that tachycardia is more likely with albuterol. However, other research hasn't found a difference. Still, if you have a heart condition that could be worsened by tachycardia, such as an abnormal heart rhythm or severe heart failure, it's possible that your prescriber will recommend Xopenex over albuterol. You shouldn’t use the two medications together, since this can increase your risk of side effects without providing additional benefits.

4. There are ways to manage side effects from Xopenex

Xopenex side effects are usually mild. For example, sore throat is one of the most common side effects of the Xopenex inhaler. But often, a sore throat can be prevented by using the inhaler correctly. Breathe in as deeply as you can with each dose. This ensures Xopenex reaches your lungs rather than getting stuck in your throat, which could contribute to soreness. Additionally, using a spacer may help move Xopenex into your lungs quickly so less of it ends up in your throat.

A runny nose is also possible with Xopenex. Over-the-counter (OTC) antihistamines can help dry up your nose temporarily, such as Zyrtec (cetirizine) or Claritin (loratadine). A corticosteroid nasal spray like Flonase (fluticasone) is another option. But talk to your prescriber first before trying OTC medications to treat Xopenex side effects.

Xopenex can cause more serious side effects, but this is rare. This includes bronchospasm (narrowing of your airways) and worsening asthma. It can also increase your blood pressure and heart rate, so people with heart conditions may need to be monitored more closely if they’re using Xopenex. Let your prescriber know if you have any existing health conditions before starting Xopenex.

Tips for saving on Xopenex

If you have insurance, the generic Xopenex inhaler may be covered by your plan. Additionally, GoodRx can help you save on the generic version of Xopenex inhaler. At certain pharmacies, one inhaler may be as low as $58.16 with a free GoodRx discount.

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Written by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Soojin Jun, PharmD

Soojin has 10 years of experience in various pharmacy settings, from inpatient to outpatient settings, and population health in value-based healthcare models. She completed training in various areas of healthcare to ensure patient safety, from activism, geriatric pharmacy, medication safety, healthcare quality, patient safety, death and dying, and trauma-informed care.

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