levalbuterol
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.
What is Levalbuterol (Xopenex) inhalation solution?
What is Levalbuterol (Xopenex) inhalation solution used for?
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)
How Levalbuterol (Xopenex) inhalation solution works
Levalbuterol (Xopenex) inhalation solution 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
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What are the side effects of Levalbuterol (Xopenex) inhalation solution?
Common Side Effects
- Viral infection (7-12%)
- Runny nose (3-11%)
- Nervousness (3-10%)
- 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%)
Other Side Effects
- Pain
- Leg cramps
- Fast heart rate
- Migraine
- Indigestion
- Dizziness
- Anxiety
- Tremor (shakiness)
- Sinus infection
- Stomach pain
- Weakness
- Hives
- Pain
Serious Side Effects
- 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
- Low potassium levels: muscle cramps or weakness, skipped heartbeats, feeling tired
Source: DailyMed
The following 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.
Pros and cons of Levalbuterol (Xopenex) inhalation solution
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
Pharmacist tips for Levalbuterol (Xopenex) inhalation solution
Levalbuterol (Xopenex) inhalation solution is available in different dosage strengths: 0.31 mg/3 mL, 0.63 mg/3 mL, and 1.25 mg/3 mL. Make sure you know which strength you have and what your dose is. If you're not sure, ask your provider or pharmacist.
Carefully read the instructions on how to use levalbuterol (Xopenex) inhalation solution with a nebulizer machine. Ask your provider or pharmacist if you have any questions about using the medication.
Keep the vials of levalbuterol (Xopenex) inhalation solution solution in the original foil pouch and store at room temperature. After opening the pouch, keep any unused vials in the foil pouch to protect them from light.
Once the foil pouch is opened, the vials inside of it should be used within 2 weeks. If outside of the pouch, vials should be used within 1 week.
Before using each vial of levalbuterol (Xopenex) inhalation solution, check the solution to make sure it's colorless. If it's discolored, throw the vial away and use a new one to be sure it's safe for you to use.
Sit in a comfortable, upright position during your breathing treatment. Using the mouthpiece or face mask, breathe as calmly, deeply, and evenly as possible until there's no more mist in the nebulizer.
Clean your nebulizer after each time you use it. This helps prevent lung infections that can happen if you use a nebulizer machine that isn't cleaned well.
Call your provider if your breathing gets worse or doesn't improve after using levalbuterol (Xopenex) inhalation solution. Also contact your provider if you're using levalbuterol (Xopenex) inhalation solution more often than usual. These could be signs you need a change in your treatment plan for your breathing problem.
Levalbuterol (Xopenex) inhalation solution can interact with many medications, which can make your medications not work as well or raise your risk of harmful side effects. Some examples include blood pressure medications (e.g., beta blockers), antidepressants (e.g., tricyclic antidepressants), and the heart medication, digoxin (Lanoxin). Don't start any new medications while taking levalbuterol (Xopenex) inhalation solution without asking your provider or pharmacist first whether the combination is safe to take.
Frequently asked questions about Levalbuterol (Xopenex) inhalation solution
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What are the risks and warnings for Levalbuterol (Xopenex) inhalation solution?
Levalbuterol (Xopenex) inhalation solution 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) inhalation solution 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) inhalation solution, 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) inhalation solution 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. Sometimes, your provider might need to add on medications like inhaled corticosteroids to help you breathe better.
Heart problems
Risk factors: High blood pressure | Heart failure | Heart rate or rhythm problems | Using more levalbuterol (Xopenex) inhalation solution than recommended
Levalbuterol (Xopenex) inhalation solution might cause changes in your blood pressure, heart rate, and heart rhythm. But these side effects are unlikely if you're only taking the recommended dose of levalbuterol (Xopenex) inhalation solution. 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) inhalation solution more often than recommended. If you feel dizziness, tiredness, tremor, fast heartbeat, or weakness after using levalbuterol (Xopenex) inhalation solution as directed, let your provider know because they might need to make changes to your breathing medications.
Allergic reactions
Allergic reactions to levalbuterol (Xopenex) inhalation solution 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) inhalation solution.
Low potassium in the blood
Risk factors: Using levalbuterol (Xopenex) inhalation solution too much
Levalbuterol (Xopenex) inhalation solution can cause the potassium levels in your blood to drop too low. Your risk is higher if you use more levalbuterol (Xopenex) inhalation solution 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) inhalation solution 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.
Only take as directed
Don't take more than the recommended dose of levalbuterol (Xopenex) inhalation solution. Though extremely rare, there have been reports of death in people who took medications similar to levalbuterol (Xopenex) inhalation solution in doses much higher than directed by their provider. The cause of death isn't clear, but it's likely related to heart problems.
In addition, taking levalbuterol (Xopenex) inhalation solution can worsen certain conditions, including diabetes and heart-related problems. While this is rare, the risk is higher if you take this medication more often than recommended.
Levalbuterol (Xopenex) inhalation solution dosage forms
Typical dosing for Levalbuterol (Xopenex) inhalation solution
People ages 12 years and older: The typical dose ranges from 0.63 mg to 1.25 mg inhaled through a nebulizer three times a day, every 6 to 8 hours.
People ages 6 to under 12 years old: The typical dose is 0.31 mg inhaled through a nebulizer three times a day.
Interactions between Levalbuterol (Xopenex) inhalation solution and other drugs
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
How much does Levalbuterol (Xopenex) inhalation solution cost?
Levalbuterol (Xopenex) inhalation solution contraindications
Allergy to levalbuterol (Xopenex) inhalation solution or albuterol
What are alternatives to Levalbuterol (Xopenex) inhalation solution?
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)
Treatment of shortness of breath in people with chronic obstructive pulmonary disease (COPD) who need more than one bronchodilator
What is the latest news about Levalbuterol (Xopenex) inhalation solution?
Levalbuterol (Xopenex) inhalation solution images
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References
Best studies we foundAmeredes, B.T., et al. (2009). Levalbuterol versus albuterol. Current Allergy and Asthma Reports.
American Academy of Allergy, Asthma and Immunology. (n.d.). Bronchospasm defined.
Gawchik, S.M., et al. (1999). The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients. The Journal of Allergy and Clinical Immunology.
Jat, K.R., et al. (2013). Levalbuterol versus albuterol for acute asthma: A systematic review and meta-analysis. Pulmonary Pharmacology & Therapeutics.
Ritedose Pharmaceuticals, LLC. (2023). Levalbuterol- levalbuterol hydrochloride solution [package insert]. DailyMed.
Ritedose Pharmaceuticals, LLC. (2023). Levalbuterol- levalbuterol hydrochloride solution [package insert]. DailyMed.
Sockrider, M. (2020). Nebulizer breathing treatments at home. American Thoracic Society.
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