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
Side effects of Levalbuterol (Xopenex) inhalation solution
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
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%)
Less Common Side Effects
Ages 12 years and older:
- Pain
- Leg cramps
- Fast heart rate
- Migraine
- Indigestion
- Dizziness
- Anxiety
- Tremor (shakiness)
- Sinus infection
Ages 6 to 11 years:
- Stomach pain
- Weakness
- Hives
- Pain
Levalbuterol (Xopenex) inhalation solution 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
- Low potassium levels: muscle cramps or weakness, skipped heartbeats, feeling tired
The following Levalbuterol (Xopenex) inhalation solution 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) 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.
Common questions about Levalbuterol (Xopenex) inhalation solution
Studies show levalbuterol (Xopenex, 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) inhalation solution 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) inhalation solution. The inhaled steroid and levalbuterol (Xopenex) inhalation solution work in different ways to help keep your airways open.
Levalbuterol (Xopenex) inhalation solution is a short-acting bronchodilator. It starts to work within minutes and usually lasts 6 to 8 hours.
Typically, your provider will ask you to use levalbuterol (Xopenex) inhalation solution 3 times a day, with 6 to 8 hours in between each dose. Don't use this medication more often than recommended because it can raise your risk for side effects such as runny nose, tremors, or headache.
Yes, levalbuterol (Xopenex) inhalation solution can raise your heart rate. But usually, your heart rate won't change by much if you're taking this medication as directed. Make sure to use the medication as prescribed by your provider at the recommended doses. Tell your provider if you have heart rate problems (e.g., atrial fibrillation (or Afib)) before starting levalbuterol (Xopenex) inhalation solution. If you do experience a fast heart rate from levalbuterol (Xopenex) inhalation solution, your provider might need to prescribe you a different breathing medication.
Levalbuterol (Xopenex) inhalation solution might affect your blood pressure, but it's very unlikely if you take it at the dose directed by your provider. A small study in children using levalbuterol (Xopenex) inhalation solution found no notable changes to blood pressure. But levalbuterol (Xopenex) inhalation solution might cause more noticeable changes in blood pressure if you take a much higher dose than recommended. To be safe, if you have high blood pressure, tell your provider before starting levalbuterol (Xopenex) inhalation solution.
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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
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 0.5ml of 1.25mg/0.5ml | 60 vials | $52.83 | $0.88 |
| 3ml of 0.31mg/3ml | 25 vials | $21.01 | $0.84 |
| 3ml of 0.63mg/3ml | 25 vials | $27.84 | $1.11 |
| 3ml of 1.25mg/3ml | 25 vials | $25.00 | $1.00 |
Typical dosage 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
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) inhalation solution 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) inhalation solution will not be safe for you to take.
- Allergy to levalbuterol (Xopenex) inhalation solution or albuterol
What are alternatives to Levalbuterol (Xopenex) inhalation solution?
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