levalbuterol

Generic Name: levalbuterol (leh val BYOO ter all)

Brand Names: Xopenex, Xopenex Concentrate, Xopenex HFA

What is levalbuterol inhalation?

Levalbuterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Levalbuterol inhalation is used to treat reversible obstructive airway conditions such as asthma, bronchitis, and emphysema.

Levalbuterol inhalation may also be used for conditions other than those listed in this medication guide.

What is the most important information I should know about levalbuterol inhalation?

Do not use more of this medication, or use doses more frequently, than directed by your doctor. Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

It is very important that you use nebulized levalbuterol properly, so that the medicine gets into the lungs. Talk to your doctor about proper nebulizer use.

What should I discuss with my healthcare provider before using levalbuterol inhalation?

Before using levalbuterol inhalation, tell your doctor if you have

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  heart disease, an irregular heartbeat, or high blood pressure;

  
  


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  a seizure disorder;

  
  


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  diabetes; or

  
  


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  an overactive thyroid (hyperthyroidism).

  
  

You may not be able to use levalbuterol inhalation or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Levalbuterol inhalation is in the FDA pregnancy category C. This means that it is not known whether levalbuterol inhalation will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant. It is not known whether levalbuterol passes into breast milk. Do not use levalbuterol inhalation without first talking to your doctor if you are breast-feeding a baby. Levalbuterol inhalation is not approved for use by children younger than 6 years of age.

How should I use levalbuterol inhalation?

Use levalbuterol inhalation exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

To use the solution for nebulization:

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  Open one vial by tearing on the serrated edge along the seam of the foil pouch. Remove one unit-dose vial for immediate use. Keep the rest of the unused unit-dose vial in the foil pouch to protect them from light. Carefully twist open the top of one unit-dose vial and squeeze the entire contents into the nebulizer reservoir (drug chamber).

  
  


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  Attach the nebulizer reservoir to the mouthpiece or face mask. Then, attach the nebulizer to the compressor. Sit upright, in a comfortable position, and put the mouthpiece into your mouth or put the face mask on, covering the nose and mouth. Turn on the compressor. Breathe slowly, deeply, and evenly until all of the medicine has been inhaled (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.

  
  


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  Clean the nebulizer after a treatment as directed by the manufacturer.

  
  

If you also use a steroid inhaler, use your levalbuterol nebulization solution first to open up your airways, then use the steroid inhaler as directed.

Do not mix other medicines for nebulization with a dose of levalbuterol unless specifically directed to do so by your doctor.

It is very important that you use nebulized levalbuterol properly, so that the medicine gets into your lungs. Talk to your doctor about proper nebulizer use.

Do not use more of this medication, or use doses more frequently, than directed by your doctor. Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack. Store levalbuterol in the protective foil pouch at room temperature, protected from light and excessive heat. Once the foil pouch is opened, the vials should be used within two weeks. Once an individual vial is removed from the foil pouch, if it is not to be used immediately, it should be protected from light and used within one week. Once an individual vial is opened, it should be used immediately or discarded. Discard the vial if the solution is not colorless.

What happens if I miss a dose?

Use the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a levalbuterol overdose include angina or chest pain, irregular heartbeats or a fluttering heart, seizures, tremor, nervousness, weakness, headache, dry mouth, dizziness, sleeplessness, nausea, and vomiting.

What should I avoid while using levalbuterol inhalation?

Avoid situations that may make your condition worse such as exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens such as pet fur.

Levalbuterol inhalation side effects

Stop using levalbuterol inhalation and seek emergency medical attention if you experience any of the following serious side effects:

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  an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  
  


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  worsening of respiratory symptoms (shortness of breath, wheezing); or

  
  


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  chest pain or irregular heartbeats.

  
  

Other, less serious side effects may be more likely to occur. Continue to use levalbuterol inhalation and talk to your doctor if you experience

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  dizziness;

  
  


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  tremor or nervousness;

  
  


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  anxiety;

  
  


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  headache;

  
  


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  cough or runny nose;

  
  


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  upset stomach; or

  
  


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  leg cramps.

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Levalbuterol Dosing Information

Usual Adult Dose for Asthma -- Acute:

Nebulization: 0.63 mg three times daily, every 6 to 8 hours.
Inhalation Aerosol: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Usual Adult Dose for Asthma -- Maintenance:

Nebulization: 0.63 mg three times daily, every 6 to 8 hours.
Inhalation Aerosol: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Usual Adult Dose for Chronic Obstructive Pulmonary Disease -- Acute:

Nebulization: 0.63 mg three times daily, every 6 to 8 hours.
Inhalation Aerosol: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Usual Adult Dose for Chronic Obstructive Pulmonary Disease -- Maintenance:

Nebulization: 0.63 mg three times daily, every 6 to 8 hours.
Inhalation Aerosol: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Usual Pediatric Dose for Asthma -- Acute:

Inhalation Aerosol:
>= 4 years: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Nebulization:
6 years to 12 years: 0.31 mg three times daily, every 6 to 8 hours.
>12 years: 0.63 mg three times daily, every 6 to 8 hours.

Patients with more severe disease or patients who do not respond to a dose of 0.63 mg may benefit from a dose of 1.25 mg three times a day.

Usual Pediatric Dose for Asthma -- Maintenance:

Inhalation Aerosol:
>= 4 years: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Nebulization:
6 years to 12 years: 0.31 mg three times daily, every 6 to 8 hours.
>12 years: 0.63 mg three times daily, every 6 to 8 hours.

Patients with more severe disease or patients who do not respond to a dose of 0.63 mg may benefit from a dose of 1.25 mg three times a day.

Usual Pediatric Dose for Chronic Obstructive Pulmonary Disease -- Acute:

Inhalation Aerosol:
>= 4 years: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Nebulization:
6 years to 12 years: 0.31 mg three times daily, every 6 to 8 hours.
>12 years: 0.63 mg three times daily, every 6 to 8 hours.

Patients with more severe disease or patients who do not respond to a dose of 0.63 mg may benefit from a dose of 1.25 mg three times a day.

Usual Pediatric Dose for Chronic Obstructive Pulmonary Disease -- Maintenance:

Inhalation Aerosol:
>= 4 years: 2 inhalations (90 mcg) every 4 to 6 hours. In some patients, one inhalation (45 mcg) every 4 hours maybe sufficient.

Nebulization:
6 years to 12 years: 0.31 mg three times daily, every 6 to 8 hours.
>12 years: 0.63 mg three times daily, every 6 to 8 hours.

Patients with more severe disease or patients who do not respond to a dose of 0.63 mg may benefit from a dose of 1.25 mg three times a day.

What other drugs will affect levalbuterol inhalation?

Before using levalbuterol inhalation, tell your doctor if you are taking any of the following medicines:

• a beta-blocker such as atenolol (Tenormin),acebutolol (Sectral), bisoprolol (Zebeta), carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), propranolol (Inderal), and others;


• a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), and others;


• a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);


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  a diuretic (water pill) such as hydrochlorothiazide (HCTZ, HydroDiuril, Microzide, others), chlorothiazide (Diuril), chlorthalidone (Hygroton, Thalitone), furosemide (Lasix), bumetanide (Bumex), ethacrynic acid (Edecrin), torsemide (Demadex), and others;

  
  


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  digoxin (Lanoxin);

  
  


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  another inhaled bronchodilator; or

  
  


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  caffeine, diet pills, or decongestants.

  
  

You may not be able to use levalbuterol inhalation, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with levalbuterol inhalation or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

More levalbuterol resources

• Levalbuterol Side Effects (in more detail)
• Levalbuterol Dosage
• Levalbuterol Use in Pregnancy & Breastfeeding
• Levalbuterol Drug Interactions
• Levalbuterol Support Group
• 11 Reviews for Levalbuterol - Add your own review/rating

• levalbuterol Inhalation, oral/nebulization Advanced Consumer (Micromedex) - Includes Dosage Information


• Levalbuterol Professional Patient Advice (Wolters Kluwer)


• Levalbuterol Prescribing Information (FDA)


• Levalbuterol Monograph (AHFS DI)


• Levalbuterol Aerosol MedFacts Consumer Leaflet (Wolters Kluwer)


• Xopenex Prescribing Information (FDA)


• Xopenex Consumer Overview


• Xopenex Solution MedFacts Consumer Leaflet (Wolters Kluwer)


• Xopenex HFA Prescribing Information (FDA)

Compare levalbuterol with other medications

• Asthma, acute
• Asthma, Maintenance
• COPD, Acute
• COPD, Maintenance

Where can I get more information?

• Your pharmacist has additional information about levalbuterol inhalation written for health professionals that you may read.

See also: levalbuterol side effects (in more detail)