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Overview: Levalbuterol is used by people who have a hard time breathing due to certain lung conditions. It comes as an inhaler and as a nebulized solution. Levalbuterol works by relaxing the muscles in your lungs. Common side effects include nervousness, tremors, headache, dizziness, a fast heartbeat, or a feeling of skipped heartbeats. Make sure you understand how to properly prepare, use, and clean the levalbuterol product you are using.

Uses

What is levalbuterol used for?

Levalbuterol is commonly used in people who have a hard time breathing due to certain lung conditions, such as asthma.

Levalbuterol may also be used for other conditions as determined by your health care provider.

How does levalbuterol work (mechanism of action)?

Levalbuterol relaxes the muscles in your lungs, making it easier to breathe.

How is levalbuterol supplied (dosage forms)?

Brands and other names

  • Xopenex
  • Xopenex HFA

Dosage forms and strengths

  • 45 mcg/actuation aerosol metered-dose inhaler
  • 0.31 mg/3 mL, 0.63 mg/3 mL, 1.25 mg/3 mL, 1.25 mg/0.5 mL nebulizer solution

How should I store levalbuterol?

Inhaled Spray. Levalbuterol inhaler should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Do not freeze the medicine or expose it to heat, flames, or direct sunlight. Keep the cap on the inhaler when it is not being used. Store the inhaler standing up, with the cap and mouthpiece on the bottom.

Nebulizer Solution. Levalbuterol nebulizer solution should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from light and excessive heat. Store levalbuterol vials in the foil pouch when not in use. If the foil pouch contains only one vial, do not open the foil pouch until you are ready to use the vial. If the foil pouch contains more than one vial, the vials must be used within two weeks after opening the pouch. If a vial is removed from the foil pouch and not used right away, it must be protected from light and used within one week. 

Ask your pharmacist if you are not sure how to store your levalbuterol product.

Side Effects

What are the most common side effects of levalbuterol?

The most common side effects of levalbuterol are listed below. These side effects may vary depending on the specific levalbuterol product you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Feeling of skipped heartbeats
  • Chest pain
  • Fast heartbeat
  • Headache
  • Dizziness
  • Tremor, shaking, or nervousness
  • Sore throat
  • Runny nose or stuffy nose
  • Vomiting
  • Inflammation of the airways (bronchitis)

There may be other side effects of levalbuterol that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of levalbuterol?

While less common, the most serious side effects of levalbuterol are described below, along with what to do if they happen.

Severe Allergic Reactions. Levalbuterol may cause allergic reactions, which can be serious. Stop using levalbuterol and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Sudden Breathing Problems. Levalbuterol may cause the muscles around your airways to tighten (bronchospasm) right after you use it instead of relaxing these muscles. In some cases, this can be serious. Stop using levalbuterol and contact your health care provider right away if your breathing gets worse instead of better right after using levalbuterol.

Heart Effects. Levalbuterol may increase your risk of certain effects on the heart, such as raising your heart rate or blood pressure. If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Also call your health care provider or get medical attention right away if you have chest pain, a fast or irregular heartbeat, or if you feel your heartbeat more than usual.

Low Potassium Levels (Hypokalemia). Levalbuterol can cause a low potassium level, which can be serious and may lead to death. Your health care provider may check your potassium levels, especially if you take certain other medicines. Keep all appointments to have your blood checked. Call your health care provider if you have any of the following symptoms of a low potassium level.

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation

Warnings & Precautions

Who should not use levalbuterol?

Allergies to Ingredients. People who are allergic to any of the following should not use levalbuterol.

  • Albuterol
  • Levalbuterol
  • Xopenex
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific levalbuterol products they stock.

What should I know about levalbuterol before using it?

Do not use levalbuterol unless it has been prescribed to you by a health care provider. Use it as prescribed. Using levalbuterol more often than prescribed may increase the risk of serious side effects.

Do not share levalbuterol with other people, even if they have the same condition as you. It may harm them.

Keep levalbuterol out of the reach of children.

This medicine is inhaled into your mouth. There are multiple forms of levalbuterol available. Read and follow the instructions for the product you have and make sure you understand how to prepare and use it properly. If you have any questions, talk to your health care provider.

If you are using a special breathing machine called a nebulizer for your levalbuterol, talk to your health care provider about how to use and clean the machine. Follow the instructions that come with your machine. 

If you are using a levalbuterol inhaler, shake the inhaler well before each use. Make sure that you or a caregiver understands how to clean your levalbuterol inhaler.

Tell your health care provider right away if your breathing problems have gotten worse or you need to use levalbuterol more often than before. Your health care provider may give you another medicine to help. 

What should I tell my health care provider before using levalbuterol?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if levalbuterol is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Diabetes
  • Heart problems
  • High blood pressure
  • Low potassium levels
  • Seizures
  • Thyroid problems

Other Medicines and Supplements. Levalbuterol may interact with other medicines and supplements. Before using levalbuterol, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how levalbuterol could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. 

Breastfeeding. It is not known if levalbuterol passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use levalbuterol while breastfeeding.

Interactions

Does levalbuterol interact with foods or drinks?

There are no known interactions between levalbuterol and foods or drinks.

It is unknown if drinking alcohol will affect levalbuterol.

Does levalbuterol interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using levalbuterol.

  • Any other medicines for asthma or other breathing problems, including other inhaled medicines
  • A beta-blocker, such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL, and others), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to lower blood pressure
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Digoxin (Lanoxin), which is a medicine used to treat an irregular heartbeat and some types of heart failure
  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
  • A tricyclic antidepressant within the past two weeks, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression

This may not be a complete list of medicines that can interact with levalbuterol. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much levalbuterol?

If you or someone else has used too much levalbuterol, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of levalbuterol?

If you use levalbuterol on a regular schedule and you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. If you use levalbuterol only when needed, use it as your health care provider recommends. Do not use double or extra doses.

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