Levalbuterol - Medication Detail

Medication Type:  Quick relief, not recommended for everyday use

Generic Names:  Levalbuterol

Brand Names:  Xopenex®, Xopenex® HFA, Xopenex® Concentrate

Description:  This medication is an inhaler or nebulized solution that is used for quick relief from asthma symptoms and for treating asthma attacks. It causes the muscles around the airways to relax, opening them for easier breathing.

Delivery

Inhaled nebulization solution, MDI (metered dose inhaler)

Spacer

Xopenex® HFA can be used with a spacer.

Dosage

Adults
Intermittent symptom relief:

  • Metered-dose inhaler: 2 puffs every 4 to 6 hours as needed
  • Solution for nebulization: 0.63 to 1.25mg every 6 to 8 hours as needed, up to 3 doses per 24 hours

Asthma attack

  • Metered-dose inhaler: 2 to 4 puffs every 20 minutes for 3 doses, then every 1 to 4 hours if responding
  • Solution for nebulization: 1.25mg every 20 minutes for 3 doses, then every 1 to 4 hours if responding

Pediatrics:
Intermittent symptom relief:

  • Metered-dose inhaler: 2 puffs every 4 to 6 hours as needed
  • Solution for nebulization:
    -Infants and children to 4 years: 0.31 to 1.25mg every 4 to 6 hours as needed
    -Children 5 to less than 12 years: 0.31 to 0.63mg every 8 hours as needed
    -Children 12 years and older, and adolescents: 0.63 to 1.25mg every 6 to 8 hours as needed (max 3 doses in 24 hours)

Asthma attack

  • Metered-dose inhaler
    -Infants and Children: 4 to 8 puffs every 20 minutes for 3 doses, then every 1 to 4 hours
    -Adolescents: 4 to 8 puffs every 20 minutes for up to 4 hours, then every 1 to 4 hours as needed
  • Solution for nebulization
    -Infants and Children: 1.25mg every 20 minutes for 3 doses, then 1.25mg to 5mg dose every 1 – 4 hours as needed.
    -Adolescents: 1.25 to 2.5 mg every 20 minutes for 3 doses, then 1.25 to 5 mg every 1 to 4 hours as needed

Use in young children should be discussed with your doctor.

Your provider may use this medication at different doses, especially if you have severe asthma attacks. Follow the instructions your provider gives you for using this medication.

Get help right away if you cannot get your asthma attack under control.

Proper Use

For proper inhaler technique visit our inhaler page.

For information on the correct use of nebulizers, visit our nebulizer page.

Metered-dose inhaler:  Shake well before use, avoid spraying in the eyes; prepare before first use or if it has not been used for 3 days by spraying 4 test sprays into the air. Clean actuator (mouthpiece) weekly with warm water and allow to air day. A spacer device or valved holding chamber is recommended when using a metered-dose inhaler. Breathe out and place the open end of the mouthpiece into your mouth. Close lips around mouthpiece. Breathe in slowly and deeply through the mouthpiece while pressing down once on the canister to spray the medication. Remove the inhaler and hold your breath for 10 seconds then breathe out slowly. Wait 1 minute between each puff if you need multiple puffs. Do not use the “float test” to test if canister is empty.

Solution for nebulization:  Remove one vial of solution from foil pouch, and leave the rest of the vials in the foil pouch until you are ready to use them. Make sure the liquid is clear and colorless. Do not use if it is cloudy or colored. Twist the top off the vial and squeeze the liquid into the nebulizer reservoir. If you are using the concentrated solution, it must be mixed with saline solution before inhaled; check with your doctor or pharmacist for instructions. Connect the nebulizer reservoir to the mouthpiece or face mask. Connect the nebulizer to the compressor. Place the mouthpiece in your mouth or put on the mask and breathe in calmly and deeply for 5 to 15 minutes until mist stops forming in the nebulizer chamber. Clean your nebulizer according to manufacturer’s instructions after use.

Precautions

Tell your doctor if you have any heart conditions (including high blood pressure or an irregular heartbeat/arrhythmia), a history of seizures, hyperthyroidism, or diabetes.

Common Interactions

This drug interacts with beta blockers, citalopram, amiodarone, and other medications.

Tell your doctor and pharmacist about all of your medications and health problems so they can check for any interactions.

Possible Side Effects

Possible side effects include runny nose, vomiting, shakiness, nervousness, sore throat, headache, and mild dizziness.

Tell your doctor or seek medical attention if you have a racing or irregular heartbeat, severe dizziness, fainting, or a bad headache.

Proper Storage

Xopenex nebulizer solution:

  • Keep unopened vials in foil pouch at room temperature.
  • Do not store in a bathroom.
  • Throw away any part of an opened pouch that is not used after 2 weeks.
  • Do not use if solution changes color.
  • If removed from foil pouch and not used immediately, protect vial from light and heat and use within 1 week.

Xopenex HFA aerosol:

  • Store at room temperature.
  • Do not store in a bathroom.
  • Store inhaler with the actuator (mouthpiece) down.
  • Keep HFA inhaler away from open flame. Do not puncture canister. Do not store in extreme temperatures, such as in a parked car.
  • Discard after 200 sprays (if you have a 15 gram canister) or 80 sprays (if you have an 8.4 gram canister). (NOTE: device will continue to spray after 200 sprays, but no medication is left.)