Known interactions

No interactions found.

Introduction into Xopenex HFA

Brand Name(s): Xopenex HFA

Generic Name Levalbuterol

What is levalbuterol inhalation aerosol?

LEVALBUTEROL (Xopenex HFA™) is a bronchodilator, a medicine that opens up your air passages and makes breathing easier. Levalbuterol is used for patients with various lung problems such as asthma and chronic bronchitis. Regular use of levalbuterol inhalation controls recurring episodes of bronchospasm. Generic levalbuterol inhalation aerosol is not available.

What should my health care professional know before I use levalbuterol?

They need to know if you have any of the following conditions:

  • diabetes
  • heart disease, or irregular heartbeat
  • high blood pressure
  • low blood levels of potassium
  • lung disease
  • pheochromocytoma
  • seizures (convulsions)
  • thyroid disease
  • an unusual or allergic reaction to albuterol, levalabuterol, sulfites, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

Levalbuterol aerosol is for inhalation through the mouth. Use levalbuterol aerosol with the mouthpiece that is supplied with the product only. Do not get the aerosol spray in your eyes.

Make sure the levalbuterol aerosol canister is firmly seated in the plastic mouthpiece adapter before each use. Shake the inhaler well. Prime the inhaler by spraying four times into the air, away from the eyes and face. Do this before using for the first time and when the inhaler has not been used for at least 3 days. Tilt your head back slightly. Breathe out fully, emptying as much air as possible from your lungs. Keep the canister upright. Place the inhaler fully into your mouth and close your lips around it. Press down on the inhaler (one puff) while breathing in deeply and slowly. Hold your breath for at least 10 seconds and then exhale (breathe out). Wait for at least 1 to 2 minutes between puffs. After inhaling each dose, it will help to rinse your mouth with water to prevent 'dry mouth'.

Make sure you are using your inhaler properly. Do not use extra or more frequent inhalations. They will not improve your condition. At least once a week, remove the metal canister and rinse the plastic case in warm running water for 30 seconds. To dry, shake off excess water and let the mouthpiece air-dry thoroughly, such as overnight. Replace canister gently without using a twisting motion. If you need to use the mouthpiece before it is dry, shake off the excess water, replace the canister, and spray the inhaler 2 times into the air, away from the eyes and face, to remove most of the remaining water. Do not clean the metal canister or allow the metal canister to become wet. Never place the metal canister in water.

If you are using other inhalers which contain steroids such as ipratropium (Atrovent®) or an inhaled steroid such as beclomethasone (Beclovent®) or triamcinolone (Azmacort®), use levalbuterol (Xopenex®) first. Wait at least 5 minutes before using the other inhaler.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

What drug(s) may interact with levalbuterol?

  • arsenic trioxide
  • astemizole
  • bepridil
  • beta-blockers, often used for high blood pressure or heart problems
  • caffeine
  • certain antibiotics (such as clarithromycin, erythromycin, gatifloxacin, gemifloxacin, grepafloxacin, levofloxacin, linezolid, moxifloxacin, sparfloxacin)
  • chloroquine
  • cisapride
  • droperidol
  • halofantrine
  • levomethadyl
  • medicines for colds and breathing difficulties
  • medicines for heart disease or high blood pressure
  • medicines known as MAO inhibitors, such as phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), and selegiline (Carbex®, Eldepryl®)
  • medicines to control heart rhythm (examples: amiodarone, disopyramide, dofetilide, flecainide, procainamide, quinidine, sotalol)
  • medicines for treating depression or mental illness (amoxapine, haloperidol, maprotiline, pimozide, phenothiazines, risperidone, sertindole, tricyclic antidepressants, ziprasidone)
  • methadone
  • pentamidine
  • probucol
  • some medicines for weight loss (including some herbal products, ephedra, ephedrine, dextroamphetamine)
  • steroid hormones such as dexamethasone, cortisone, hydrocortisone
  • terfenadine
  • theophylline
  • thyroid hormones
  • water pills or diuretics

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check before starting or stopping any of your medicines.

What side effects may I notice from using levalbuterol?

Side effects that you should report to your prescriber or health care professional as soon as possible:


  • skin rash or hives
  • swelling of the tongue, face, or lips with difficulty breathing, difficulty swallowing, hoarseness, or tightening of the throat (angioedema)


  • difficulty breathing or wheezing which increases or does not go away
  • dizziness or fainting spell
  • chest pain or palpitations (fast, pounding heartbeat)
  • fast or irregular heartbeat
  • fever
  • headache (severe)
  • increased blood pressure
  • muscle cramps or weakness
  • numbness in fingers or toes
  • vomiting

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • anxiety, nervousness, trembling
  • cough
  • diarrhea
  • difficulty sleeping
  • dry mouth
  • mild headache
  • nasal congestion, runny nose
  • nausea, upset stomach
  • throat irritation (mild)
  • unusual taste

What should I watch for while taking levalbuterol?

Tell your prescriber or health care professional if your symptoms do not improve. If your asthma or bronchitis gets worse while you are using levalbuterol call your prescriber or health care professional as soon as you can for advice.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water, will help.

Where can I keep my medicine?

Keep out of the reach of children.

Store at a room temperature between 20 and 25 °C (68 and 77 °F); do not freeze. The contents are under pressure and may burst when exposed to high environmental temperatures, heat or flame. Do not freeze. Bring canisters to room temperature before use to ensure proper actuations. Throw away the canister after 200 sprays or after the expiration date, even if there is still medicine left in the canister.

(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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