Levalbuterol Inhalation Solution

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: chest pain, fast/pounding/irregular heartbeat, headache, shaking (tremors), nervousness, weakness, severe dizziness, seizures.

Use levalbuterol inhalation solution as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Follow how to use as you have been told by the doctor or read the package insert.
• Keep out of your eyes.
• For breathing in only as a liquid (solution) by a special machine (nebulizer) into the lungs.
• Do not use if the solution is cloudy, leaking, or has particles.
• Do not use if solution changes color.
• Some of these products must be mixed with saline before use. Check with your doctor or pharmacist to see if your product needs to be mixed.
• Do not mix other drugs in nebulizer.

What do I do if I miss a dose?

• If you take this medicine on a regular basis, take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.
• Many times levalbuterol inhalation solution is taken on an as needed basis. Do not take more often than told by the doctor.

More Common Side Effects

• Some of the more common side effects that can occur with use of levalbuterol solutions for nebulization include:

  • palpitations (feeling like your heart skipped or added a beat )
  • chest pain
  • tachycardia (fast heart rate)
  • headache
  • dizziness
  • shakiness (tremor)
  • nervousness
  • heart changes on an electrocardiogram test
  • low blood levels of potassium. Symptoms can include:
    • irregular heartbeat
    • muscle weakness or spasms
    • tingling
  • high blood sugar levels. Symptoms can include:
    • feeling more thirsty than normal
    • feeling more hungry than normal
    • urinating more than normal

• Some of the more common side effects that can occur with the use of levalbuterol HFA inhalers include: 

  • dizziness
  • chest pain
  • inflammation of the air passages between your nose and your lungs (bronchitis)
  • sore throat (pharyngitis)
  • runny nose
  • vomiting
  • shakiness (tremor)

If these effects are mild, they may go away within a few hours. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Chest pain with a very fast heart rate or pulse

• More trouble breathing

• Allergic reaction. Symptoms can include:

  • itching
  • swelling of your face or throat
  • rash
  • trouble breathing because of spasms in the airways of your lungs

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Levalbuterol can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor or pharmacist about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Other asthma drugs

You shouldn’t take certain other drugs that open the airways to help you breathe when you’re using levalbuterol. They can increase effects of levalbuterol and cause side effects in the heart. Examples of these drugs include: 

• short-acting sympathomimetic bronchodilators, such as:
  •  albuterol

Depression drugs

Ask your doctor whether this drug is safe for you if you’re taking drugs used to treat depression or have stopped these drugs in the last 2 weeks. These drugs may increase the action of levalbuterol on the heart and blood vessels. Your doctor may give you other asthma drugs if you’re taking depression medications. Examples of these drugs include:

• monoamine oxidase inhibitors (MAOIs), such as:
  • phenelzine
  • selegiline
  • tranylcypromine
• tricyclic antidepressants, such as:
  • amitriptyline
  • imipramine
  • nortriptyline

Digoxin

Levalbuterol may decrease your digoxin blood levels. This means that digoxin may not work as well for you. Your doctor may check your blood levels of digoxin if you take both of these drugs.

Epinephrine

Talk to your doctor about whether this drug is safe for you if you’re taking levalbuterol. Taking these drugs together can cause effects on the heart. 

High blood pressure drugs

Certain high blood pressure drugs, beta blockers, can block the action of levalbuterol on your lungs. These drugs may also cause a severe spasm in your lungs. In general, you shouldn’t use beta blockers if you have asthma. Examples of these drugs include:

• beta blockers, such as:
  • acebutolol
  • atenolol
  • betaxolol
  • bisoprolol
  • esmolol
  • metoprolol
  • nadolol
  • nebivolol
  • penbutolol
  • pindolol
  • propranolol
  • sotalol
  • timolol

Water pills (diuretics)

Levalbuterol, especially at high doses, can decrease your potassium levels and cause changes on your electrocardiogram if you’re also taking a water pill that decreases potassium levels in your body. Your doctor may need to check your potassium blood levels while you’re taking these medicines. Examples of these drugs include:

• loop diuretics
  • bumetanide
  • ethacynic acid
  • furosemide
  • torsemide
• thiazide diuretics
  • hydrochlorothiazide
  • chlorothiazide
  • chlorthalidone
  • indapamide
  • metolazone

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking. Drug warnings

People with heart problems

This drug can cause side effects on the heart, including increased heart rate (tachycardia) and blood pressure. Talk to your doctor about whether this drug is safe for you if you have heart-related disorders, such as coronary insufficiency, heart rhythm disorders (arrhythmias), and high blood pressure.

People with seizures

Talk to your doctor about whether this drug is safe for you if you have a seizure disorder. This drug may cause seizures.

People with hyperthyroidism

Talk to your doctor about whether this drug is safe for you if you have hyperthyroidism. It may make your condition worse.

People with diabetes

This drug may increase your blood sugar levels. Your doctor may change your diabetes medicines.

People with low blood levels of potassium (hypokalemia)

This drug may lower your blood potassium levels temporarily, which can worsen low potassium levels you already have. This can affect your heart. 

Pregnant women

There haven’t been enough studies done in humans to be certain how levalbuterol might affect a fetus when the mother takes it. Research in animals has shown adverse effects. Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk.

Women who are breast-feeding

It isn’t known if levalbuterol passes into breast milk or causes side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your baby. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, your doctor may start you at the lowest effective dose and adjust your dose slowly.

For children

The safety and effectiveness of the inhalation solution haven’t been established in children younger than 6 years.

The safety and effectiveness of the HFA inhaler haven’t been established in children younger than 4 years.

When to call the doctor

If you need more of this drug than usual, feel like it’s not helping to decrease symptoms, or if your symptoms get worse, let your doctor know right away. Your asthma may be getting worse and you may need other medicines, such as corticosteroids.

Allergies

Tell your doctor if you’ve ever had an allergic reaction to albuterol (Ventolin, Proair) or this drug. They may prescribe a different medicine to treat your acute asthma attacks.

This drug can cause a severe allergic reaction. Symptoms can include:

• itching
• swelling of your face or throat (angioedema)
• skin rash
• trouble breathing
• fast development of trouble breathing

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room. 

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

What are you taking this medication for?

Treat or prevent spasm in the airways caused by asthma

Brand: Xopenex HFA

Form: HFA metered-dose inhaler with 80 or 200 actuations Strength: each actuation delivers 59 mcg of levalbuterol

Brand: Xopenex solution

Form: Inhalation solution Strength: 3-mL unit-dose vials contain 0.31 mg, 0.63 mg, or 1.25 mg levalbuterol

Brand: Xopenex solution, concentrate

Form: Inhalation solution concentrate Strength: 0.5-mL unit-dose vial contains 1.25 mg levalbuterol

Generic: levalbuterol

Form: Inhalation solution Strength: 3-mL unit-dose vials contain 0.31 mg, 0.63 mg, or 1.25 mg levalbuterol Form: Inhalation solution concentrate Strength: 0.5-mL unit-dose vial contains 1.25 mg levalbuterol

Inhalation solution

Adult dosage (ages 18–64 years)

• Inhalation solution for nebulization: The recommended dose is 0.63 mg taken three times per day, 6–8 hours apart. If you have severe asthma and don’t respond to the 0.63-mg dose, you doctor may tell you to take 1.25 mg three times per day every 6–8 hours.
• Concentrated inhalation solution for nebulization: The recommended dose is 1.25 mg taken three times per day, 6–8 hours apart.

Child dosage (ages 12–17 years)

• Inhalation solution for nebulization: The recommended dose is 0.63 mg taken three times per day, 6–8 hours apart. If you have severe asthma and don’t respond to the 0.63-mg dose, you doctor may tell you to take 1.25 mg three times per day every 6–8 hours.
• Concentrated inhalation solution for nebulization: The recommended dose is 1.25 mg taken three times per day, 6–8 hours apart.

Child dosage (ages 6–11 years)

The recommended dose is 0.31 mg (one unit-dose vial) taken three times a day by nebulization. You shouldn’t take more than 0.63 mg three times a day.

Child dosage (ages 0–5 years)

The safety and effectiveness of levalbuterol inhalation solution haven’t been established in children younger than 6 years.

HFA inhaler

Adult dosage (ages 18–64 years)

Use 1–2 puffs every 4–6 hours.

Child dosage (ages 12–17 years)

Use 1–2 puffs every 4–6 hours.

Child dosage (ages 4–6 years)

The usual dose is 1–2 inhalations taken every 4–6 hours.

Child dosage (ages 0–3 years)

The safety and effectiveness of levalbuterol HFA inhaler haven’t been established in children younger than 4 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.

Seniors should start at a dose of 0.63 mg of levalbuterol inhalation solution or the lowest dose of the HFA inhaler. This can help keep levels of this drug from building up too much in your body. If your asthma doesn’t improve, your doctor may increase your dose to the maximum recommended daily dose.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you. Important considerations for taking this drug

Don’t use this drug more often than three times a day or every 6–8 hours

Store this drug carefully

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A prescription for this medication is refillable

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Travel

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Self-management

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Clinical monitoring

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Not every pharmacy stocks this drug and necessary supplies

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