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Levalbuterol (By breathing)

Levalbuterol (lee-val-BUE-ter-ol)

Treats or prevents bronchospasm in patients with asthma or other reversible lung diseases.

Brand Name(s):

Xopenex, Xopenex HFA, Xopenex Pediatric

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to levalbuterol or albuterol.

How to Use This Medicine:

Spray, Liquid

  • Take your medicine as directed.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
  • Your doctor may order other medicines for you to take to treat and control your asthma. Take all of your medicines as directed.
  • You will use this medicine with an inhaler device called a nebulizer. The nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer.
  • Aerosol inhaler:
    • You will use this medicine with a device called a metered-dose inhaler. The inhaler fits on the medicine canister and turns the medicine into a fine spray that you breathe in through your mouth and to your lungs. You may be told to use a spacer, which is a tube that is placed between the inhaler and your mouth. Your caregiver will show you how to use your inhaler and the spacer (if needed).
    • Shake the inhaler well just before each use. Avoid spraying this medicine into your eyes.
    • Remove the cap and look at the mouthpiece to make sure it is clean.
    • Prime the inhaler the first time you use it. Point the inhaler away from your face. Spray into the air 4 times. You also need to prime it when you do not use the inhaler for more than 3 days in a row.
    • To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright.
    • Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down on the top of the canister once.
    • Hold your breath for about 5 to 10 seconds, then breathe out slowly.
    • If you are supposed to use more than one puff, wait 1 to 2 minutes before inhaling the second puff. Repeat these steps for the next puff, starting with shaking the inhaler.
    • When you have finished all your inhalations, rinse your mouth out with water.
    • Clean the inhaler with warm water and air dry it thoroughly. Do this at least once a week.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Solution (for nebulizer): Store the medicine vials in their foil pouch at room temperature, away from heat and direct light. Open a vial only when you are ready to use the nebulizer. The rest of the vials in the pouch should be used within 2 weeks after the foil pouch has been opened. Do not use the medicine after the expiration date.
  • Inhaler:Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.
  • Inhaler: Throw away the canister after either 80 or 200 sprays have been used. Ask your pharmacist if you are not sure. Do not place the canister in water to see if the canister is full (float test).
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are also using digoxin (Lanoxin®), blood pressure medicine (such as atenolol, metoprolol, propranolol, Bystolic®, Tenormin®), or a diuretic (water pills, such as furosemide, hydrochlorothiazide, torsemide, Lasix®).
  • Tell your doctor if you have used medicine for depression (such as amitriptyline, nortriptyline, Elavil®) or an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, Parnate®) within the past 2 weeks.
  • This medicine should not be used together with similar inhaled medicines such as albuterol (Proventil®, Ventolin®), metaproterenol (Alupent®), or pirbuterol (Maxair®).

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have diabetes, heart disease, heart rhythm problems, high blood pressure, low potassium in the blood, an overactive thyroid, or seizures.
  • Stop using this medicine and check with your doctor right away if you have coughing, trouble breathing, or wheezing after you use this medicine. This medicine may cause paradoxical bronchospasm, which may be life-threatening.
  • If you use a corticosteroid medicine to control your asthma, keep using it as ordered by your doctor.
  • If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Chest pain, fast, pounding, or uneven heartbeat
  • Dry mouth, increased thirst, muscle cramps, nausea or vomiting, uneven heartbeat
  • Lightheadedness or fainting
  • More trouble breathing
  • Tremors or shaking

If you notice these less serious side effects, talk with your doctor:

  • Headache or dizziness
  • Nervousness or trouble sleeping

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 4/4/2014

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