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Xopenex
Xopenex (generic name: levalbuterol) is a short-acting beta-agonist (SABA) used to treat and prevent bronchospasm in people with asthma or chronic obstructive pulmonary disease (COPD). It is a bronchodilator that relaxes the muscles around the airways, making it easier to breathe during an asthma attack or periods of breathing difficulty. Xopenex is often prescribed as an alternative to albuterol, as it contains only the active (R)-isomer of albuterol, which may reduce side effects in some patients.
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Frequently Asked Questions
How quickly does Xopenex start working?
Xopenex typically starts to relieve bronchospasm within 5 to 10 minutes after administration, making it effective for quick relief of asthma or COPD symptoms.
How long do the effects of Xopenex last?
The effects of Xopenex generally last for 4 to 6 hours, depending on the dose and individual response.
Can Xopenex be used for long-term asthma control?
No, Xopenex is intended for rescue use to relieve sudden symptoms of asthma or COPD. For long-term control, your doctor may prescribe other medications, such as inhaled corticosteroids.
Is Xopenex safe for children?
Yes, Xopenex can be used in children 6 years of age and older for nebulizer solution and 4 years of age and older for the HFA inhaler. Always follow the dosage instructions provided by your healthcare provider.
Can I use Xopenex if I’m pregnant or breastfeeding?
Consult your healthcare provider before using Xopenex if you are pregnant or breastfeeding. While it may be prescribed if necessary, your doctor will weigh the risks and benefits.
Comprehensive Drug Guide
How Does Xopenex Work?
Xopenex works by stimulating beta-2 adrenergic receptors in the lungs, leading to relaxation of the smooth muscle around the bronchial tubes. This causes the airways to open up, allowing more air to flow in and out of the lungs. It helps relieve symptoms such as wheezing, coughing, chest tightness, and shortness of breath.
Common Dosages
- Inhalation solution for use with a nebulizer in concentrations of 0.31 mg/3 mL, 0.63 mg/3 mL, and 1.25 mg/3 mL
- Xopenex HFA Inhaler with 45 mcg per actuation
Typical Dosing
- Inhalation solution (nebulizer): Typical dose for adults and children (age 6 and older) is 0.63 mg administered three times daily, every 6 to 8 hours. The dose may be increased to 1.25 mg if necessary.
- Xopenex HFA Inhaler: For adults and children (age 4 and older), the typical dose is two inhalations every 4 to 6 hours as needed. A dose of one inhalation may suffice for some patients.
Typical Dosing
FDA Approved Indications
- Treatment or prevention of bronchospasm in patients with reversible obstructive airway disease (such as asthma)
- Relief of acute bronchospasm in chronic obstructive pulmonary disease (COPD)
Who Shouldn't Take Xopenex?
- Known hypersensitivity to levalbuterol, albuterol, or any other components of the formulation.
- Severe allergic reactions to similar medications, such as beta-agonists.
Advice From The Pharmacist
- Use Xopenex only as directed by your healthcare provider. Do not exceed the recommended dose, as overuse may lead to serious side effects such as heart problems.
- For nebulizer use, ensure the nebulizer is properly maintained and clean to avoid infection or reduced medication effectiveness.
- If using the Xopenex HFA Inhaler, shake well before each use and prime the inhaler if it has not been used for more than 3 days.
- Carry your inhaler or nebulizer solution with you at all times to manage sudden asthma symptoms or attacks.
Side Effects of Xopenex
Common Side Effects
- Nervousness or anxiety
- Tremors (shakiness)
- Dizziness
- Headache
- Throat irritation
Uncommon/Severe Side Effects
- Chest pain or rapid heart rate (tachycardia)
- High blood pressure (hypertension)
- Hypokalemia (low potassium levels)
Risks and Warnings of Xopenex
- Paradoxical Bronchospasm: In rare cases, Xopenex can cause the opposite of the intended effect, leading to worsening bronchospasm. If this occurs, stop use immediately and seek medical attention.
- Cardiovascular Effects: Xopenex may cause an increase in heart rate, blood pressure, and palpitations, particularly in patients with underlying heart conditions. Use caution if you have cardiovascular disease.
- Overuse Risk: Overuse of short-acting beta-agonists like Xopenex can lead to a reduction in efficacy over time and increase the risk of severe asthma attacks. Consult your healthcare provider if you need to use Xopenex more frequently than prescribed.
Interactions with Xopenex
Common Drug Interactions
- Beta-blockers: These medications (such as propranolol) may reduce the effectiveness of Xopenex by blocking beta-2 receptors.
- Diuretics: Certain diuretics (such as furosemide) may increase the risk of hypokalemia when used with Xopenex.
- MAO inhibitors: Using Xopenex with MAO inhibitors or tricyclic antidepressants may increase the risk of cardiovascular side effects.
Alternatives to Xopenex
- Albuterol (Proventil, Ventolin): Another short-acting beta-agonist (SABA) used to relieve bronchospasm in asthma and COPD.
- Symbicort (budesonide/formoterol): A combination of a long-acting beta-agonist (LABA) and a corticosteroid used for long-term control of asthma.
- Advair (fluticasone/salmeterol): A combination medication used for the management of asthma and COPD, containing a corticosteroid and a long-acting beta-agonist.
- DuoNeb (albuterol/ipratropium): A combination of a SABA and an anticholinergic used for bronchospasm in COPD patients.
