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Xopenex Concentrate
Xopenex Concentrate (levalbuterol hydrochloride) is a bronchodilator used to treat or prevent bronchospasm in people with reversible obstructive airway disease, such as asthma or chronic obstructive pulmonary disease (COPD). It helps open the airways in the lungs, making it easier to breathe. Levalbuterol is the R-enantiomer of albuterol, providing effective relief of bronchospasm with potentially fewer side effects than racemic albuterol.
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Frequently Asked Questions
How long does it take for Xopenex Concentrate to work?
Xopenex Concentrate typically begins to work within minutes after nebulization, providing rapid relief from bronchospasm. The effects usually last for 4-6 hours.
Can I use Xopenex Concentrate every day?
Yes, Xopenex can be used as prescribed for maintenance or acute treatment of bronchospasm. However, if you find you are needing it more frequently than usual, consult your healthcare provider, as this may indicate worsening control of your condition.
How do I prepare Xopenex Concentrate for nebulization?
Your healthcare provider will instruct you to dilute the concentrated solution with saline before nebulizing. The usual dilution will depend on your prescribed dose.
Can I use Xopenex if I am pregnant?
Xopenex should be used during pregnancy only if clearly needed. Discuss the risks and benefits with your healthcare provider if you are pregnant or planning to become pregnant.
What should I do if I miss a dose of Xopenex?
If you miss a scheduled dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not double up doses.
Comprehensive Drug Guide
How Does Xopenex Concentrate Work?
Xopenex Concentrate works by stimulating beta-2 adrenergic receptors in the lungs, which leads to the relaxation of the smooth muscles in the airways. This relaxation opens up the airways, making it easier to breathe and relieving symptoms of bronchospasm such as wheezing, coughing, and shortness of breath.
Common Dosages
- 0.31 mg, 0.63 mg, or 1.25 mg per nebulizer treatment.
Typical Dosing
- For bronchospasm: The typical starting dose for adults and children aged 6 and older is 0.63 mg administered by nebulization three times daily. In some cases, the dose may be increased to 1.25 mg three times daily for more severe symptoms.
- For acute bronchospasm exacerbations: A dose of 1.25 mg is often used in emergency settings.
- The solution must be diluted with normal saline before use in a nebulizer.
Typical Dosing
FDA Approved Indications
- Bronchospasm in patients with asthma or COPD.
- Acute exacerbations of bronchospasm, typically in a clinical or emergency setting.
Who Shouldn't Take Xopenex Concentrate?
- Hypersensitivity to levalbuterol or albuterol.
- Severe hypersensitivity to beta-2 agonists.
Advice From The Pharmacist
- Dilute the concentrate with normal saline as directed before using it in the nebulizer. Your healthcare provider will give you specific instructions on how to prepare the solution.
- Administer the treatment with a nebulizer as directed. It generally takes about 5-15 minutes for the treatment session.
- If you notice paradoxical bronchospasm (worsening breathing or wheezing right after use), discontinue Xopenex immediately and seek medical attention.
- Monitor for cardiovascular side effects such as increased heart rate, palpitations, or dizziness, which are more common with higher doses.
- Rinse your mouth after each treatment to avoid irritation or dryness.
Side Effects of Xopenex Concentrate
Common Side Effects
- Tremors
- Headache
- Nervousness
- Dizziness
- Increased heart rate
Uncommon/Severe Side Effects
- Paradoxical bronchospasm (worsening of breathing)
- Chest pain or heart palpitations
- Hypokalemia (low potassium levels)
- Allergic reactions, such as swelling or rash
Risks and Warnings of Xopenex Concentrate
- Paradoxical Bronchospasm: In rare cases, Xopenex can cause worsening bronchospasm (breathing difficulty) immediately after use. If this occurs, stop using the medication and seek medical attention.
- Cardiovascular Effects: Xopenex may cause an increased heart rate, palpitations, or changes in blood pressure. This is more likely at higher doses, so use caution if you have a history of heart disease or arrhythmias.
- Electrolyte Imbalance: Xopenex can lead to a drop in potassium levels (hypokalemia) with prolonged or high-dose use. Regular monitoring is recommended if you are at risk of electrolyte imbalances.
Interactions with Xopenex Concentrate
Common Drug Interactions
- Beta-blockers: Beta-blockers (e.g., propranolol) can reduce the effectiveness of Xopenex and may worsen bronchospasm.
- Diuretics: Diuretics, such as furosemide, can increase the risk of hypokalemia when taken with Xopenex.
- Other bronchodilators: Using Xopenex with other short-acting beta agonists (like albuterol) may increase the risk of side effects, such as heart palpitations and tremors.
- Tricyclic antidepressants and MAO inhibitors: These medications may increase the cardiovascular side effects of Xopenex, so caution is advised.
Alternatives to Xopenex Concentrate
- Albuterol (Proventil, Ventolin, ProAir): A similar short-acting beta-2 agonist used for the treatment of asthma and COPD.
- DuoNeb (albuterol and ipratropium): A combination of a beta-agonist and an anticholinergic, used for the treatment of bronchospasm in COPD.
- Brovana (arformoterol): A long-acting beta-agonist used for maintenance treatment of COPD.
