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Xopenex HFA

Xopenex HFA (generic name: levalbuterol) is an inhaled bronchodilator used to treat or prevent bronchospasm in patients with asthma or chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, making it easier to breathe during asthma attacks, exercise-induced bronchospasm, or COPD flare-ups. Xopenex HFA is a short-acting beta-2 agonist (SABA), and it is commonly used for quick relief of asthma symptoms.

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Frequently Asked Questions

How quickly does Xopenex HFA work?
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Xopenex HFA typically starts working within 5 to 10 minutes after inhalation, providing rapid relief of bronchospasm symptoms.

Can I use Xopenex HFA for long-term asthma control?
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Xopenex HFA is intended for quick relief of acute symptoms (rescue inhaler) and is not a substitute for long-term asthma control medications, such as inhaled corticosteroids.

How should I store Xopenex HFA?
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Store Xopenex HFA at room temperature, away from heat, moisture, and direct sunlight. Do not puncture the canister or expose it to high heat, as it may burst.

What should I do if I miss a dose of Xopenex HFA?
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Xopenex HFA is used on an as-needed basis for relief of symptoms. If you forget to use it, take your next dose when symptoms occur.

Can I use Xopenex HFA more than four times a day?
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Using Xopenex HFA more than the recommended dose (2 inhalations every 4 to 6 hours) can increase the risk of side effects, including tremors, increased heart rate, and low potassium. If you find that you need to use it more frequently, consult your healthcare provider, as this may indicate that your asthma is not well controlled.

Comprehensive Drug Guide

How Does Xopenex HFA Work?

Levalbuterol, the active ingredient in Xopenex HFA, works by stimulating beta-2 adrenergic receptors in the smooth muscle of the airways. This leads to the relaxation of bronchial muscles, resulting in bronchodilation (widening of the airways) and improved airflow to the lungs. It provides quick relief of breathing difficulties associated with bronchospasm in asthma or COPD.

Common Dosages

  • 45 mcg per inhalation (metered-dose inhaler)

Typical Dosing

  • For acute bronchospasm or prevention of bronchospasm, the typical dose is 2 inhalations (45 mcg each) every 4 to 6 hours as needed.
  • Prevention of exercise-induced bronchospasm: Use 2 inhalations 15 to 30 minutes before exercise.

Typical Dosing

FDA Approved Indications

  • Treatment or prevention of bronchospasm in adults and children aged 4 years and older with reversible obstructive airway diseases (e.g., asthma, COPD).
  • Prevention of exercise-induced bronchospasm.

Who Shouldn't Take Xopenex HFA?

  • Known hypersensitivity to levalbuterol, albuterol, or any components of the formulation.

Advice From The Pharmacist

  • Shake the inhaler well before each use, and prime the inhaler by spraying it into the air if it hasn’t been used in more than 3 days.
  • Use a spacer if recommended by your healthcare provider, as this can help ensure the medication reaches the lungs more effectively.
  • Rinse your mouth with water after each use to prevent irritation and reduce the risk of throat infections (such as thrush).
  • Keep track of the number of inhalations used, and replace the inhaler after the labeled number of doses is reached, even if it still feels like there's medication remaining.

Side Effects of Xopenex HFA

Common Side Effects

  • Tremors
  • Nervousness
  • Increased heart rate (tachycardia)
  • Headache
  • Dizziness

Uncommon/Severe Side Effects

  • Worsening bronchospasm (paradoxical bronchospasm)
  • Chest pain or irregular heartbeat
  • Hypokalemia (low potassium levels)
  • Allergic reactions (rash, swelling, difficulty breathing)

Risks and Warnings of Xopenex HFA

  • Paradoxical Bronchospasm: In rare cases, Xopenex HFA can cause worsening of breathing (paradoxical bronchospasm). If this occurs, stop using the inhaler immediately and seek medical attention.
  • Cardiovascular Effects: Xopenex HFA can cause increased heart rate, palpitations, and elevated blood pressure. Patients with heart disease or hypertension should use this medication with caution and under close supervision.
  • Hypokalemia: Levalbuterol can cause low potassium levels, especially when used in high doses or combined with other medications that affect potassium levels.

Interactions with Xopenex HFA

Common Drug Interactions

  • Beta-blockers (e.g., propranolol, metoprolol): These medications can reduce the effectiveness of Xopenex HFA and may worsen bronchospasm.
  • Diuretics: Diuretics that deplete potassium, such as furosemide, may increase the risk of hypokalemia when used with Xopenex HFA.
  • MAO inhibitors or tricyclic antidepressants: These medications may enhance the cardiovascular side effects of levalbuterol (increased heart rate, blood pressure).

Alternatives to Xopenex HFA

  • Albuterol (ProAir HFA, Ventolin HFA): Another short-acting beta-2 agonist used for quick relief of asthma symptoms and bronchospasm.
  • Ipratropium (Atrovent): A short-acting bronchodilator used to relieve symptoms of bronchospasm in COPD.
  • Formoterol (Foradil): A long-acting beta-2 agonist (LABA) used for long-term control of asthma and COPD but not for acute symptoms.