AIM | Medications

Medications

Medication Type	Quick Relief
Brand Names	Xopenex®, Xopenex HFA
Generic Names	Levalbuterol
Description	This nebulized mist treatment causes muscles around the airways to relax, opening them for easier breathing.
Dosage	Adults and children greater than 12 years old inhale 0.63mg (in nebulized solution) every 6 to 8 hours. If patient does not respond, 1.25mg (in nebulized solution) every 6 to 8 hours may be helpful. 6 to 11 years of age: 0.31mg administered 3 times/day by nebulizer. Do not exceed routine dosing of 0.63 3 times/day. 4 years of age and older: 2 inhalations (90mcg) repeated every 4 to 6 hours; in some patients, 1 inhalation every 4 hours may be sufficient. More frequent administration or a larger number of inhalations is not routinely recommended. Asthma: 4 to 8 inhalations every 20 min up to 4 hr, then every 1 to 4 hr as needed. Safety and effectiveness have not been established for children younger than 4 years of age Asthma: 4 to 8 inhalations orally every 20 min for 3 doses, then every 1 or 4 as needed; add mask for children less than 4 years of age. Available in 0.31 mg/3mL, 0.63 mg/3mL, and 1.25 mg/3mL solutions. Available in 0.045mg/actuation.
Precautions	Patients should use caution when using this medication if they have cardiovascular disease (including high blood pressure and irregular heart beat), seizure disorder, hyperthyroidism, diabetes or low sodium. Patients who have not responded well to this or any sympathomimetic should use caution.
Side Effects	Nasal inflammation, increased heart rate, dizziness, shakiness, upset stomach, leg cramps, viral infection in the lungs.
Proper Use	See instructions for correct use of nebulizer and inhaler.
Common Interactions	Digoxin, loop diuretics (furosemide, torsemide, bumetanide, ethacrynic acid), thiazide diuretics, chlorothiazide, hydrochlorothiazide, indapamide, metolazone), monoamine oxidase inhibitors (MAOIs: isocarboxazid, phenelzine, tranylcypromine), tricyclic antidepressants (TCAs: amitriptyline, clomipramine, doxepin, imipramine, trimipramine), propranolol and other β-blockers (atenolol, esmolol, betaxolol, penbutolol, carteolol, bisoprolol, pindolol, metoprolol, timolol, sotalol, acebutolol, nadolol).
Proper Storage	Xopenex solution: Keep unopened vials in foil pouch. Use vials within 2 weeks after opening. If removed from foil pouch and not used immediately, protect from light and heat and use within 1 week. Xopenex HFA: Store between 20◦ and 25◦C (68◦ and 77◦F). Protect from freezing temperatures and direct sunlight. Store inhaler with the actuator (mouthpiece) down. Do not puncture or incinerate. Exposure to temperature above 49◦C (120◦F) may cause bursting.