Xopenex Concentrate, Xopenex

Introduction

Written by Julz Richterman, PharmD, MBA, BCGP
Medically reviewed by Elizabeth Scheffel, PharmD
Updated on October 11, 2023

Levalbuterol (leve al BYOO ter ole) is a generic medication prescribed to treat and help prevent sudden tightening of your airways. It’s used in adults and some children. Levalbuterol belongs to a group of drugs called beta-agonist bronchodilators.

Common questions about levalbuterol

Below you’ll find answers to a few commonly asked questions about levalbuterol.

Is levalbuterol similar to albuterol?

Yes, they’re similar. Both levalbuterol and albuterol belong to the same class of drugs called beta-agonist bronchodilators. Both are used to treat and help prevent bronchospasms. With bronchospasms, you experience a sudden tightening of your airways that leads to wheezing, coughing, and difficulty breathing.

Levalbuterol can be used in children ages 6 years or older. And albuterol can be used in children of all ages. Both of these drugs can be used in adults.

Albuterol is made up of two compounds: R-albuterol and S-albuterol. R-albuterol is the active component that makes the drug work. S-albuterol is a lot less active and is believed to cause side effects. Levalbuterol is only made up of R-albuterol.

Talk with your doctor or pharmacist to learn more about the differences and similarities between levalbuterol and albuterol.

Does levalbuterol come as an inhaler?

Yes, levalbuterol comes as an inhaler. It’s available in a generic version called levalbuterol tartrate and a brand-name version called Xopenex HFA.

Levalbuterol also comes as an inhalation solution that you’ll take using a nebulizer. A nebulizer is a device that creates a fine mist, which allows a medication to be delivered to your lungs continuously. This is different from an inhaler, which uses an aerosol chemical to help get the drug into your lungs while you breathe in.

Talk with your doctor or pharmacist if you have questions about levalbuterol inhaler.

What brand names are available for levalbuterol?

The brand name for levalbuterol inhalation solution is Xopenex. 

A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less compared to brand-name drugs.

Talk with your doctor or pharmacist if you have any questions about brand-name and generic medications.

Is levalbuterol a steroid?

No, levalbuterol is not a corticosteroid, also known as a steroid. Corticosteroids are drugs that help reduce inflammation (swelling) that occurs with certain conditions, such as asthma.

Levalbuterol does not reduce inflammation. Instead, it relaxes and loosens the muscles around your bronchi to help open your airway. Your bronchi are two tubes that connect your windpipe to your left and right lung. If levalbuterol doesn’t help ease your symptoms, your doctor may prescribe you an inhaled or oral corticosteroid to help decrease inflammation in your airway.

Talk with your doctor or pharmacist if you have questions about taking corticosteroids with levalbuterol.

How does levalbuterol work? And how long does it take to start working?

Levalbuterol is a beta-agonist bronchodilator. An agonist is a substance that activates a certain receptor (a structure on cells that receives and responds to chemical signals). 

In this case, levalbuterol activates the beta-2 adrenergic receptors. These are located in your airway on smooth muscles (muscles you cannot control, such as ones used in digestion).

When levalbuterol activates these receptors, it causes smooth muscles in your airway to relax. This opens your airway, making it easier to breathe. 

Levalbuterol takes about 5–15 minutes to start working.

If you’d like to know more about this, talk with your doctor or pharmacist. 

Side effects of levalbuterol

Levalbuterol may cause mild or serious side effects. More common mild side effects of levalbuterol and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about levalbuterol’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for levalbuterol listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of levalbuterol are listed below. These side effects may differ based on the form of levalbuterol you use. 

This article doesn’t include all possible mild side effects of the drug. To learn more about levalbuterol’s side effects, refer to the prescribing information for levalbuterol listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Levalbuterol inhalation solution’s* mild side effects include:

• fast heartbeat
• headache
• dizziness
• nervousness
• mild allergic reaction†

* Levalbuterol can come as an inhalation solution that you’ll take using a nebulizer. A nebulizer is a device that creates a fine mist, which allows a medication to be delivered to your lungs continuously. 
† For details about this side effect, see the “Interactions and warnings for levalbuterol” section.

Serious side effects

Serious side effects of levalbuterol are listed below. These side effects may differ based on the form of levalbuterol you use. 

This article doesn’t include all possible serious side effects of the drug. To learn more about levalbuterol’s side effects, refer to the prescribing information for levalbuterol listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number. 

In general, levalbuterol’s serious side effects include:

• worsened bronchospasm (sudden tightening of your airways)
• heart-related effects, such as increased or irregular heartbeat that can be life threatening
• low potassium level that may cause heart-related events, such as heart attack
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for levalbuterol” section.

Uses of levalbuterol

The Food and Drug Administration (FDA) approves prescription drugs such as levalbuterol for certain conditions. Approved uses for levalbuterol are described below. 

Use for bronchospasm

Doctors may prescribe levalbuterol inhaled solution* to treat and help prevent bronchospasms. It’s used for this purpose in adults and children ages 6 years and older. It’s usually prescribed short-term or as needed.

With bronchospasms, the muscles around your bronchi tighten. Your bronchi are two tubes that connect your windpipe to your left and right lung. This narrows your airway, making it harder to breathe. Symptoms may include:

• shortness of breath
• coughing
• wheezing
• chest pain or tightness

Levalbuterol causes the muscles around your bronchi to relax and loosen. This widens your airway, making it easier to breathe. 

Levalbuterol may be prescribed with other medications, such as inhaled or oral corticosteroids, to treat your bronchospasms.

* Levalbuterol can come as an inhalation solution that you’ll take using a nebulizer. A nebulizer is a device that creates a fine mist, which allows a medication to be delivered to your lungs continuously. 

Interactions and warnings for levalbuterol

Below you’ll find information about levalbuterol’s possible interactions and warnings. 

Interactions of levalbuterol

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction. 

Before you use levalbuterol, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for levalbuterol” section below.

Warnings for levalbuterol

Levalbuterol should be used cautiously by certain people. 

Levalbuterol could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether levalbuterol is a safe option for you. These warnings may differ based on the form of levalbuterol you use.

Ask your doctor about specific warnings for levalbuterol, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Levalbuterol can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to levalbuterol or any of its ingredients, your doctor will likely not prescribe levalbuterol. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems 

If you have an allergic reaction to levalbuterol, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of levalbuterol

If you inhale levalbuterol, you should not use more levalbuterol than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve used too much levalbuterol, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and levalbuterol

Information about levalbuterol and pregnancy and breastfeeding is described below.

Levalbuterol and pregnancy

It’s not known whether levalbuterol should be used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication. 

If your doctor recommends using levalbuterol while pregnant, there’s a pregnancy registry for levalbuterol. A pregnancy registry collects information about the safety of certain drugs during pregnancy. For more information, see the registry website or call 877-311-8972. You can also talk with your doctor or pharmacist.

Levalbuterol and breastfeeding

It’s not known whether levalbuterol should be used while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication. 

What to ask your doctor

Let your doctor know if you have questions about levalbuterol or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Is levalbuterol safe to use with my other medications?
• Should I use levalbuterol only as needed or can I schedule it?
• What should I do if my symptoms do not ease or if I feel that I need to use levalbuterol more than prescribed?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Levalbuterol inhalation solution. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/a60ea366-65a8-4559-9af5-5afd97875d2e/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.