Xopenex is an inhaled prescription medicine used for the treatment or prevention of airway spasms (bronchospasm). Do not use your Xopenex more often than your doctor tells you to.

Xopenex Overview

Reviewed: July 9, 2014

Xopenex is an inhaled prescription medicine used for the treatment or prevention of airway spasms (bronchospasm) in people 6 years of age and older. Xopenex belongs to a group of drugs called beta agonists, or bronchodilators, which work by relaxing and opening air passages to the lungs to make breathing easier.

Xopenex comes as a solution (liquid) to be inhaled by mouth using a nebulizer every 6 to 8 hours. 
Common side effects of Xopenex include a noticeably rapid, strong, or irregular heartbeat (palpitations), chest pain, and fast heart rate. 
See "Xoponex HFA" for information about the inhaler form of Xopenex. 

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Xopenex Cautionary Labels


Uses of Xopenex

Xopenex is an inhaled prescription medicine used for the treatment or prevention of airway spasms (bronchospasm) in people 6 years of age and older.

Xopenex has not been shown to be safe and effective in children younger than 6 years of age.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.



Xopenex Drug Class

Xopenex is part of the drug class:

Side Effects of Xopenex

Xopenex can cause serious side effects. See "Xopenex Precautions" section.

The most common side effects of Xopenex include:

  • noticeably rapid, strong, or irregular heartbeat (palpitations)
  • chest pain
  • fast heart rate
  • headache
  • dizziness
  • tremor
  • nervousness

Tell your doctor if you have any side effects that bother you or that does not go away.

These are not all the possible side effects of Xopenex. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Xopenex Interactions

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • other asthma medicines
  • beta blockers such as metoprolol (Toprol XL, Lopressor), carvedilol (Coreg), bisoprolol (Zebeta), betaxolol (Kerlone), nebivolol (Bystolic), propranolol (Inderal)
  • heart medicines
  • medicines that increase urination (diuretics) such as acetazolamide (Diamox), amiloride (Midamor), bumetanide (Bumex), chlorothiazide (Diuril), chlorthalidone (Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Microzide, HCTZ), metolazone (Zaroxolyn), torsemide (Demadex), triamterene (Dyrenium, Dyazide, Maxzide)
  • digoxin (Lanoxin)
  • Monoamine Oxidase Inhibitors such as tranylcypromine (Parnate), phenelzine (Nardil), selegiline (Eldepryl, Zelapar), isocarboxazid (Marplan), and rasagiline (Azilect)
  • Tricyclic Antidepressants such as trimipramine (Surmontil), amitriptyline (Elavil), nortriptyline (Pamelor, Aventyl), protriptyline (Vivactil), and clomipramine (Anafranil)
  • medicine to treat chronic obstructive pulmonary disease (COPD)

This is not a complete list of Xopenex drug interactions. Ask your pharmacist or doctor for more information. 


Xopenex Precautions

Serious side effects have been reported with Xopenex including the following:

  • sudden shortness of breath (bronchospasm). Sudden shortness of breath can happen right away after using Xopenex.
  • worsening asthma
  • heart problems
  • death. If you use too much Xopenex you can have heart or lung problems that can lead to death.
  • serious allergic reactions. Call your doctor and stop using levalbuterol right away if you have any symptoms of an allergic reaction such as:
    • swelling of the face, throat or tongue
    • hives
    • rash
    • breathing problems
  • low potassium levels in your blood

Call your doctor or go to the nearest hospital emergency room right away if you have any of the serious side effects listed above or if you have worsening lung symptoms.

Do not use Xopenex if you are allergice to Xoponex, levalbuterol, racemic albuterol, or any of the ingredients in Xopenex. 


Xopenex Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Xopenex there are no specific foods that you must exclude from your diet when receiving this medication. 

Inform MD

Before you use Xopenex, tell your doctor if you have:

  • had an allergic reaction to levalbuterol or racemic albuterol or Xopenex
  • heart problems
  • high blood pressure
  • seizures
  • diabetes
  • thyroid problems
  • any other medical conditions
  • are pregnant or planning to become pregnant
  • are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.


Xopenex and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant. 

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Xopenex falls into category C. There are no good studies that have been done in humans with Xopenex. Because animal reproduction studies are not always predictive of human response, Xopenex should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.


Xopenex and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Xopenex crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Xopenex.

Xopenex Usage

Use Xopenex exactly as your doctor tells you to. Do not change your dose without talking to your doctor first.

  • Your doctor will tell you how many times and when to use your Xopenex.
  • An adult should help a child use Xopenex.
  • Do not use your Xopenex more often than your doctor tells you to.
  • Get medical help right away if Xopenex:
    • does not work as well for your asthma symptoms or
    • your asthma symptoms get worse or
    • you need to use Xopenex more often than usual
  • If you also use another medicine by inhalation, you should ask your doctor for instructions on when to use it while you are also using Xopenex.
  • Do not mix Xopenex with other medicines in your nebulizer.
  • Only use Xopenex if it is colorless. Throw away the Xopenex inhalation solution vial if the liquid medicine is not colorless.
  • Do not use Xopenex after the expiration date on the vial.

To use Xopenex, follow these steps:

  1. Open the foil pouch by tearing through the rough edge along the side of the pouch and remove one vial. Leave the rest of the vials inside the foil pouch to protect them from light. Look at the solution in the vial to be sure it is colorless. If it is not colorless, call your doctor or pharmacist and do not use the solution.

  2. Twist off the top of the vial and squeeze all of the liquid into the reservoir of your nebulizer. Do not add any other medications to the nebulizer because it may not be safe to mix them with Xopenex. Use all nebulized medications separately unless your doctor specifically tells you to mix them.

  3. If you are using the concentrated solution, add the amount of normal saline that your doctor told you to use to the reservoir. Gently swirl the nebulizer to mix the normal saline and the concentrated solution.

  4. Connect the nebulizer reservoir to your mouthpiece or face mask.

  5. Connect the nebulizer to the compressor.

  6. Sit upright and place the mouthpiece in your mouth or put on the face mask.

  7. Turn on the compressor.

  8. Breathe calmly, deeply, and evenly until mist stops forming in the nebulizer. This should take between 5 and 15 minutes.

  9. Clean the nebulizer according to the manufacturer's instructions.

Clean your nebulizer regularly. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your nebulizer. 


Xopenex Dosage

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

  • your age
  • the severity of the condition being treated

The recommended doses of Xopenex for treating airway spasms (bronchospasm) are the following:

  • Children 6-11 years old: 0.31 mg administered three times a day, by nebulization. Routine dosing should not exceed 0.63 mg three times a day.

  • Adults and Adolescents ≥12 years old: 0.63 mg administered three times a day, every 6 to 8 hours, by nebulization.

  • Patients 12 years of age and older with more severe asthma or patients who do not respond adequately to a dose of 0.63 mg of Xopenex may benefit from a dosage of 1.25 mg three times a day.

Xopenex Overdose

If you take too much Xopenex, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

Other Requirements

  • Store unopened Xopenex vials in the protective foil pouch they come in between 68°F to 77°F (20°C to 25°C).
  • Keep Xopenex away from light and heat.
  • When a Xopenex foil pouch is opened, use the vials within 2 weeks.
  • When Xopenex vials are removed from the foil pouch, use them right away or within 1 week.
  • Keep this and all medicines out of the reach of children.