Xopenex
Xopenex Side Effects Center
Medical Editor: John P. Cunha, DO, FACOEP
Xopenex (levalbuterol HCl) is used to treat reversible obstructive airway conditions such as asthma, bronchitis, and emphysema. It is a bronchodilator. This medication is available in generic form in some strengths. Common side effects include headache, nervousness, shaking (tremor), dizziness, trouble sleeping, dry mouth, nausea, stomach upset, diarrhea, cough, sore throat, or runny nose.
The recommended dosage of Xopenex Inhalation Solution for patients 6-11 years old is 0.31 mg administered three times a day, by nebulization. Routine dosing should not exceed 0.63 mg three times a day. The recommended starting dosage of Xopenex for patients 12 years of age and older is 0.63 mg administered three times a day, every 6 to 8 hours, by nebulization. Xopenex may interact with beta-blockers, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), diuretics (water pills), digoxin, other inhaled bronchodilators, caffeine, diet pills, or decongestants. Xopenex should be used only when prescribed during pregnancy. It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
Our Xopenex (levalbuterol HCl) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is Patient Information in Detail?
Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.
Xopenex in Detail - Patient Information: Side Effects
Stop using levalbuterol inhalation and seek emergency medical attention if you experience any of the following serious side effects:
- an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
- worsening of respiratory symptoms (shortness of breath, wheezing); or
- chest pain or irregular heartbeats.
Other, less serious side effects may be more likely to occur. Continue to use levalbuterol inhalation and talk to your doctor if you experience
- dizziness;
- tremor or nervousness;
- anxiety;
- headache;
- cough or runny nose;
- upset stomach; or
- leg cramps.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Xopenex (Levalbuterol) »
What is Patient Information Overview?
A concise overview of the drug for the patient or caregiver from First DataBank.
Xopenex Overview - Patient Information: Side Effects
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if any of these unlikely but serious side effects occur: anxiety, leg/muscle cramps, swollen glands.
Get medical help right away if you have any unlikely but very serious side effect, including: fast/pounding/irregular heartbeat, chest pain.
Rarely, this medication has caused severe (rarely fatal), sudden worsening of breathing problems/asthma (paradoxical bronchospasm). If you experience sudden wheezing, get medical help right away.
A very serious allergic reaction to this drug is unlikely. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Xopenex (Levalbuterol)»
What is Prescribing information?
The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.
Xopenex FDA Prescribing Information: Side Effects
(Adverse Reactions)
SIDE EFFECTS
Adults And Adolescents ≥ 12 Years Old
Adverse events reported in ≥ 2% of patients receiving Xopenex Inhalation Solution or racemic albuterol and more frequently than in patients receiving placebo in a 4-week, controlled clinical trial are listed in Table 3.
Table 3: Adverse Events Reported in a 4-Week, Controlled
Clinical Trial in Adults and Adolescents ≥ 12 years old
| Body System Preferred Term | Percent of Patients | |||
| Placebo (n=75) |
Xopenex 1.25 mg (n=73) |
Xopenex 0.63 mg (n=72) |
Racemic albuterol 2.5 mg (n=74) |
|
| Body as a Whole | ||||
| Allergic reaction | 1.3 | 0 | 0 | 2.7 |
| Flu syndrome | 0 | 1.4 | 4.2 | 2.7 |
| Accidental injury | 0 | 2.7 | 0 | 0 |
| Pain | 1.3 | 1.4 | 2.8 | 2.7 |
| Back pain | 0 | 0 | 0 | 2.7 |
| Cardiovascular System | ||||
| Tachycardia | 0 | 2.7 | 2.8 | 2.7 |
| Migraine | 0 | 2.7 | 0 | 0 |
| Digestive System | ||||
| Dyspepsia | 1.3 | 2.7 | 1.4 | 1.4 |
| Musculoskeletal System | ||||
| Leg cramps | 1.3 | 2.7 | 0 | 1.4 |
| Central Nervous System | ||||
| Dizziness | 1.3 | 2.7 | 1.4 | 0 |
| Hypertonia | 0 | 0 | 0 | 2.7 |
| Nervousness | 0 | 9.6 | 2.8 | 8.1 |
| Tremor | 0 | 6.8 | 0 | 2.7 |
| Anxiety | 0 | 2.7 | 0 | 0 |
| Respiratory System | ||||
| Cough increased | 2.7 | 4.1 | 1.4 | 2.7 |
| Infection viral | 9.3 | 12.3 | 6.9 | 12.2 |
| Rhinitis | 2.7 | 2.7 | 11.1 | 6.8 |
| Sinusitis | 2.7 | 1.4 | 4.2 | 2.7 |
| Turbinate edema | 0 | 1.4 | 2.8 | 0 |
The incidence of certain systemic beta-adrenergic adverse effects (e.g., tremor, nervousness) was slightly less in the Xopenex 0.63 mg group compared with the other active treatment groups. The clinical significance of these small differences is unknown.
Changes in heart rate 15 minutes after drug administration and in plasma glucose and potassium 1 hour after drug administration on day 1 and day 29 were clinically comparable in the Xopenex 1.25 mg and racemic albuterol 2.5 mg groups (see Table 4). Changes in heart rate and plasma glucose were slightly less in the Xopenex 0.63 mg group compared with the other active treatment groups (see Table 4). The clinical significance of these small differences is unknown. After 4 weeks, effects on heart rate, plasma glucose, and plasma potassium were generally diminished compared with day 1 in all active treatment groups.
Table 4: Mean Changes from Baseline Heart Rate at 15
Minutes and Glucose and Potassium at 1 Hour after First Dose (Day 1) in Adults
and Adolescents ≥ 12 years old
| Treatment | Mean Changes (day 1) | ||
| Heart Rate (bpm) | Glucose (mg/dL) | Potassium (mEq/L) | |
| Xopenex 0.63 mg, n=72 | 2.4 | 4.6 | -0.2 |
| Xopenex 1.25 mg, n=73 | 6.9 | 10.3 | -0.3 |
| Racemic albuterol 2.5 mg, n=74 | 5.7 | 8.2 | -0.3 |
| Placebo, n=75 | -2.8 | -0.2 | -0.2 |
No other clinically relevant laboratory abnormalities related to administration of Xopenex Inhalation Solution were observed in this study.
In the clinical trials, a slightly greater number of serious adverse events, discontinuations due to adverse events, and clinically significant ECG changes were reported in patients who received Xopenex 1.25 mg compared with the other active treatment groups. The following adverse events, considered potentially related to Xopenex, occurred in less than 2% of the 292 subjects who received Xopenex and more frequently than in patients who received placebo in any clinical trial:
Body as a Whole: chills, pain, chest pain
Cardiovascular System: ECG abnormal, ECG change, hypertension, hypotension, syncope
Digestive System: diarrhea, dry mouth, dry throat, dyspepsia, gastroenteritis, nausea
Hemic and Lymphatic System: lymphadenopathy
Musculoskeletal System: leg cramps, myalgia
Nervous System: anxiety, hypesthesia of the hand, insomnia, paresthesia, tremor
Special Senses: eye itch
The following events, considered potentially related to Xopenex, occurred in less than 2% of the treated subjects but at a frequency less than in patients who received placebo: asthma exacerbation, cough increased, wheezing, sweating, and vomiting.
Adverse reactions (children 6-11 years old)
Adverse events reported in ≥ 2% of patients in any treatment group and more frequently than in patients receiving placebo in a 3-week, controlled clinical trial are listed in Table 5.
Table 5: Most Frequently Reported Adverse Events ( ≥ 2% in
Any Treatment Group) and Those Reported More Frequently Than in Placebo during
the Double-Blind Period (ITT Population, 6-11 Years Old)
| Body System Preferred Term | Percent of Patients | ||||
| Placebo (n=59) |
Xopenex 0.31 mg (n=66) |
Xopenex 0.63 mg (n=67) |
Racemic albuterol 1.25 mg (n=64) |
Racemic albuterol 2.5 mg (n=60) |
|
| Body as a Whole | |||||
| Abdominal pain | 3.4 | 0 | 1.5 | 3.1 | 6.7 |
| Accidental injury | 3.4 | 6.1 | 4.5 | 3.1 | 5.0 |
| Asthenia | 0 | 3.0 | 3.0 | 1.6 | 1.7 |
| Fever | 5.1 | 9.1 | 3.0 | 1.6 | 6.7 |
| Headache | 8.5 | 7.6 | 11.9 | 9.4 | 3.3 |
| Pain | 3.4 | 3.0 | 1.5 | 4.7 | 6.7 |
| Viral Infection | 5.1 | 7.6 | 9.0 | 4.7 | 8.3 |
| Digestive System | |||||
| Diarrhea | 0 | 1.5 | 6.0 | 1.6 | 0 |
| Hemic and Lymphatic | |||||
| Lymphadenopathy | 0 | 3.0 | 0 | 1.6 | 0 |
| Musculoskeletal System | |||||
| Myalgia | 0 | 0 | 1.5 | 1.6 | 3.3 |
| Respiratory System | |||||
| Asthma | 5.1 | 9.1 | 9.0 | 6.3 | 10.0 |
| Pharyngitis | 6.8 | 3.0 | 10.4 | 0 | 6.7 |
| Rhinitis | 1.7 | 6.1 | 10.4 | 3.1 | 5.0 |
| Skin and Appendages | |||||
| Eczema | 0 | 0 | 0 | 0 | 3.3 |
| Rash | 0 | 0 | 7.5 | 1.6 | 0 |
| Urticaria | 0 | 0 | 3.0 | 0 | 0 |
| Special Senses | |||||
| Otitis Media | 1.7 | 0 | 0 | 0 | 3.3 |
Note: Subjects may have more than one adverse event per body system and preferred term.
Changes in heart rate, plasma glucose, and serum potassium are shown in Table 6. The clinical significance of these small differences is unknown.
Table 6: Mean Changes from Baseline Heart Rate at 30
Minutes and Glucose and Potassium at 1 Hour after First Dose (Day 1) and Last
Dose (Day 21) in Children 6-11 years old
| Treatment | Mean Changes (Day 1) | ||
| Heart Rate (bpm) | Glucose (mg/dL) | Potassium (mEq/L) | |
| Xopenex 0.31 mg, n=66 | 0.8 | 4.9 | -0.31 |
| Xopenex 0.63 mg, n=67 | 6.7 | 5.2 | -0.36 |
| Racemic albuterol 1.25 mg, n=64 | 6.4 | 8.0 | -0.27 |
| Racemic albuterol 2.5 mg, n=60 | 10.9 | 10.8 | -0.56 |
| Placebo, n=59 | -1.8 | 0.6 | -0.05 |
| Treatment | Mean Changes (Day 21) | ||
| Heart Rate (bpm) | Glucose (mg/dL) | Potassium (mEq/L) | |
| Xopenex 0.31 mg, n= 60 | 0 | 2.6 | -0.32 |
| Xopenex 0.63 mg, n=66 | 3.8 | 5.8 | -0.34 |
| Racemic albuterol 1.25 mg, n= 62 | 5.8 | 1.7 | -0.18 |
| Racemic albuterol 2.5 mg, n= 54 | 5.7 | 11.8 | -0.26 |
| Placebo, n= 55 | -1.7 | 1.1 | -0.04 |
Postmarketing Adverse Reactions
In addition to the adverse events reported in clinical trials, the following adverse events have been observed in postapproval use of Xopenex Inhalation Solution. These events have been chosen for inclusion due to their seriousness, their frequency of reporting, or their likely beta-mediated mechanism: angioedema, anaphylaxis, arrhythmias (including atrial fibrillation, supraventricular tachycardia, extrasystoles), asthma, chest pain, cough increased, dyspnea, metabolic acidosis, nausea, nervousness, rash, tachycardia, tremor, urticaria. Because these events have been reported spontaneously from a population of unknown size, estimates of frequency cannot be made.
Read the entire FDA prescribing information for Xopenex (Levalbuterol) »
Additional Xopenex Information
Xopenex - User Reviews
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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