Levalbuterol (Xopenex HFA): A Rescue Inhaler for Asthma and COPD


Levalbuterol (Xopenex HFA) is a medication that belongs to the class of short-acting beta-agonists (SABA). It is used to treat or prevent sudden wheezing or shortness of breath in people with certain lung conditions, such as asthma, bronchitis, and emphysema. It works by relaxing the muscles in the lungs and opening the airways, making it easier to breathe.

Levalbuterol (Xopenex HFA) is available as a metered dose inhaler (MDI) that delivers a measured amount of medication with each puff. It is often called a rescue or quick-relief inhaler because it can provide fast relief from breathing problems. It is not a long-term treatment for asthma or COPD and should not be used more than twice a day or more often than prescribed by your doctor.

How to Use Levalbuterol (Xopenex HFA)

Levalbuterol (Xopenex HFA) is intended for inhalation through the mouth. The usual dose is one or two puffs every four to six hours as needed. Follow these steps to use your inhaler correctly:

  • Shake the inhaler well before each use.
  • Remove the cap from the mouthpiece and check that it is clean.
  • Breathe out fully and place the mouthpiece in your mouth, closing your lips around it.
  • Press down on the top of the inhaler while breathing in deeply and slowly.
  • Hold your breath for about 10 seconds or as long as comfortable.
  • Release your finger from the inhaler and breathe out slowly.
  • If you need a second puff, wait at least one minute before repeating the steps.
  • Replace the cap on the mouthpiece after each use.

Levalbuterol (Xopenex HFA) comes with instructions for use that you should read carefully and follow. If you have any questions about how to use your inhaler, ask your pharmacist or doctor for help. You should also keep track of how many puffs you have used and replace your inhaler when it is empty or when it expires, whichever comes first.

Possible Side Effects of Levalbuterol (Xopenex HFA)

Levalbuterol (Xopenex HFA) can cause some side effects, such as sore throat, runny nose, body pain, dizziness, nervousness, tremor, chest pain, hoarseness, and cough. These side effects are usually mild and may go away over time as your body gets used to the medication. However, some side effects can be serious and require immediate medical attention, such as:

  • Allergic reaction: hives, swelling of your face or tongue, difficulty breathing
  • Sudden narrowing of your airways: difficulty breathing, wheezing, chest pain or tightness, cough
  • Heart problems: dizziness, fatigue, weakness, tremor, irregular heartbeat, worsening symptoms of heart problem you already have

If you experience any of these serious side effects, stop using levalbuterol (Xopenex HFA) and call your doctor right away or seek emergency medical care. You should also tell your doctor about any other side effects that bother you or do not go away.

Precautions and Interactions of Levalbuterol (Xopenex HFA)

Before using levalbuterol (Xopenex HFA), you should tell your doctor if you have any of the following conditions:

  • Heart disease
  • High blood pressure
  • High blood sugar (diabetes)
  • Irregular heartbeat or rhythm
  • Kidney disease
  • Pheochromocytoma
  • Seizures
  • Thyroid disease
  • An unusual or allergic reaction to albuterol, levalbuterol, other medications, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Breast-feeding

You should also tell your doctor about all the medications you are taking, including prescription and over-the-counter drugs, vitamins, supplements, and herbal products. Some medications can interact with levalbuterol (Xopenex HFA) and affect how it works or increase the risk of side effects. Some of these medications include:

  • Anti-infectives like chloroquine and pentamidine
  • Caffeine
  • Cisapride
  • Diuretics
  • Medications for colds
  • Medications for depression or for emotional or psychotic conditions
  • Medications for weight loss including some herbal products
  • Methadone
  • Some antibiotics like clarithromycin, erythromycin, levofloxacin, and linezolid
  • Some heart medications
  • Steroid hormones like dexamethasone, cortisone, hydrocortisone
  • Theophylline
  • Thyroid hormones

This is not a complete list of possible interactions. You should always check with your doctor or pharmacist before starting, stopping, or changing any medication.

Levalbuterol (Xopenex HFA) Price and Availability

Levalbuterol (Xopenex HFA) is a prescription medication that is available in generic form in some strengths. The price of levalbuterol (Xopenex HFA) may vary depending on the pharmacy, the dosage, the quantity, and the insurance coverage. You can compare prices and find coupons for levalbuterol (Xopenex HFA) at GoodRx.com.

Levalbuterol (Xopenex HFA) in Different Countries

Levalbuterol (Xopenex HFA) is approved for use in the United States by the Food and Drug Administration (FDA). It is also available in some other countries under different brand names, such as:

  • Airet® in Canada
  • Levosalbutamol® in India
  • Rapivent® in Australia and New Zealand
  • Xoponex® in South Africa
  • Xoponex® HFA in Mexico and Brazil

The availability and price of levalbuterol (Xopenex HFA) may vary depending on the country and the regulations. You should always consult your doctor or pharmacist before using levalbuterol (Xopenex HFA) in a different country.

Table 1: Price of Levalbuterol (Xopenex HFA) in Different Countries (as of October 2023)


CountryBrand NameDosageQuantityPrice (USD)Reference
USAXopenex HFA45 mcg/puff200 puffs/inhaler$24.50 – $61.51GoodRx.com
CanadaAiret50 mcg/puff200 puffs/inhaler$30.00 – $40.00CanadaDrugsDirect.com
IndiaLevosalbutamol50 mcg/puff200 puffs/inhaler$4.00 – $6.00MedPlusMart.com
Australia/New ZealandRapivent50 mcg/puff200 puffs/inhaler$20.00 – $30.00PharmacyDirect.co.nz

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