Other interactions can increase side effects or make them more severe. Below are lists of medications that can interact with Xopenex. These lists do not contain all the drugs that may interact with Xopenex. Before taking Xopenex, talk with your doctor and pharmacist.
Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. This includes heart-related side effects such as chest pain, palpitations feeling fluttering with your heartbeat , or changes in your blood pressure.
Interactions with these drugs are described below. Taking these medications together can further increase your risk of having a low potassium level. Symptoms of low potassium level include muscle cramps, problems with your heart rhythm, dizziness, and fainting. Typically, changes in your potassium level that are caused by taking Xopenex or Xopenex HFA are temporary. And your potassium level usually returns to normal without being treated.
If you need to take a diuretic, your doctor will likely recommend that you use a drug other than Xopenex or Xopenex HFA. Using beta-blockers with either of these drugs can also make you more prone to having bronchospasm tightening of your airways that can make it hard for you to breathe. If you need to take a beta-blocker, your doctor will likely recommend that you use a drug other than Xopenex or Xopenex HFA.
This can make digoxin less effective to treat your condition. In some cases, your doctor may recommend that you use a drug other than Xopenex or Xopenex HFA if you need to take digoxin. Examples of these antidepressant medications include:. These side effects can include fast heart rate, palpitations feeling fluttering with your heartbeat , or changes in your blood pressure. However, you should still check with your doctor or pharmacist before using any of these products while taking Xopenex.
Sometimes severe, life-threatening side effects can occur with overuse or misuse of these drugs. You can also call the American Association of Poison Control Centers at or use their online tool. But if your symptoms are severe, call or go to the nearest emergency room right away. Studies are currently being done to better understand if these drugs have an effect on pregnant women or on their developing fetuses. The doses of these drugs given in the studies were higher than typical doses given to humans.
No negative effects were seen in fetuses exposed to either drug. More studies are needed to know if these drugs affect human pregnancies. They can discuss with you the risks and benefits of different treatment options. Your doctor can recommend healthy and safe ways to feed your child.
Your insurance plan may require you to get prior authorization before they approve coverage for Xopenex. This means that your doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Xopenex.
If you need financial support to pay for Xopenex HFA, or if you need help understanding your insurance coverage, help is available. Sunovion Pharmaceuticals Inc. For more information, call Xopenex and Xopenex HFA are each used as needed to treat and prevent bronchospasm caused by certain breathing conditions. With bronchospasm, your airways becomes tight and narrow, which makes it hard for you to breathe.
It generally takes about 5 to 15 minutes for each treatment. Instructions for how to use your nebulizer will be specific to your machine. Children or older adults who are taking Xopenex may need help to set up and use their nebulizer. With an MDI, the drug is released in puffs, which are inhaled. For some people, using an MDI is more difficult than using a nebulizer. Xopenex and Xopenex HFA are short-acting beta-agonists beta agonists. Examples of reversible obstructive airway disease include conditions such as asthma and certain other breathing problems that are related to allergies.
Xopenex and Xopenex HFA work by quickly relaxing the muscles in your airways, which makes it easier for you to breathe. After taking each dose of Xopenex or Xopenex HFA, your breathing symptoms should be noticeably improved within about 15 minutes. Xopenex and Xopenex HFA are considered rescue medications because they work quickly to treat symptoms when they occur. Xopenex may not be right for you if you have certain medical conditions or other factors affecting your health.
These include:. When you get Xopenex from the pharmacy, the pharmacist will add an expiration date to the label on the container. The expiration date helps guarantee the effectiveness of the medication during this time.
If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it. How long a medication remains good can depend on many factors, including how and where you store the medication.
Vials of Xopenex liquid solution come in a foil pouch. Canisters of Xopenex HFA aerosol spray come in a box. Do not puncture or burn canisters of Xopenex HFA. Also, avoid storing them near heat. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment. The FDA website provides several useful tips on medication disposal.
You can also ask your pharmacist for information on how to dispose of your medication. Canisters containing Xopenex HFA should never be disposed of in a fire or incinerator.
The medication inside the canisters is stored under pressure. If heated, the canisters may burst open. Xopenex and Xopenex HFA are beta2 adrenergic-agonists, which activate receptors on the smooth muscle tissue of airways. This in turn activates adenylate cyclase to increase concentrations of cyclic adenosine monophosphate AMP.
Increased concentrations of cyclic AMP activates protein kinase A, which interferes with the phosphorylation of myosin and decreases calcium concentrations in smooth muscle cells. This leads to relaxation in the muscles and provides relief of bronchospasm symptoms. Xopenex and Xopenex HFA relax the airways from the trachea down to the terminal bronchioles.
Because beta2-adrenergic receptors are also present in the heart, Xopenex may cause heart-related side effects. Xopenex and Xopenex HFA are metabolized in the gastrointestinal tract via sulfotransferase SULT1A3 and are eliminated primarily in the urine as unchanged drug and metabolite. The elimination half-life of Xopenex is estimated to be 3 to 4 hours.
Xopenex and Xopenex HFA are contraindicated in people with a previous hypersensitivity reaction to levalbuterol or albuterol. Several different precautions exist. Vials containing Xopenex liquid solution are supplied in a foil pouch. Once a foil pouch is opened, the vials must be used within 2 weeks. If vials are removed from the pouch, they must be protected from light and used within 1 week.
Canisters containing Xopenex HFA aerosol spray are supplied in a box. The actuator mouthpiece should be facing down when stored. Do not puncture, burn, or store canisters near heat. Disclaimer: Medical News Today 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 other 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. Chronic obstructive pulmonary disease COPD support groups can give people a place to talk, share resources, and make friends.
It is important to obtain a baseline of cardiac function prior to administering these drugs at the same time. Beta blockers, often used to control heart rate and blood pressure, are functionally opposite of beta-agonists.
Their functions will counteract each other. If a patient must be both a beta blocker and a beta-agonist, using a cardioselective beta blocker is preferred.
Examples of cardioselective beta blockers include atenolol and metoprolol, among others. This is not a complete list of potential drug interactions. Please seek the medical advice of a healthcare professional for a complete understanding of potential drug interactions. If this occurs, therapy should be stopped immediately and a new treatment should be started. Destabilization of asthma may occur over a period of hours, days, or longer. If an asthmatic patient begins to require an increasing amount of a bronchodilator to control asthma symptoms, this could be a sign that destabilization is occurring.
Patients experiencing this may need anti-inflammatory treatments such as corticosteroids or a change in their maintenance medication regimen. Levalbuterol and albuterol, especially at doses above the recommended amount, may cause serious cardiovascular effects such as increased heart rate and blood pressure.
In some serious cases, cardiac arrest has occurred. Never exceed the recommended dosing your doctor has prescribed. Low serum potassium levels, or hypokalemia, has been observed with levalbuterol and albuterol.
This may be caused by intracellular shunting. While these drugs are sometimes used off-label to lower potassium levels intentionally, this effect should be monitored. Levalbuterol is a prescription drug that is a short-acting beta-agonist, also known as a bronchodilator. It is used to treat bronchospasm related to asthma and COPD.
It is also used off-label to help prevent exercise-induced bronchospasm. It is available in the form of a metered-dose inhaler as well as solutions to be used in a nebulizer.
Albuterol is also a prescription drug that is a short-acting beta-agonist. It is also known as a bronchodilator and is used to treat bronchospasm related to asthma and COPD as well as to prevent exercise-induced bronchospasm.
It is available in various forms including oral tablets, oral solutions, metered-dose inhalers, and solutions to be used in a nebulizer. Levalbuterol and albuterol are chemically similar, but they are not exactly the same.
Albuterol is a racemic mixture of two chemical enantiomers, R-albuterol and S-albuterol. It is sometimes referred to as racemic albuterol.
Mark : And do your best to avoid accepting samples—it ultimately costs patients more in the long run. There is no difference between albuterol and levalbuterol in effectiveness or side effects in children with moderate asthma exacerbations. Be prepared for the mandatory switch in metered-dose inhalers to products containing hydrofluoroalkane HFA in place of chlorofluorocarbon CFC by the end of Be aware of publication bias.
Studies that show drugs in a positive light are more likely to be submitted for publication. For this reason, the published studies on levalbuterol look good. But if you look at all of the studies submitted to the FDA, levalbuterol and albuterol are equivalent, with albuterol costing less.
Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Reprints are not available from the authors. Comparison of fixed-dose weight-adjusted unfractionated heparin and low-molecular-weight heparin for acute treatment of venous thromboembolism. Levalbuterol versus racemic albuterol in the treatment of acute exacerbation of asthma in children.
Pediatr Emerg Care. Comparison of levalbuterol and racemic albuterol combined with ipratropium bromide in acute pediatric asthma: a randomized controlled trial. J Emerg Med. A comparison of levalbuterol with racemic albuterol in the treatment of acute severe asthma exacerbations in adults.
Am J Emerg Med. Levalbuterol tartrate Xopenex HFA for the treatment of bronchospasm. Am Fam Physician. Sepracor Q4 earnings call transcript. Accessed January 15, Withdrawal of albuterol inhalers containing chlorofluorocarbon propellants. N Engl J Med. Sepracor Inc. Peak change in FEV1 after first dose was higher in combined levalbuterol group compared to combined racemic albuterol group 0.
At 4 weeks, peak change in FEV1 was higher in combined levalbuterol group but the difference was not statistically significant 0. When different doses are compared, levalbuterol 1. It is unclear whether the higher mean FEV1 change seen with levalbuterol 1. Levalbuterol 1. Levalbuterol 0. Overall, treatment with levalbuterol 0.
The study suggested that the greater improvement in pulmonary function seen with levalbuterol alone compared to equal dose of levalbuterol given as part of racemicalbuterol was likely due to negative effects of S-albuterol.
Similar results were also found in pediatric population. In a randomized, double-blind, placebo-controlled, cross over study by Gawchik et al, 33 patients age range with chronic stable asthma were treated with levalbuterol, racemic albuterol or placebo in single dose during 4 treatment visits [10].
Notably, this study was also supported by Sepracor. In this double-blind, cross over study, 20 asthmatic patients age range ; mean age 50 yrs were randomized to receive R-albuterol dose range 6.
The FEV1 was measured 20 minutes after dosing. S-albuterol was found to have no effect on FEV1 compared with placebo and thus concluded to be clinically inactive. Furthermore, in a retrospective chart review of patients aged 18 or older presenting to ED with acute airflow obstruction no difference in changes in heart rate was observed when equivalent doses of R-albuterol were administered [12].
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