Xopenex Nebules (Levalbuterol)

You should tell your doctor if you're allergic to levalbuterol, albuterol (Proventil, Ventolin, and others), or any other medications before taking XOPENEX.

This medicine controls symptoms of asthma and other lung diseases, but it isn't a cure. You should continue to use XOPENEX even if you feel well. Don't stop taking this drug or any other medications without first talking to your doctor.

XOPENEX can cause wheezing and breathing difficulties immediately after it's inhaled. This is more likely to occur the first time you use a new canister. Call your doctor right away if this happens to you.

You should also call your doctor immediately if your symptoms become worse, the drug becomes less effective, or you require more doses of medication than is usually needed for relief.

Before taking XOPENEX, tell your doctor if you have or have ever had:

• High blood pressure
• An irregular heartbeat
• Any type of heart disease
• Seizures
• Hyperthyroidism
• Diabetes
• Kidney disease

A XOPENEX inhaler shouldn't be given to a child younger than 4 years old. XOPENEX solution (taken via a nebulizer) shouldn't be given to a child younger than 6 years old.

Pregnancy and XOPENEX

XOPENEX is a Pregnancy Category C drug, which means harm to an unborn baby cannot be ruled out. You should tell your doctor if you are pregnant or plan to become pregnant before taking this medicine.

It's also not known whether XOPENEX will affect a breastfeeding baby. You shouldn't breastfeed while using this drug without first talking to your doctor.

Common Side Effects of XOPENEX

You should tell your doctor if any of the following side effects are severe or don't go away:

• Dizziness
• Nervousness
• Headache
• Uncontrollable shaking
• Heartburn
• Vomiting
• Cough
• Weakness
• Fever
• Leg cramps
• Muscle pain
• Diarrhea

Serious Side Effects of XOPENEX

You should call your doctor immediately if you experience any of the following serious side effects:

• Chest pain
• Pounding or fast heartbeat
• Hives, itching, or skin rash
• Increased difficulty breathing
• Difficulty swallowing
• Hoarseness
• Swelling of your face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

You should always tell your doctor about any prescription, non-prescription, illegal, and recreational drugs; herbal remedies; and nutritional and dietary supplements you're taking, especially:

• Beta blockers, such as atenolol (Tenormin), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
• Digoxin (Digitek, Lanoxin)
• Diuretics (water pills)
• Epinephrine (EpiPen, Primatene Mist)
• Medications for colds
• Other inhaled medications to relax the air passages, such as metaproterenol (Alupent) and pirbuterol (Maxair)

You should also tell your doctor if you are taking the following medications or if you have stopped taking them within the past two weeks:

• Antidepressants, such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor, Sensoval), protriptyline (Vivactil), and trimipramine (Surmontil)
• Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan, Marplon, Enerzer), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar)

XOPENEX comes as a solution to inhale by mouth using a nebulizer (a machine that turns medication into an inhalable mist), a concentrated solution to mix with saline and inhale with a nebulizer, or as an aerosol to take using an inhaler.

The solution for oral inhalation is typically used 3 or 4 times a day, once every 6 to 8 hours. The aerosol inhaler is typically used every 4 to 6 hours.

You should follow the instructions on your prescription label carefully when taking this medicine. Don't take more or less of the drug than your doctor prescribes.

Don't use the aerosol inhaler when you are near a heat source. It can explode if exposed to very high temperatures. Also, don't inhale any other medication out of your inhaler canister.

You should read the written instructions on your aerosol inhaler or nebulizer before using either device. Ask your doctor or pharmacist to show you how to use it.

Clean your nebulizer or inhaler regularly. Follow the manufacturer's directions, and ask your doctor if you have any questions.

XOPENEX Overdose

Symptoms of an overdose include severe forms of some of the side effects listed above.

If you suspect an overdose, you should contact a poison control center or emergency room immediately.

Missed Dose of XOPENEX

If you miss a dose of XOPENEX, take it as soon as your remember.

However, if it's almost time for your next dose, skip the missed dose and continue on your regular dosing schedule. Don't take extra medicine to make up for a missed dose.