Levalbuterol Tartrate HFA

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 02, 2024

Warnings

Levalbuterol Tartrate (Xopenex HFA) Risks, Warnings, and Complications

Levalbuterol tartrate may cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for your lung condition if you are at an increased risk of adverse effects from this medication. Some of the risks of taking levalbuterol tartrate include:

Paradoxical Bronchospasm: Levalbuterol tartrate (Xopenex HFA) can sometimes cause paradoxical bronchospasm (narrowing of the airways and a severe acute asthmatic crisis), which can be life-threatening. If paradoxical bronchospasm occurs (if you develop wheezing or difficulty breathing after taking a dose), stop using levalbuterol tartrate immediately. Do not use the medicine again until you’ve spoken to your healthcare provider. This risk of this happening is greatest when you first use a new canister of the medicine.
Worsening Asthma: Asthma can worsen rapidly over a few hours or more slowly over several days to weeks. When a previously effective dosage regimen is no longer controlling symptoms, a reevaluation of the patient and treatment regimen is required. Tell your doctor if you have worsening asthma control on the prescribed dose of levalbuterol tartrate. You may need to take anti-inflammatory medications such as corticosteroids or other appropriate symptomatic therapy.
Cardiovascular Effects: Levalbuterol tartrate and other beta-adrenergic agonists can cause clinically significant cardiovascular effects in some people, including effects on heart rate and blood pressure and electrocardiogram (ECG) changes. A significant cardiovascular effect is rare when this medicine is used at the recommended doses. However, if it occurs, you may need to discontinue using levalbuterol tartrate. Levalbuterol tartrate and other inhaled sympathomimetic drugs should be used with caution in people with cardiovascular disease, especially coronary artery disease, cardiac arrhythmias, and hypertension in order to avoid deleterious cardiovascular effects,
Drug Interactions: Certain other drugs can block the pulmonary effects of beta-adrenergic agonists, such as levalbuterol tartrate and/or produce adverse cardiovascular effects. For example, beta-adrenergic blocking agents, diuretics, digoxin, monoamine oxidase inhibitors, or tricyclic antidepressants should be avoided or used with caution in patients taking levalbuterol tartrate. When it is necessary to use beta blockers, a cardioselective beta receptor blocker should be chosen. Give your doctor a complete list of your medications before starting levalbuterol tartrate treatment to prevent potentially dangerous drug-drug interactions.
Severe Allergic Reactions: Immediate hypersensitivity reactions have been reported after administration of racemic albuterol. Signs and symptoms may include skin rash, hives, swelling, difficulty breathing, and throat closing. Seek emergency medical attention if you develop these symptoms after taking levalbuterol tartrate.
Coexisting Conditions: Levalbuterol tartrate and other sympathomimetic amines should be used with caution in people with medical conditions such as cardiovascular disease, hypertension, cardiac arrhythmias, epilepsy, hyperthyroidism, and diabetes mellitus. These conditions may worsen if levalbuterol tartrate is prescribed. For example, experiments with large doses of intravenous racemic albuterol sulfate demonstrated that they can aggravate preexisting diabetes mellitus and ketoacidosis.
Hypokalemia: Levalbuterol tartrate and other beta-adrenergic agonist medications can produce significant hypokalemia (low potassium levels) in some people. This can have deleterious cardiovascular effects. The decrease in potassium levels is usually temporary and does not typically require potassium supplementation. However, significant laboratory abnormalities observed may require discontinuation of treatment with this medicine.

Precautions Before Starting Levalbuterol Tartrate (Xopenex HFA)

Tell your doctor if you have ever had an allergic reaction to levalbuterol tartrate, albuterol (Ventolin, Proventil, others), any of the active or inactive ingredients in levalbuterol tartrate formulations, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a list of all your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal remedies. This can help avoid possible interactions between levalbuterol tartrate and your other medications.

Levalbuterol tartrate may not be safe for people with certain medical conditions. Tell your doctor if you have high blood pressure, cardiac arrhythmias, heart disease, diabetes, hyperthyroidism, seizures, or decreased renal function (kidney disease).

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant soon, or are breast-feeding. Fertility studies in animals showed a significant dose-related increase in congenital abnormalities with racemic albuterol sulfate. Post-marketing experience with racemic albuterol sulfate showed rare instances of various congenital anomalies. However, since the pregnant women were taking multiple medications, no consistent pattern or direct relationship has been established between the marketed albuterol HFA inhaler and congenital anomalies.

Precautions During Use of Levalbuterol Tartrate (Xopenex HFA)

Keep all your medical and laboratory appointments during levalbuterol tartrate therapy.

If you are taking other inhaled medications, ask your healthcare provider if you need to take them away from your levalbuterol tartrate.

Call your doctor if you become pregnant while on levalbuterol tartrate.

Tell all your providers you are on levalbuterol tartrate, especially before any surgery, including dental procedures.

Sometimes, levalbuterol tartrate can paradoxically produce severe bronchospasm (wheezing and difficulty breathing). Stop using the medicine and call your doctor right away if you develop asthma-related adverse reactions.

Levalbuterol Tartrate (Xopenex HFA) Drug Interactions

Certain other drugs can affect how levalbuterol tartrate works. Possible drug interactions with other medicines can increase the risk of severe adverse reactions. The following medications can have interactions with levalbuterol tartrate:

Beta-adrenergic blocking agents (beta blockers) such as metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), nadolol (Corgard), labetalol (Normodyne), and propranolol (Inderal)
Epinephrine (Epipen, Primatene Mist)
Heart medications such as digoxin (Digitek, Lanoxin)
Water pills or diuretics
Medications used to treat colds
Other inhaled medications used to open up the air passages, such as pirbuterol (Maxair) or metaproterenol (Alupent)

Tell your doctor or pharmacist if you are currently taking or have taken the following medications within the past 2 weeks:

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

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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