Levalbuterol: What it is and how to use it safely

Levalbuterol (brand name Xopenex) is a fast-acting bronchodilator used to relieve wheezing and shortness of breath from asthma or COPD. It's the R‑isomer of albuterol, so some people tolerate it better or notice fewer side effects. You’ll find it as an MDI (inhaler) or as a solution for a nebulizer.

How levalbuterol works and common uses

Levalbuterol relaxes the muscles around your airways, making it easier to breathe during an attack or when symptoms flare. People use it for quick relief of acute symptoms and sometimes before exercise that triggers bronchospasm. It treats symptoms but doesn’t replace long-term control medicines like inhaled steroids.

Typical dosing varies by form. For inhalers: Xopenex HFA delivers 45 mcg per puff; a common dose is one or two puffs every 4 to 6 hours as needed. For nebulizer solution: common concentrations are 0.63 mg or 1.25 mg given three times daily. Doses differ by age and health, so follow your doctor’s instructions exactly.

Safety, side effects, and important tips

Common side effects include tremor, nervousness, headache, fast heart rate, and throat irritation. Less common but serious problems include chest pain, significant rapid heartbeat, severe tremors, low potassium, and paradoxical bronchospasm (worsening breathing). If you notice breathing getting worse after use, stop and seek medical help.

Watch for interactions. Beta‑blockers (used for heart disease or migraine) can reduce the effect of levalbuterol. MAO inhibitors and certain antidepressants may increase cardiovascular side effects. Diuretics can raise the risk of low potassium. Tell your prescriber about heart disease, high blood pressure, seizures, diabetes, or thyroid problems before starting levalbuterol.

Use inhalers correctly: shake the can, exhale fully, hold the inhaler 1–2 inches from your mouth (or use a spacer), press and inhale slowly, and hold your breath about 10 seconds. Wait about 1 minute between puffs if you need more than one. For nebulizers: use clean, functioning equipment, and follow the clinic or manufacturer steps to run the treatment until the mist stops.

Store levalbuterol at room temperature, away from heat and freezing. Keep the inhaler capped when not in use. Check expiration dates and dispose of empty or expired devices properly.

Buying online? Levalbuterol requires a prescription. Use a licensed pharmacy, verify contact details, and avoid prices that look too good to be true. Keep your prescription and get pharmacist support if you’re unsure about dosing or device use.

If you have questions about using levalbuterol with other inhalers or your long-term asthma plan, talk to your doctor or pharmacist. Proper use helps control symptoms and reduces emergency visits—so get the right dose, device technique, and follow-up.