Xopenex HFA

Levalbuterol is used to treat wheezing and shortness of breath that commonly occur with lung problems (e.g., asthma, chronic obstructive pulmonary disease). Controlling these symptoms can decrease time lost from work or school. Levalbuterol is a bronchodilator (beta-2 receptor agonist) that works by opening breathing passages to make breathing easier.

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Read the Patient Information Leaflet for instructions on proper use of this medication and the proper cleaning of the mouthpiece. Consult your doctor or pharmacist if you have any questions. Shake the canister well before each inhalation and test spray. Follow the instructions for test sprays in the air if you are using a new canister or if you have not used it for 3 days or more. Avoid spraying the medication in your eyes. A fine mist is a sign that the inhaler is properly working. Take the cap off the mouthpiece. Place the mouthpiece near your mouth and exhale. Place the mouthpiece fully into your mouth and press the inhaler as you breathe in deeply. Hold your breath for 10 seconds if possible to allow the drug to be absorbed. If more than one inhalation is prescribed, wait at least one full minute between inhalations. If you take other asthma drugs by mouth or with inhaling devices, ask your doctor about how to correctly take this medication with your other asthma medicines. Take this medication exactly as prescribed. Inhale by mouth usually every 4 to 6 hours or as directed by your doctor. Dosage is based on your medical condition and response to therapy. Do not take more of this medication or take it more often than recommended by your doctor. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. If you find it difficult to correctly use this inhaler, it may help to use a spacer device with this inhaler. Ask your doctor or pharmacist for more information. If you notice less effect than usual from this medication, if your symptoms get worse, or you feel you need to take any of your asthma medications more often than recommended, seek immediate medical attention. Keep track of the number of inhalations used from each canister. Discard the canister after you have used the number of inhalations marked on the manufacturer's package. Sprays used to prime the inhaler should also be counted. Do not float the metal canister in water to test if any more drug is left in the canister. Learn which of your inhalers you should use every day and which you should use if your breathing suddenly worsens. Ask your doctor what to do if you have worsening cough or shortness of breath, wheezing, increased sputum, or worsening peak flow meter readings. Learn when you can self-medicate and when you should get medical help right away.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first. Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before, during, and after treatment with this medication. In some cases a serious, possibly fatal drug interaction may occur. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other asthma drugs (e.g., albuterol), some beta blockers (such as propranolol), digoxin, inhaled anesthetics (e.g., halothane, isoflurane), other sympathomimetic drugs (e.g., ephedrine, epinephrine), tricyclic antidepressants (e.g., amitriptyline, nortriptyline), certain "water pills" (diuretics that cause potassium loss such as furosemide, hydrochlorothiazide). This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Do not share this medication with others. Avoid allergens, irritants, smoking and other factors that make asthma worse. Laboratory and/or medical tests (e.g., blood pressure, heart rate, EKG) may be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details. Learn to use a peak flow meter, use it daily, and promptly report worsening asthma (such as readings in the yellow/red range or increased use of quick-relief inhalers).

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: chest pain, fast/pounding/irregular heartbeat, headache, shaking (tremors), nervousness, weakness, severe dizziness, seizures.

Before taking levalbuterol, tell your doctor or pharmacist if you are allergic to it; or to similar bronchodilators (e.g., albuterol, metaproterenol, salmeterol); or to sympathomimetic drugs (e.g., epinephrine, pseudoephedrine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (e.g., high blood pressure, abnormal heart rhythm, coronary insufficiency), seizures, overactive thyroid (hyperthyroidism), diabetes, kidney disease, low blood potassium level (hypokalemia). This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. The elderly may be at greater risk for the effects on the heart while using this drug. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Store at room temperature between 68-77 degrees F (20-25 degrees C) away from direct sunlight. It is best to store the inhaler with the mouthpiece down. Avoid freezing. Do not puncture the canister or expose it to high heat or open flame. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Headache, nausea, nervousness, dizziness, shaking (tremor), trouble sleeping, dry mouth, cough, sore throat, or runny nose may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: fast/pounding/irregular heartbeat, muscle cramps, weakness. Seek immediate medical attention if this unlikely but serious side effect occurs: chest pain. Rarely, this medication has caused severe (rarely fatal), sudden worsening of breathing problems/asthma (paradoxical bronchospasm). If you experience sudden wheezing, seek immediate medical attention. A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.