Home Drug Guide Levalbuterol Hydrochloride

Drug Guide

Generic Name

Levalbuterol Hydrochloride

Brand Names Xopenex

Classification

Therapeutic: Bronchodilator for asthma and COPD

Pharmacological: Beta-2 adrenergic agonist

FDA Approved Indications

Relief of bronchospasm in patients with reversible airway obstruction due to asthma or COPD

Mechanism of Action

Levalbuterol selectively stimulates beta-2 adrenergic receptors in smooth muscle of the airways, causing relaxation and bronchodilation.

Dosage and Administration

Adult: 0.63-1.25 mg inhaled every 6-8 hours as needed

Pediatric: 0.31-0.63 mg inhaled every 20 minutes for up to 3 doses, then as needed; dosages may vary based on age and weight

Geriatric: Use with caution; start at lower end of dosing spectrum with monitoring

Renal Impairment: Adjust dose based on severity of impairment, if necessary

Hepatic Impairment: No specific adjustments necessary

Pharmacokinetics

Absorption: Rapid absorption after inhalation

Distribution: Wide distribution; minimal plasma protein binding

Metabolism: Primarily hepatic via conjugation to inactive metabolites

Excretion: Renal excretion of metabolites

Half Life: about 3-4 hours

Contraindications

Hypersensitivity to levalbuterol or other sympathomimetics

Precautions

Use cautiously in patients with cardiovascular disorders, diabetes, hyperthyroidism, or seizure disorders.

Adverse Reactions - Common

Tremor (Common)
Nervousness (Common)
Headache (Uncommon)
Dizziness (Uncommon)

Adverse Reactions - Serious

Cardiac arrhythmias (Rare)
Hypersensitivity (including bronchospasm, angioedema) (Rare)

Drug-Drug Interactions

Other sympathomimetics, beta-blockers, monoamine oxidase inhibitors (MAOIs)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, lung sounds, and pulse before and after administration.

Diagnoses:

Ineffective Airway Clearance
Impaired Gas Exchange

Implementation: Administer via inhaler or nebulizer as prescribed. Monitor for side effects.

Evaluation: Assess improvements in lung function and symptom relief.

Patient/Family Teaching

Use inhaler/spacer properly as instructed.
Notify healthcare provider if symptoms worsen or if adverse reactions occur.
Avoid exceeding prescribed dose.
Keep track of inhaler doses and when to replace.

Special Considerations

Black Box Warnings:

None currently

Genetic Factors: None specific to levalbuterol

Lab Test Interference: None known

Overdose Management

Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, chest pain.

Treatment: Discontinue drug, provide supportive care, monitor cardiac status, and treat symptoms symptomatically.

Storage and Handling

Storage: Store at room temperature, away from heat and moisture.

Stability: Stable for up to 24 months when stored properly.