Levalbuterol (Xopenex HFA) for COPD

Levalbuterol (brand name, Xopenex HFA) is a short-acting bronchodilator (rescue bronchodilator) to treat or prevent a bronchospasm (narrowing of the airways), or to relieve or prevent the wheezing, coughing, and chest tightness caused by COPD and lung diseases such as asthma. Bronchodilators work by relaxing and opening the lungs’ airways, making it easier to breath.

How does levalbuterol for COPD work?

Levalbuterol is a selective beta2-adrenergic receptor agonist. These receptors are present on the smooth muscle of the bronchi and, when stimulated, they relax the muscle to bronchodilate the airways. Beta2-adrenergic receptor agonists also increase the flow of calcium and potassium ions through the walls of bronchi muscle cells, which also helps muscles to relax.

Beta2-receptors are predominant in the muscle cells of the lungs, but they are also present in the heart, which means levalbuterol may have cardiac effects, such as irregular heartbeats.

Studies of levalbuterol

A study (NCT00665600) investigated the efficacy and safety of levalbuterol treatment, at doses of 0.63 mg or 1.25 mg for six weeks, in COPD patients. Published results found the treatment was well-tolerated and producing significant bronchodilation compared to placebo. Treatment was also found to improve clinical control of COPD, reducing the need for rescue medication, compared to placebo and albuterol.

Indications and side effects

Levalbuterol is available as a solution to inhale by mouth using a nebulizer, a concentrated solution to be mixed with normal saline and inhaled by mouth using a nebulizer, and as an aerosol to inhale by the mouth using an inhaler. Either solution  is usually used three times a day, once every 6 to 8 hours, while the aerosol is usually used every 4 to 6 hours.

This medicine offers quick-relief from bronchospasms related to COPD or asthma, typically easing symptoms in a few minutes.

Common levalbuterol side effects may be dizziness, nervousness, tremors, runny nose and sore throat, chest pain or tightness, irregular heartbeats, pain or vomiting.


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