From the Guidelines
The recommended dosage of Xopenex (levalbuterol) HFA is 2 inhalations (45 mcg per inhalation) every 4 to 6 hours as needed for bronchospasm, with a maximum daily dose not exceeding 8 inhalations in 24 hours, as supported by the guidelines for asthma management 1.
Key Considerations
- For adults and children 4 years and older, the typical dosage is 2 inhalations (45 mcg per inhalation) every 4 to 6 hours as needed.
- The maximum daily dose should not exceed 8 inhalations in 24 hours.
- For children under 4 years, dosing should be determined by a healthcare provider based on individual needs.
- Patients should shake the inhaler well, exhale fully, place the mouthpiece between their lips, inhale deeply while pressing down on the canister, hold their breath for 10 seconds, and then exhale slowly.
- Patients should wait at least one minute between inhalations.
Mechanism of Action
Xopenex is a short-acting beta-agonist that works by relaxing the smooth muscles in the airways, which helps to open constricted airways and improve breathing, as described in the guidelines for the management of asthma exacerbations 1.
Important Precautions
- Patients should rinse their mouth after use to prevent throat irritation and possible fungal infections.
- If symptoms worsen or do not improve after regular use, medical attention should be sought immediately.
Evidence-Based Recommendations
The recommended dosage is based on the guidelines for asthma management, which provide evidence-based recommendations for the treatment of bronchospasm 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION: Children 6–11 years old: The recommended dosage of Xopenex (levalbuterol HCl) Inhalation Solution for patients 6–11 years old is 0.31 mg administered three times a day, by nebulization. Routine dosing should not exceed 0. 63 mg three times a day. Adults and Adolescents ≥12 years old: The recommended starting dosage of Xopenex (levalbuterol HCl) Inhalation Solution for patients 12 years of age and older is 0.63 mg administered three times a day, every 6 to 8 hours, by nebulization. The recommended dosage of Xopenex (levalbuterol) HFA is not explicitly stated in the provided drug label, as the label appears to be for the inhalation solution, not the HFA formulation. 2
From the Research
Xopenex HFA Dosage
The recommended dosage of Xopenex (levalbuterol) HFA is not explicitly stated in the provided studies. However, the following information can be gathered:
- Levalbuterol can be administered at lower doses than racemic albuterol to provide comparable bronchodilation, with the potential for reduced beta-mediated adverse effects in adults and children 3, 4.
- A study compared levalbuterol 1.25 mg q6-8h with racemic albuterol 2.5 mg q1-4h in hospitalized patients with acute asthma or COPD, and found that levalbuterol required significantly fewer median total nebulizations 5.
- Another study compared levalbuterol 1.25 mg three times daily with albuterol 2.5 mg four times daily in hospitalized adults with COPD or asthma, and found that the numbers of scheduled and rescue nebulizations were similar between the two groups 6.
- A study evaluated the effectiveness of a single dose of nebulized levalbuterol in stable COPD, and found that levalbuterol 1.25 mg led to significant improvements in FEV(1) compared to placebo, similar to racemic albuterol 2.5 mg and combined racemic albuterol and ipratropium 7.
Key Points
- Levalbuterol can be administered at lower doses than racemic albuterol.
- The dosage of levalbuterol may vary depending on the specific condition being treated and the patient population.
- Studies have compared different dosing regimens of levalbuterol with racemic albuterol in various patient populations, including hospitalized patients with acute asthma or COPD, and stable COPD patients.
- The results of these studies suggest that levalbuterol may require fewer nebulizations and have similar clinical outcomes compared to racemic albuterol, but may also have higher treatment costs and longer hospital stays in some cases.