Xopenex Inhalation Solution Concentrate Side Effects

Please note - some side effects for Xopenex Inhalation Solution Concentrate may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects by Body System - for Healthcare Professionals

Applies to: inhalation aerosol; inhalation solution

General

Levalbuterol has been generally well-tolerated and adverse effects seen have been consistent with its pharmacological activity. In general, the severity of these adverse effects have been dose dependent. The potential and significance for fewer side effects with levalbuterol compared to racemic albuterol remains to be established.

Cardiovascular

Adverse cardiovascular effects may be due to significant hypokalemia produced by levalbuterol, thought to be due to intracellular shunting. Aggravation of angina may be due to tachycardia produced by levalbuterol. Supraventricular ectopic beats and ventricular tachycardia have also been reported. Higher doses of levalbuterol should be used with caution in patients with cardiac disease, arrhythmias, or hypertension. All of these effects are dose-related and lower doses may be tolerated.

Cardiovascular side effects have included palpitations and peripheral vasodilatation, commonly resulting in reflex tachycardia. Blood pressure has been increased or decreased. Levalbuterol in higher dosages has rarely aggravated angina, myocardial ischemia, or cause atrial or ventricular arrhythmias. Pulmonary edema has been reported in pregnant patients receiving racemic albuterol.

Musculoskeletal

Musculoskeletal side effects have included tremors, particularly at higher dosages. Tolerance has developed to the tremorogenic effects. Severe muscle cramping has occurred infrequently.

Metabolic

One hour following doses of 0.63 mg and 1.25 mg levalbuterol via nebulizer, potassium levels decreased from baseline by 0.2 and 0.3 mEq/L and glucose levels increased from baseline by 4.6 and 10.3 mg/dL respectively.

Levalbuterol may stimulate sodium-potassium ATPase, resulting in an intracellular shift of potassium.

Metabolic side effects have included hypokalemia, and less commonly, hyperglycemia.

Nervous system

Nervous system side effects have included nervousness, headache, dizziness, anxiety, and insomnia.

Other

Other side effects have included the development of tachyphylaxis to the bronchodilating effects of albuterol. Although conflicting data exist, complete tolerance has not been reported.

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