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Xopenex Side Effects

Generic name: levalbuterol

Medically reviewed by Last updated on Dec 5, 2022.

Note: This document contains side effect information about levalbuterol. Some dosage forms listed on this page may not apply to the brand name Xopenex.


Common side effects of Xopenex include: rhinitis. Other side effects include: nervousness and tremor. Continue reading for a comprehensive list of adverse effects.

Applies to levalbuterol: inhalation aerosol powder, inhalation solution.

Serious side effects of Xopenex

Along with its needed effects, levalbuterol (the active ingredient contained in Xopenex) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking levalbuterol:

More common

Less common

  • Chest pain or tightness
  • dizziness
  • feeling “faint”
  • lightheadedness
  • troubled breathing

Incidence not known

  • Confusion
  • cough
  • difficult or labored breathing
  • difficulty swallowing
  • drowsiness
  • extra heartbeat
  • fainting
  • fast, pounding, slow, or irregular heartbeat or pulse
  • hives, welts, itching, or rash
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • nausea
  • noisy breathing
  • rapid, deep breathing
  • redness of the skin
  • restlessness
  • stomach cramps
  • unusual tiredness or weakness
  • vomiting

Get emergency help immediately if any of the following symptoms of overdose occur while taking levalbuterol:

Symptoms of overdose

  • Chest pain
  • dizziness
  • dry mouth
  • general feeling of discomfort or illness
  • headache
  • impaired consciousness
  • irregular or fast heartbeat
  • lightheadedness
  • nausea
  • nervousness
  • seizures
  • sleeplessness
  • sweating
  • tremor

Other side effects of Xopenex

Some side effects of levalbuterol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Accidental injury (in children 4 to 11 years of age)
  • anxiety
  • body aches or pain
  • chills
  • congestion
  • cough
  • dryness or soreness of the throat
  • fever
  • general aches and pains
  • headache
  • hoarseness
  • increased cough
  • leg cramps
  • loss of appetite
  • migraines or other headaches
  • muscle tightness
  • nervousness
  • runny or stuffy nose

Less common

  • Abnormal growth filled with fluid or semisolid material
  • blemishes on the skin
  • blood in the urine
  • bloody nose
  • burning, dry, or itching eyes
  • burning or stinging of the skin
  • cough producing mucus
  • cramps
  • diarrhea
  • difficulty having a bowel movement
  • discharge from the eye
  • dry mouth or throat
  • ear pain
  • excessive tearing
  • eye itch
  • heavy menstrual bleeding
  • muscle pain
  • night sweats
  • numbness or decreased sensitivity of the hand
  • pain
  • painful cold sores or blisters on the lips, nose, eyes, or genitals
  • pimples
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • stomach pain
  • tingling sensation in the arms or legs
  • vaginal yeast infection
  • weight loss

For Healthcare Professionals

Applies to levalbuterol: inhalation aerosol, inhalation solution.


This drug has been associated with paradoxical bronchospasm, cardiovascular effects, immediate hypersensitivity reactions, and hypokalemia.[Ref]


ECG abnormal, ECG change, hypotension, and syncope occurred in less than 2%.[Ref]

Common (1% to 10%): Hypertension, tachycardia

Frequency not reported: ECG abnormal, ECG change, hypotension, syncope

Postmarketing reports: Arrhythmias (including atrial fibrillation, supraventricular tachycardia, extrasystoles)[Ref]


Myalgia occurred in less than 2%.[Ref]

Common (1% to 10%): Leg cramps

Frequency not reported: Myalgia[Ref]


Metabolic acidosis occurred in less than 2%.[Ref]

Frequency not reported: Changes in plasma glucose and serum potassium; metabolic acidosis[Ref]

Nervous system

Central nervous system stimulation and hyperesthesia of the hand occurred in less than 2%.[Ref]

Common (1% to 10%): Dizziness, migraine, tremor, nervousness

Frequency not reported: Central nervous system stimulation, hyperesthesia of the hand[Ref]


Common (1% to 10%): Pain, flu syndrome, accidental injury, asthenia, fever

Frequency not reported: Ear pain, herpes simplex, chills, cyst[Ref]

Ear pain, herpes simplex, chills, and cyst occurred in less than 2%.[Ref]


Diarrhea, dry mouth, dry throat, nausea, gastroenteritis, vomiting, and constipation occurred in less than 2%.

Common (1% to 10%): Dyspepsia

Frequency not reported: Diarrhea, dry mouth, dry throat, nausea, gastroenteritis, vomiting, constipation

Postmarketing reports: Gastroesophageal reflux disease (GERD), nausea


Viral infection, epistaxis, lung disorder, asthma exacerbation, and wheezing occurred in less than 2%.

Common (1% to 10%): Asthma, pharyngitis, rhinitis, bronchitis, sinusitis, turbinate edema, cough increased, viral infection

Frequency not reported: Epistaxis, lung disorder, asthma exacerbation, wheezing

Postmarketing reports: Chest pain, dysphonia, dyspnea


Frequency not reported: Acne, sweating

Postmarketing reports: Rash, urticaria

Acne and sweating occurred less than 2%.


Common (1% to 10%): Allergic reactions

Postmarketing reports: Angioedema, anaphylaxis


Frequency not reported: Hematuria, dysmenorrhea, vaginal moniliasis

Hematuria, dysmenorrhea, vaginal moniliasis occurred in less than 2%.


Frequency not reported: Lymphadenopathy

Lymphadenopathy occurred in less than 2%.


Eye itch occurred in less than 2%.

Frequency not reported: Eye itch


Common (1% to 10%): Anxiety

Frequency not reported: Insomnia

Insomnia occurred in less than 2%.


1. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):

2. Nelson HS, Bensch G, Pleskow WW, DiSantostefano R, DeGraw S, Reasner DS, Rollins TE, Rubin PD "Improved bronchodilation with levalbuterol compared with racemic albuterol in patients with asthma." J Allergy Clin Immunol 102 (1998): 943-52

3. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol 103 (1999): 615-21

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.