Xopenex (levalbuterol) is a brand-name inhaled medication prescribed to treat and help prevent difficulty breathing associated with bronchospasm. Xopenex comes in two forms: a solution for use with a nebulizer and an inhaler.

Specifically, doctors prescribe Xopenex to treat and help prevent bronchospasm (a sudden narrowing of the airways) due to reversible obstructive airway disease. This includes asthma as well as difficulty breathing caused by allergies.

The drug is prescribed for adults, adolescents, and younger children over a certain age. For details, see “Pediatric dosage” in the “Xopenex dosage” section just below.

Xopenex belongs to a drug class called short-acting beta-agonists. Xopenex is available in a generic version.

Keep reading for specific information about the dosage of Xopenex, including its strengths and how to use the medication. For a comprehensive look at Xopenex, including the drug’s side effects, see this article.

Note: This article describes typical dosages for Xopenex provided by the drug’s manufacturer. When taking Xopenex, always follow the dosage prescribed by your doctor.

The typically recommended dosages for Xopenex and other details about the drug are below.

Xopenex forms

Xopenex is available in two forms:

  • A solution in unit-dose vials for use in a nebulizer. This is a device that turns the solution into a mist you can inhale. For details, see the “How to take Xopenex” section below.
  • A metered-dose inhaler. This device releases the drug as an aerosol spray (puff). This form is called Xopenex HFA.

Xopenex strengths

Xopenex comes in the following strengths:

  • 0.31 milligrams per 3 milliliters (mg/mL)
  • 0.63 mg/3 mL
  • 1.25 mg/3 mL

Xopenex is also available as a concentrated solution that you dilute before using. The strength is 1.25 mg/5 mL.

Xopenex HFA comes in one strength: 15-gram (g) canister that holds 200 actuations (puffs). One puff delivers 45 micrograms (mcg) levalbuterol (the active drug in Xopenex).

Typical dosages

With the nebulizer solution, your doctor may start by prescribing a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly prescribed or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for bronchospasm

If you take Xopenex nebulizer solution, the typical dosage for bronchospasm in adults is 0.63 mg three times per day. Your doctor may increase your dosage to 1.25 mg three times per day.

If you take Xopenex HFA, the typical dosage for bronchospasm is two puffs every 4–6 hours. Sometimes, the doctor may lower your dosage to one puff every 4–6 hours. Each puff delivers 45 mcg levalbuterol.

Pediatric dosage

Xopenex is approved to treat bronchospasm in some children. Specifically, Xopenex solution may be prescribed for children ages 6 years and older. Xopenex HFA inhaler may be prescribed for children ages 4 years and older.

If your child is 4 or 5 years old, their doctor will prescribe Xopenex solution. If your child is 6 years old or over, their doctor can prescribe either form of the drug. Your child’s doctor will help determine the form that’s right for your child.

The table below shows the typically recommended children’s dosages by drug form and age:

Drug formAgeRecommended dosageMaximum dosage
solution6–11 years0.31 mg three times per day0.63 mg three times per day
solution12 years and older0.63 mg three times per day1.25 mg three times per day
inhaler4 years and olderone to two puffs* every 4–6 hourstwo puffs* every 4 hours

* Each puff of Xopenex delivers 45 mcg levalbuterol.

Long-term treatment

Xopenex is a rescue medication for treating sudden difficulty breathing. You use a rescue medication during an active bronchospasm. It helps relax your airways quickly, making it easier to breathe. If you and your doctor determine that Xopenex is safe and effective for you, you’ll likely take it long term.

If you have questions about what to expect with Xopenex, talk with your doctor for more information.

The Xopenex dosage your doctor prescribes will depend on several factors. These include:

  • the severity of the condition you’re taking Xopenex to treat
  • the form of Xopenex you take
  • the child’s age
  • other medical conditions you have

Talk with your doctor if you’d like to learn about the factors affecting your dosage.

You take Xopenex by inhaling the medication into your lungs. The specific instructions depend on the drug form your doctor prescribes: Xopenex solution for nebulization or Xopenex HFA metered-dose inhaler.


You’ll take Xopenex solution using a nebulizer. This medical device turns the solution into a mist you can inhale. First, you put the solution in your nebulizer and put on the mask that goes with it. Then you inhale the mist through the mask. Xopenex nebulizer treatments usually take 5–15 minutes.

If your doctor prescribes concentrated Xopenex, you’ll need to dilute it before use. To dilute Xopenex, empty the entire contents of the vial (0.5 milliliters [mL]) into the nebulizer. Then fill the nebulizer up to the 3 mL mark with sterile normal saline.* This will provide a dose of 1.25 milligrams (mg) Xopenex for nebulization.

Note: You will need a prescription for a nebulizer from your doctor. If you don’t already have one, your doctor or pharmacist can make recommendations. (Most insurance companies cover the cost of these devices.) Be sure to follow the directions that come with your nebulizer. They’ll explain how to load your medication and clean the device. You can also ask your doctor or pharmacist how to use the nebulizer before doing it yourself.

* Sterile normal saline is a specific strength of salt in sterile water. It’s available for purchase over the counter. You can ask your pharmacist for the supplies you’ll need for your treatment.

Xopenex HFA

To use Xopenex HFA metered-dose inhaler, you can refer to the “Instructions for Use” section of the drug’s prescribing information.

You’ll need to be able to coordinate deep, slow breaths with releasing a puff from the inhaler. Some people may find it easier to use a nebulizer.

If you have questions about how to take Xopenex or Xopenex HFA, talk with your doctor or pharmacist.


Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

If you take more Xopenex than your doctor prescribes, you may develop harmful effects.

It’s important that you do not take more Xopenex than your doctor advises.

Symptoms of an overdose

Xopenex overdose symptoms can include:

In severe cases, cardiac arrest and death may occur.

If you take more than the recommended amount of Xopenex

Call your doctor right away if you believe you’ve taken too much Xopenex. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number or go to the nearest emergency room.

Below are some common questions related to Xopenex’s dosage.

What’s the maximum daily dosage of Xopenex?

The maximum daily dosage of Xopenex depends on your age and the form of Xopenex you take. The drug comes as a solution for nebulization (Xopenex) and as a metered-dose inhaler (Xopenex HFA).

The maximum dosage of Xopenex for adults and children ages 12 years and older is 1.25 milligrams (mg) three times per day. In children ages 6–11 years, the maximum dosage is 0.63 mg three times per day.

The maximum dosage of Xopenex HFA is two puffs every 4 hours. (One puff is 45 micrograms [mcg] levalbuterol — the active drug in Xopenex.)

If you have questions about this, talk with your doctor for more information. If you feel your dosage isn’t working as well as expected, talk with your doctor. They can evaluate your breathing and adjust your treatment plan if necessary. As with any drug, never change your Xopenex or Xopenex HFA dosage without your doctor’s recommendation.

How often can I use Xopenex each week?

Your doctor will tell you how often you can use Xopenex each week for bronchospasm (sudden narrowing of the airways). In general, treatment guidelines for asthma suggest using rescue medications* no more than twice per week. (Xopenex is a rescue medication.) Rescue medications aren’t for daily use.

If you frequently experience difficulty breathing, talk with your doctor about your treatment plan. You may need a maintenance medication in addition to your rescue medication. When taken daily, maintenance medications such as an inhaled corticosteroid (ICS) help prevent bronchospasm before it starts. Your doctor can recommend an ICS that’s right for you.

There may be other treatment options to manage your condition. Ask your doctor or pharmacist about additional options you may have.

* A rescue medication works quickly to relax your airways. This opens them up and makes it easier for you to breathe.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Xopenex for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Xopenex without your doctor’s recommendation. If you have questions about the dosage of Xopenex that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Xopenex. These additional articles might be helpful:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.