Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For levalbuterol, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to levalbuterol, albuterol, or other inhaled asthma medicines. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Levalbuterol has not been studied in pregnant women. However, studies in animals have shown that albuterol, a very similar medicine, may cause birth defects or other problems. Levalbuterol has the potential to interfere with contractions during labor. Before taking this medicine, make sure your doctor knows if you are pregnant or may become pregnant.

Breast-feeding—It is not known whether levalbuterol passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—This medicine has been tested in children 12 years of age and older. In effective doses, this medicine has not been shown to cause different side effects or problems than it does in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same as they do in young adults. Although there is limited information comparing the use of levalbuterol in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults. Your doctor may want to begin with a lesser dose and increase the dosage as tolerated.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your doctor and pharmacist if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicines, including the following:

• Aerosol bronchodilators, short-acting (albuterol [e.g., Proventil, Ventolin], bitolterol [e.g., Tornalate], ephedrine [OTC], epinephrine [OTC, e.g., Primatene], isoetharine [e.g., Bronkosol], isoproterenol [e.g., Isuprel], pirbuterol [e.g., Maxair], terbutaline [e.g., Brethaire])—Using levalbuterol while you are using short-acting aerosol bronchodilators may cause some heart problems

• Beta-adrenergic blocking agents, systemic (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], carteolol [e.g., Cartrol], labetolol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Betapace, Sotacor], timolol [e.g., Blocadren])—Using levalbuterol while you are using beta-adrenergic blocking agents may block the relaxation of smooth muscle in the lungs to ease breathing

• Digoxin—Levalbuterol may decrease the levels of digoxin in the blood. Blood levels of digoxin should be monitored when possible

• Diuretics, non-potassium-sparing (bumetanide [e.g., Bumex], ethacrynic acid [e.g., Edecrin], furosemide [e.g., Lasix], indapamide [e.g., Lozol], thiazide diuretics [water pills])—Use may worsen salt imbalance in the blood

• Methylxanthines (caffeine, theophylline [e.g., Theo-Dur])—Using levalbuterol with methylxanthines may result in irregular heartbeat

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) or
• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Norpramin, Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl, Pamelor], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil])—Taking levalbuterol while you are taking, or within 2 weeks of taking, MAO inhibitors or tricyclic antidepressants may cause a change in blood pressure or pulse rate

Other medical problems—The presence of other medical problems may affect the use of levalbuterol. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart disease (irregular heartbeat or decreased blood flow through the heart) or
• High blood pressure—Use of levalbuterol may worsen these conditions

• Diabetes mellitus (sugar diabetes)—Levalbuterol may worsen blood glucose control

• Hyperthyroidism (overactive thyroid)

• Seizures—Concurrent use may worsen this condition