Combivent

Generic Name: albuterol and ipratropium (inhalation) (al BYOO ter ol and ip ra TRO pee um)
Brand Names: Combivent, DuoNeb

What is Combivent?

Combivent is a metered-dose inhaler containing a combination of albuterol and ipratropium. Albuterol and ipratropium are bronchodilators that relax muscles in the airways and increase air flow to the lungs.

Combivent is used as an inhaled medication to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD) who are also using other medicines to control their condition.

Combivent may also be used for purposes not listed in this medication guide.

Important information about Combivent

You should not use Combivent if you are allergic to albuterol (Proventil, Ventolin), ipratropium (Atrovent), or atropine (Atreza, Sal-Tropine). Do not use Combivent if you are allergic to soybeans, peanuts, or other food products that contain soya lecithin.

Before you use Combivent, tell your doctor if you have heart disease, high blood pressure, coronary artery disease, a heart rhythm disorder, seizures, diabetes, overactive thyroid, an enlarged prostate, urination problems, liver disease, or kidney disease.

Call your doctor right away if any of your medications do not seem to work as well in preventing bronchospasm.

Before using Combivent

You should not use Combivent if you are allergic to albuterol (Proventil, Ventolin), ipratropium (Atrovent), or atropine (Atreza, Sal-Tropine). Do not use Combivent if you are allergic to soybeans, peanuts, or other food products that contain soya lecithin.

To make sure you can safely use Combivent, tell your doctor if you have any of these other conditions:

• heart disease, high blood pressure, coronary artery disease, or heart rhythm disorder;

• a seizure disorder such as epilepsy;

• diabetes;

• overactive thyroid;

• glaucoma;

• enlarged prostate, problems with urination; or

• liver or kidney disease.

FDA pregnancy category C. It is not known whether Combivent is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether this albuterol or ipratropium passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using Combivent.

See also: Combivent pregnancy and breastfeeding warnings (in more detail)

How should I use Combivent?

Use Combivent exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Combivent may increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication.

Combivent comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

To use the inhaler (Combivent):

• Shake the canister vigorously for at least 10 seconds before each spray.

• Uncap the mouthpiece of the inhaler. Breathe out fully. Put the mouthpiece into your mouth and close your lips. Keep your eyes closed to prevent spraying any medicine into your eyes. Breathe in slowly while pushing down on the canister. Hold your breath for 10 seconds, then breathe out slowly.

• If you use more than one inhalation at a time, wait at least 2 minutes before using the second inhalation.

• Keep your Combivent inhaler clean and dry, and store it with the cap on the mouthpiece. Clean your inhaler once a week by removing the canister and placing the mouthpiece under warm running water for at least 30 seconds. Allow the parts to dry before putting the inhaler back together.

Call your doctor right away if any of your medications do not seem to work as well in preventing attacks.

To be sure Combivent is helping your condition and not causing harmful effects, your lung function will need to be tested often. You may also need blood tests at your doctor's office. Visit your doctor regularly.

Store Combivent at room temperature away from moisture and heat. Extreme heat can cause the medicine canister to burst. Do not store it in your car on hot days. Do not throw an empty canister into open flame.

Use Combivent regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of albuterol and ipratropium can be fatal. Overdose symptoms may include chest pain or heavy feeling, rapid or uneven heart rate, pain spreading to the arm or shoulder, nausea, sweating, weakness, or general ill feeling.

What should I avoid while using Combivent?

Avoid getting Combivent in your eyes. If this does happen, rinse the eyes with water and seek medical attention. This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Combivent side effects

Stop using this medication and get emergency medical help if you have any of these signs of an allergic reaction to Combivent: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Combivent and call your doctor at once if you have any of these serious side effects:

• bronchospasm (wheezing, chest tightness, trouble breathing), especially after starting a new canister of Combivent;

• chest pain and fast, pounding, or uneven heart beats;

• swelling of your ankles or feet;

• vision problems, eye pain, or seeing halos around lights;

• pain or burning with urination; or

• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure).

Less serious Combivent side effects may include:

• hoarse voice, sore throat, cough, runny or stuffy nose;

• constipation, diarrhea;

• nausea, upset stomach;

• headache; or

• leg cramps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Combivent side effects (in more detail)

What other drugs will affect Combivent?

Tell your doctor about all other medications you use, especially:

• atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

• bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

• clidinium (Quarzan);

• glycopyrrolate (Robinul);

• hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);

• dicyclomine (Bentyl);

• mepenzolate (Cantil);

• methantheline (Provocholine);

• bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

• irritable bowel medications such as dicyclomine (Bentyl) or propantheline (Pro Banthine);

• a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), metoprolol (Lopressor), propranolol (Inderal), and others;

• a diuretic (water pill);

• an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate);

• a stimulant, ADHD medication, diet pills, or over-the-counter cold or allergy medicines; or

• medicines used to treat Parkinson's disease such as benztropine (Cogentin), orphenadrine (Norflex), trihexyphenidyl (Artane, Trihexane), and others.

This list is not complete and other drugs may interact with Combivent. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Combivent.