Generic Name: albuterol and ipratropium (inhalation) (al BUE ter ol and IP ra TRO pee um)
Brand Name: Combivent, Combivent Respimat, DuoNeb

What is albuterol and ipratropium inhalation?

Albuterol and ipratropium is a combination bronchodilator that relaxes muscles in the airways and increases air flow to the lungs.

Albuterol and ipratropium inhalation is used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD) who are also using other medicines to control their condition.

Albuterol and ipratropium inhalation may also be used for purposes not listed in this medication guide.

What is the most important information I should know about albuterol and ipratropium inhalation?

You should not use this medication if you are allergic to albuterol (Proventil, Ventolin), ipratropium (Atrovent), or atropine (Atreza, Lomotil, Vi-Atro, Sal-Tropine).

Slideshow: Flashback: FDA Drug Approvals 2013

Seek medical attention if you think this medication is not working as well as usual.

What should I discuss with my healthcare provider before using albuterol and ipratropium inhalation?

You should not use this medication if you are allergic to albuterol (Proventil, Ventolin), ipratropium (Atrovent), or atropine (Atreza, Lomotil, Vi-Atro, Sal-Tropine).

To make sure albuterol and ipratropium inhalation is safe for you, tell your doctor if you have:

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

  • a seizure disorder such as epilepsy;

  • diabetes;

  • overactive thyroid;

  • glaucoma;

  • liver or kidney disease; or

  • enlarged prostate, problems with urination.

FDA pregnancy category C. It is not known whether this medication 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 albuterol and ipratropium passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using this medication.

How should I use albuterol and ipratropium inhalation?

Follow the directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Overuse of this medicine may increase the risk of death. It is critical that you use only the prescribed dose of this medicine.

This medication comes with patient instructions for safe and effective use, and directions for priming the inhaler device. Duoneb, Combivent, and Combivent Respimat have different patient instructions. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

To use the inhaler (Combivent or Combivent Respimat):

  • Shake the Combivent canister vigorously for at least 10 seconds before each spray. You do not need to shake Combivent Respimat before use.

  • 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.

  • Carefully follow all directions for cleaning your specific inhaler device once per week.

To use the solution with a nebulizer (Duoneb):

  • Open the foil pouch and remove one vial. Squeeze all of the medicine out into the chamber of the nebulizer.

  • Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright in a comfortable position. Place the mouthpiece into your mouth or put the face mask on, covering your nose and mouth.

  • Breathe in slowly and evenly until you have inhaled all of the medicine (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.

  • Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

Keep track of the number of sprays you have used.

  • Throw away the Combivent inhaler canister after 200 sprays.

  • Throw away the Combivent Respimat inhaler canister after 3 months or 120 sprays, whichever comes first.

Seek medical attention if you think this medication is not working as well as usual.

While using albuterol and ipratropium, you may need frequent blood tests at your doctor's office.

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

Store at room temperature away from moisture, heat, and light. Keep each Duoneb vial in its foil pouch until you are ready to use it. Do not store Combivent in your car on hot days. Extreme heat can cause the medicine canister to burst. Do not throw an empty canister into open flame.

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, fast or pounding heartbeats, extreme thirst, muscle weakness or limp feeling, severe headache, buzzing in your ears, weak pulse, fainting, or slow breathing (breathing may stop).

What should I avoid while using albuterol and ipratropium inhalation?

If this medication gets in your eyes, rinse 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.

Albuterol and ipratropium inhalation side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using albuterol and ipratropium inhalation and call your doctor at once if you have:

  • wheezing, choking, or other breathing problems (especially after starting a new canister of this medicine);

  • chest pain, pounding heartbeats or fluttering in your chest;

  • dangerously high blood pressure (severe headache, anxiety, uneven heartbeats);

  • swelling of your ankles or feet;

  • eye pain, or seeing halos around lights;

  • painful or difficult urination; or

  • low potassium (confusion, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling).

Common side effects may include:

  • mild headache; or

  • cold symptoms such as stuffy nose, sneezing, cough, or sore throat.

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: Side effects (in more detail)

What other drugs will affect albuterol and ipratropium inhalation?

Tell your doctor about all medications you use, and those you start or stop using during your treatment with albuterol and ipratropium, especially:

  • heart or blood pressure medication--penbutolol, pindolol, propranolol, sotalol, timolol, and others.

This list is not complete. Other drugs may interact with albuterol and ipratropium, including prescription, over-the-counter, vitamin, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about albuterol and ipratropium inhalation.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.05. Revision Date: 2013-10-01, 10:43:32 AM.

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