IPRATROPIUM/ALBUTEROL (SALBUTAMOL) - INHALATION
Common Brand Name(s): Combivent
Phonetic Pronunciation: (IP-ra-TROE-pee-um/al-BUE-ter-ol) (sal-BUE-tah-mol)
Information last revised August 2010
What does IPRATROPIUM/ALBUTEROL INHL look like?
Combivent 18 mcg-103 mcg/Actuation Aerosol Inhaler
Uses:
This product is a combination of 2 medications: albuterol (also known as salbutamol) and ipratropium. It is used to treat or prevent wheezing and shortness of breath caused by ongoing breathing problems (e.g., chronic obstructive pulmonary disease-COPD, emphysema, chronic bronchitis). It works in the airways by opening breathing passages and relaxing muscles. Controlling symptoms of breathing problems can decrease time lost from work or school.
Missed Dose
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
How To Use
Read the Patient Information Leaflet provided by your pharmacist before you start using this product and each time you get a refill. Refer to the illustrated directions provided by the manufacturer for directions on how to use this device. If any of the information is unclear, consult your doctor or pharmacist. Follow the instructions for test sprays in the air (priming) if you are using a new canister or if you have not used it for more than 24 hours. Avoid spraying the medication in your eyes. Before each dose, shake the inhaler well for at least 10 seconds. Inhale this medication by mouth, usually 4 times daily or as directed by your doctor. You may use more doses if you have wheezing and shortness of breath between your prescribed doses. However, the manufacturer recommends that you do not use more than 12 inhalations in a 24-hour period. Doing so may increase the risk of serious side effects. Use this medication regularly to receive the most benefit from it. To help you remember, use it at the same times each day. If you find it difficult to use this inhaler correctly, it may help to use a spacer device with this inhaler. Ask your doctor or pharmacist for more information. Keep track of the number of inhalations you use, and discard the inhaler after you have used the labeled number of inhalations on the product package. Test sprays used to prime the inhaler should also be counted. Learn which of your inhalers you should use every day and which you should use if your breathing suddenly worsens. Ask your doctor what to do if you have worsening cough or shortness of breath, wheezing, increased sputum, or worsening peak flow meter readings. Learn when you can self-medicate and when you should get medical help right away. If this medication stops working well or your breathing symptoms become worse, seek immediate medical attention.
Drug Interactions
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before, during, and after treatment with this medication. In some cases a serious, possibly fatal drug interaction may occur. Before using this product, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: anticholinergic drugs (e.g., benztropine, trihexyphenidyl), anti-spasmodic drugs (e.g., dicyclomine, hyoscyamine), adrenaline-like drugs (e.g., ephedrine, pseudoephedrine), asthma drugs (e.g., salmeterol, formoterol), some beta blockers (such as propranolol), pramlintide, tricyclic antidepressants (e.g., amitriptyline, nortriptyline), "water pills"/diuretics (e.g., furosemide, hydrochlorothiazide). Check the labels on all your medicines (e.g., cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate or blood pressure. Ask your pharmacist about the safe use of these products. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
Medical Alert
Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).
Notes
Do not share this medication with others. Laboratory and/or medical tests (e.g., pulmonary function tests, blood pressure, potassium blood levels) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details. Learn to use a peak flow meter, use it daily, and promptly report worsening breathing problems (such as readings in the yellow/red range, increased use of quick-relief inhalers). Avoid allergens/irritants such as smoke, pollen, pet dander, dust, or molds that may worsen breathing problems. Ask your doctor or pharmacist whether you should have an annual flu shot.
Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: chest pain, fast/pounding/irregular heartbeat, shaking (tremors).
Precautions
Before using this product, tell your doctor or pharmacist if you are allergic to albuterol (salbutamol) or ipratropium; or to atropine or other belladonna-type drugs; or if you have any other allergies. This product may contain inactive ingredients (such as soy lecithin from soybeans), which can cause allergic reactions or other problems. Some people who are allergic to peanuts may also be allergic to soy. Talk to your pharmacist for more details. Before using this product, tell your doctor your medical history, especially of: diabetes, heart disease (e.g., irregular heartbeat, coronary insufficiency), high blood pressure, glaucoma, low potassium blood level (hypokalemia), seizure, overactive thyroid (hyperthyroidism), urination problems (e.g., due to enlarged prostate, urinary retention). This drug may make you dizzy. If accidentally sprayed into your eyes, it may also cause temporary blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages. Before having surgery, tell your doctor or dentist that you are using this medication. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.
Storage
Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Do not puncture the canister or expose it to high heat or open flame. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Side Effects
Headache, nausea, nervousness, trouble sleeping, dizziness, dry mouth/throat, coughing, or runny nose may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: eye pain, fast/pounding heartbeat, muscle cramps, trouble urinating, vision changes, weakness. Seek immediate medical attention if any of these rare but very serious side effects occur: chest pain, irregular heartbeat. Rarely, this medication has caused severe (rarely fatal), sudden worsening of breathing problems/asthma (paradoxical bronchospasm). If you have trouble breathing or experience sudden wheezing, seek immediate medical attention. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.