1 What is Combivent?

Brand: Combivent, Combivent Respimat, Duoneb

Generic: Ipratropium and albuterol

Brand name:

Combivent, Combivent Respimat, Duoneb.

Ipratropium and albuterol combination are bronchodilators used to help control the symptoms of lung diseases, such as asthma, chronic bronchitis, emphysema, and COPD.

This drug combination is breathed in through the mouth and relaxes the smooth muscles to open up the bronchial tubes in the lungs. This drug requires a prescription.

2 What to Know Before Using

Before taking this drug, the risks and benefits for your body should be discussed with your healthcare provider.

Inform your healthcare provider for any allergic reactions to these drugs or any other drugs, foods, dyes, preservatives, or animals.

Carefully read the label of non-prescription drugs for any possible allergic reaction or contraindications.

Studies in the pediatric population on the correlation of age to the effects of ipratropium and albuterol combination have not been performed while safety and efficacy have not been established.

Studies in the elderly have not demonstrated any geriatric-specific problems that would limit the utility of CombiventВ® RespimatВ® spray.  

The relationship of age to the effects of CombiventВ® in geriatric patients is still under investigation.

Drugs should not be taken together to prevent any interactions but in necessary cases inquire your healthcare provider regarding the adjustments in dosage or any other necessary precautions to prevent any unwanted side effects.

Inform your healthcare professional if you are taking any other drugs such as:

  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Atomoxetine
  • Clomipramine
  • Desipramine
  • Dibenzepin
  • Doxepin
  • Imipramine
  • Iobenguane I 123
  • Levalbuterol
  • Lofepramine
  • Melitracen
  • Nortriptyline
  • Opipramol
  • Oxymorphone
  • Protriptyline
  • Tianeptine
  • Trimipramine.

Intake of specific food or using alcohol or tobacco with this drug is associated with an increased risk of certain side effects.

Your healthcare professional can give you special instructions about the use of food, alcohol, or tobacco.

Inform your healthcare provider for any other medical problems such as allergy to soya lecithin, soybean, or peanuts, cardiovascular problems, hypertension, diabetes, difficult urination, enlarged prostate, hyperthyroidism, hypokalemia, narrow-angle glaucoma, seizures, or urinary bladder blockage.

3 Proper Usage

This drug must be taken exactly as directed by your healthcare professional. To prevent any side effects, take this drug exactly as directed on the label or as prescribed by your healthcare professional.

Follow the instructions on the label or as directed by your healthcare professional. Use a jet nebulizer that is connected to an air compressor with a good air flow if you are taking an inhalation solution.

Use a face mask or mouthpiece to inhale the drug and keep the spray away from your eyes as this drug may cause eye pain or discomfort, irritation, blurred vision, or start seeing halos or odd colors when you look at things.

Consult with your healthcare professional right away if accidental contact to your eyes happens.

Insert the metal canister firmly and fully into the clear end of the CombiventВ® Inhalation Aerosol mouthpiece.

This mouthpiece should not be used with other inhaled drugs. Remove the cap and look at the mouthpiece to make sure it is clean.

Shake the inhaler for at least 10 seconds and test spray it in the air 3 times before using it for the first time or if the inhaler has not been used for 24 hours.

To inhale this drug, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright.

Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down once on the top of the canister.

Hold your breath for about 10 seconds, and then breathe out slowly. If you are supposed to use more than one puff, wait 1 to 2 minutes before inhaling the second puff.

Repeat these steps for the second puff, starting with shaking the inhaler. When you have finished all of your doses, rinse your mouth with water. Clean the inhaler mouthpiece every day with hot water.

Dry it thoroughly before use. Insert the cartridge into the CombiventВ® RespimatВ® inhaler if you are using the spray form.

Before using the inhaler, prime it by spraying the drug towards the ground, until an aerosol cloud is visible. Repeat 3 more times. The inhaler is now ready for use.

If the inhaler is not used for more than 3 days, prime the inhaler once to prepare it for use. If it not used for more than 21 days, prime the inhaler 3 times.

To inhale this drug, breathe out fully, trying to get as much air out of the lungs as possible.

Open your mouth and breathe in slowly and deeply, and at the same time firmly press down once the release button of the inhaler. Hold your breath for about 10 seconds, and then breathe out slowly.

After using the inhaler, clean the mouthpiece with a damp cloth or tissue at least once a week. This inhaler has a dose indicator window that shows how much drug is left.

When the pointer enters the red area of the scale, it is the time that you need to refill your prescription. Throw away the inhaler 3 months from its first use or when the inhaler is locked (after 60 or 120 puffs).

Use only the brand of this drug that your healthcare professional prescribed. Different brands may not work the same way. The dose of this drug will be variable for different patients.

The directions on the label or the prescription by your healthcare professional should be followed. The dosage of this drug you take depends on the medical problem for which you are using this drug.

Adults with symptoms of chronic obstructive pulmonary disease (COPD) should do 2 puffs of the aerosol form four times a day and as needed. Do not use more than 12 puffs in any 24-hour period.

Use and dose in children must be determined by your healthcare professional. One 3 milliliters (mL) vial in the nebulizer four times a day is recommended if the inhalation solution is used.

You may use 2 additional treatments per day if needed. Use and dose in children must be determined by your healthcare professional.

For the use of spray form in adults, one puff four times a day is recommended. You may take additional doses per day if needed. Do not use more than 6 puffs in any 24-hour period.

Use and dose in children must be determined by your healthcare professional. A missed dose should be taken as soon as possible.

However, skip the missed dose and go back to your regular dosing schedule if it is almost time for your next dose.

Store the drug in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children.

Dispose any outdated or expired drugs and ask your healthcare professional for the proper disposal of the drugs.

4 Precautions to Take

Your health care provider should closely monitor the effectiveness of this drug as well as check for unwanted effects.

 This drug may cause paradoxical bronchospasm which will worsen your breathing or wheezing.

Consult with your healthcare professional immediately if you experience symptoms of bronchospasm such as coughing, difficulty breathing, shortness of breath, or wheezing after using this drug.

Contact emergency medical services immediately if you have symptoms of anaphylaxis such as rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while taking this drug.

Inform your healthcare professional immediately if you experience chest pain, notice any changes in your blood pressure, or notice your heart beating faster or slower.

Take all of your COPD drugs as your healthcare professional ordered. Continue to use any type of corticosteroid drug ordered by your healthcare professional to control your breathing.

Call your healthcare professional immediately if you feel that any of your drugs is not working. Consult with your healthcare professional before you change the dose or stop taking this drug.

This drug may cause dizziness, blurred vision, or trouble in seeing clearly. Be careful in taking this drug before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to see well.

Seek advice from your healthcare professional before you take any other prescription or non-prescription drugs for appetite control, asthma, colds, cough, hay fever, or sinus problems, and herbal or vitamin supplements.

5 Potential Side Effects

Side effects may vary for each individual and prompt medical attention should be given if they occur.

Consult with your healthcare professional immediately if you experience symptoms of:

  • body aches or pain
  • chills
  • cough
  • a cough producing mucus
  • the difficulty with breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • A runny nose
  • sneezing
  • a sore throat
  • stuffy nose
  • tightness in the chest
  • unusual tiredness or weakness
  • bladder pain
  • bloody or cloudy urine
  • blurred vision
  • burning while urinating
  • burning
  • crawling
  • itching
  • numbness
  • prickling
  • "pins and needles", or tingling feelings
  • chest pain
  • congestion
  • diarrhea
  • difficult
  • burning
  • painful urination
  • dizziness
  • fainting
  • fast, slow, irregular, pounding, or racing heartbeat or pulse
  • frequent urge to urinate
  • the general feeling of discomfort or illness
  • hoarseness
  • increased sputum
  • joint pain
  • loss of appetite lower
  • back or side pain
  • muscle aches and pains
  • nausea
  • nervousness
  • noisy breathing pain
  • pain or tenderness around the eyes and cheekbones
  • pounding in the ears
  • shakiness in the legs, arms, hands, or feet
  • shivering
  • sweating
  • swelling
  • tender, swollen glands in the neck
  • trembling or shaking of the hands or feet
  • trouble sleeping
  • trouble swallowing
  • voice changes
  • vomiting
  • skin rash or hives
  • swelling of the face, lips, eyelids, mouth, or throat
  • chest discomfort
  • the decrease in the frequency of urination
  • the decrease in urine volume
  • difficulty in passing urine
  • itching skin
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • pain or discomfort in the arms, jaw, back, or neck puffiness
  • swelling of the eyelids or around the eyes, face, lips, or tongue
  • redness of the skin, or welts

Some side effects may occur that usually do not need medical attention. As your body adjusts to the medicine, the side effects will slowly disappear.

Ask your healthcare professional about ways to prevent or reduce some of these side effects.

If any of the following side effects persists or are inconvenient, or if you notice any other effects, or if you have any questions about them, consult with your health care professional.

Report any side effects to the FDA hotline at 1-800-FDA-1088.

6 Related Clinical Trials