Ipratropium/albuterol (By breathing)
Albuterol Sulfate (al-BUE-ter-ol SUL-fate), Ipratropium Bromide (ip-ra-TROE-pee-um BROE-mide)
Treats a lung problem called chronic obstructive pulmonary disease (COPD). This includes chronic bronchitis and emphysema.
Combivent, DuonebThere may be other brand names for this medicine.
When This Medicine Should Not Be Used:You should not use this medicine if you have had an allergic reaction to albuterol (Proventil®, Ventolin®), ipratropium (Atrovent®), levalbuterol (Xopenex?), an ipratropium/albuterol combination (Combivent®, Duoneb®), or atropine. You should not use the Combivent® brand of this medicine if you are allergic to soya lecithin, soybeans, or peanuts.
How to Use This Medicine:
- Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. This medicine comes as a liquid that is used in a device called a nebulizer and also as an inhaler.
- You will use this medicine with an inhaler device called a nebulizer. The nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer.
- You will use this medicine with a device called a metered-dose inhaler. The inhaler fits on the medicine canister and turns the medicine into a fine spray that you breathe in through your mouth and to your lungs. You may be told to use a spacer, which is a tube that is placed between the inhaler and your mouth. Your caregiver will show you how to use your inhaler and the spacer (if needed).
- Shake the inhaler well just before each use. Avoid spraying this medicine into your eyes.
- Remove the cap and look at the mouthpiece to make sure it is clean.
- Test spray in the air before using for the first time or if the inhaler has not been used for a while. Spray the medicine three times into the air and away from your face.
- To inhale this medicine, 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 on the top of the canister once.
- Hold your breath for about 5 to 10 seconds, 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 next puff, starting with shaking the inhaler.
- When you have finished all your inhalations, rinse your mouth out with water.
- Clean the inhaler mouthpiece daily with warm water.
- This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine:
- Use all of the nebulizer liquid in the vial right away or throw it away. Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.
- Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using digoxin (Lanoxin®), or any blood pressure medicines (such as atenolol, labetalol, metoprolol, propranolol, Inderal®, Lopressor®, or Tenormin®), or diuretics or "water pills" (such as hydrochlorothiazide (HCTZ), furosemide, torsemide, Demadex®, or Lasix®). Tell your doctor if you have used medicine for depression (such as amitriptyline, doxepin, nortriptyline, Elavil®, Pamelor®, or Sinequan®) or an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®) within the past 2 weeks.
- This medicine should not be used together with similar inhaled medicines such as albuterol (Ventolin®), levalbuterol (Xopenex?), isoproterenol (Isuprel®), metaproterenol (Alupent®), pirbuterol (Maxair®), or terbutaline (Brethaire®).
Warnings While Using This Medicine:
- Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, diabetes, blood vessel problems, heart disease, heart rhythm problems, high blood pressure, low potassium in the blood, an overactive thyroid, seizures, narrow-angle glaucoma, an enlarged prostate, or problems with urination.
- This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hives; hoarseness; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.
- Take all of your COPD medicines as your doctor ordered. If you use any type of corticosteroid medicine to control your breathing, keep using it as ordered by your doctor. This includes corticosteroid medicines that are taken by mouth or inhaled (such as prednisone, Azmacort®, or Flovent®). If any of your COPD medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
- Do not spray the medicine near your eyes. If the medicine does get in your eyes, rinse your eyes with cool water for a few minutes and call your doctor. The medicine might make the dark part of your eye bigger for a few hours. Call your doctor if you have eye pain, blurred vision, or start seeing halos or odd colors when you look at things.
- If your symptoms do not improve or if they get worse, call your doctor.
Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Chest pain, or fast, pounding, or irregular heartbeat.
- Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
- Fever, chills, cough, sore throat, stuffy or runny nose, and body aches.
- Lightheadedness or fainting.
- Problems with urination.
- Seizures or tremors.
- Shortness of breath or troubled breathing.
If you notice these less serious side effects, talk with your doctor:
- Blurred vision.
- Diarrhea or upset stomach.
- Leg cramps.
- Nervousness, trouble with sleeping.
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Last Updated: 1/4/2011
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