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IPRATROPIUM AND ALBUTEROL (Inhalation-Local)

Some commonly used brand names are:

In the U.S.—

• Combivent
• DuoNeb

Another commonly used name for albuterol is salbutamol .

Category

• Bronchodilator

Description

Ipratropium (i-pra-TROE-pee-um) and albuterol (al-BYOO-ter-ol) combination is a bronchodilator (medicine that opens up narrowed breathing passages). It is taken by inhalation to help control the symptoms of lung diseases, such as asthma, chronic bronchitis, and emphysema.

Ipratropium in combination with albuterol helps decrease coughing, wheezing, shortness of breath, and troubled breathing by increasing the flow of air into the lungs.

This medicine is available only with your doctor"s prescription, in the following dosage form:

• Inhalation
• Inhalation aerosol (U.S.)
• Inhalation solution (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ipratropium and albuterol combination, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to albuterol, ipratropium, atropine, belladonna, hyoscyamine, or scopolamine, or to other inhalation aerosol medicines. Also tell your health care professional if you are allergic to soya lecithin or related food substances such as soybeans and peanuts.

Pregnancy—Ipratropium and albuterol have not been studied in pregnant women. However, studies in animals have shown that albuterol causes birth defects when given in doses comparable to the maximum human dose. Ipratropium has not been found to cause birth defects or other problems in animal studies.

Breast-feeding—It is not known whether ipratropium or albuterol passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Studies comparing the effects of the inhalation aerosol dosage form of ipratropium and albuterol in children with those in other age groups have not been done.

Older adults—Ipratropium and albuterol combination has been tested in elderly patients and has not been found to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ipratropium and albuterol combination, it is especially important that your health care professional know if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of ipratropium and albuterol combination. Make sure you tell your doctor if you have any other medical problems, especially:

• Difficult urination—This medicine may make the condition worse

• Glaucoma—This medicine may make the condition worse if it gets into the eyes

• Heart rhythm problems or
• High blood pressure (hypertension) or
• Problems with blood circulation to the heart—The albuterol contained in this combination medicine can cause unwanted effects on the heart in some patients

Proper Use of This Medicine

This medicine usually comes with patient directions. Read them carefully before using this medicine. If you do not understand the directions or you are not sure how to use the inhaler or nebulizer, ask your doctor, nurse, or pharmacist to show you how to use it.

When you use the inhaler for the first time, or if you have not used it for more than 24 hours, the inhaler may not give the right amount of medicine with the first puff. Therefore, before using the inhaler, prime it by spraying the medicine into the air three times. The inhaler will now be ready to give the right amount of medicine when you use it.

When you use the inhalation solution, make sure you use a jet nebulizer that is connected to an air compressor with a good air flow. Use a face mask or mouthpiece to inhale the medicine.

Keep the spray away from the eyes because this medicine may cause irritation or blurred vision. This is especially important for people with glaucoma. Closing your eyes while you are inhaling this medicine may help keep it out of your eyes.

It is very important that you use ipratropium and albuterol combination only as directed. Do not use more of it and do not use it more often than directed. To do so may increase the chance of serious side effects.

Dosing—The dose of ipratropium and albuterol combination will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

• For inhalation aerosol dosage form :
  • For symptoms of chronic obstructive pulmonary disease:
    • Adults—2 puffs four times a day and as needed. No more than a total of 12 puffs should be used in any twenty-four-hour period.
    • Children—Use and dose must be determined by your doctor.

• For inhalation solution dosage form (used with a nebulizer):
  • For symptoms of chronic obstructive pulmonary disease:
    • Adults—Use one 3 mL (milliliter) vial in the nebulizer 4 times a day. You may have 2 additional treatments per day if needed.
    • Children—Use and dose must be determined by your doctor.

Missed dose—If you are using ipratropium and albuterol combination regularly and you miss a dose, use it as soon as possible. Then use any remaining doses for that day at regularly spaced intervals.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light. Keep unused vials of inhalation solution in the foil pouch or carton.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Check with your doctor at once if difficulty in breathing continues after using a dose of this medicine or if your condition gets worse.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 07/29/1998
Revised: 07/03/2001

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