Uses

What is ipratropium/albuterol used for?

Ipratropium/albuterol is commonly used to help treat symptoms of chronic obstructive pulmonary disease (COPD).

Ipratropium/albuterol may also be used for other conditions as determined by your healthcare provider.

How does ipratropium/albuterol work (mechanism of action)?

Ipratropium/albuterol contains two different medicines, ipratropium, and albuterol. Both medicines work together to relax the muscles around your airways. This allows your airways to widen and makes it easier to breathe.

How is ipratropium/albuterol supplied (dosage forms)?

Ipratropium/albuterol is available as Combivent Respimat and generic ipratropium/albuterol in the following dosage forms that are inhaled by mouth.

  • 20 mcg/100 mcg per actuation metered-dose inhaler (Combivent Respimat inhaler)
  • 0.017% (0.5 mg)/0.083% (2.5 mg) nebulizer solution

How should I store ipratropium/albuterol?

Inhaled Spray. Ipratropium/albuterol inhaler should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Do not freeze. Throw away the inhaler and cartridge after 3 months, when the inhaler is locked, or it expires, whichever comes first. 

Nebulizer Solution. Ipratropium/albuterol nebulizer solution should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect the vials from light by keeping them in the foil pouch. Only open the foil pouch or carton of ipratropium/albuterol vials when you are ready to use it. Throw away any unopened vials after the expiration date printed on the carton.

Side Effects

What are the most common side effects of ipratropium/albuterol?

The most common side effects of ipratropium/albuterol are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Infection in the nose or throat, sore throat, or common cold symptoms
  • Cough
  • Bronchitis
  • Headache
  • Shortness of breath
  • Chest pain
  • Constipation or diarrhea
  • Urinary tract infection (UTI)
  • Leg cramps
  • Nausea

There may be other side effects of ipratropium/albuterol that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of ipratropium/albuterol?

While less common, the most serious side effects of ipratropium/albuterol are described below, along with what to do if they happen.

Severe Allergic Reactions. Ipratropium/albuterol may cause allergic reactions, which can be serious. Stop using ipratropium/albuterol and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Sudden Breathing Problems. Ipratropium/albuterol can cause the muscles in your airways to tighten (bronchospasm) right after you use it instead of relaxing them. In some cases, this can be serious. Stop using the medicine and call your healthcare provider right away if your breathing gets worse instead of better right after using ipratropium/albuterol.

Heart Effects. Ipratropium/albuterol may increase your risk of certain heart problems, such as raising your heart rate, blood pressure, or causing an abnormal heart rhythm (arrhythmia). If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Also call your healthcare provider or get medical attention right away if you have chest pain, a fast or irregular heartbeat, or if you feel your heartbeat more than usual.

Glaucoma. Ipratropium/albuterol may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. Tell your healthcare provider right away if you have any of the following symptoms of glaucoma.

  • Loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Inability to Empty Bladder (Urinary Retention). Ipratropium/albuterol might make it harder to empty your bladder, especially if you already have a blockage or take other medicines for overactive bladder or Parkinson’s disease. Call your healthcare provider right away if you cannot empty your bladder.

Low Potassium Level. Ipratropium/albuterol can cause a low potassium level (hypokalemia), which can be serious. Your healthcare provider will check your potassium levels, especially if you take certain other medicines. Call your healthcare provider if you have any of the following symptoms of a low potassium level.

  • Weakness 
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation

Warnings & Precautions

Who should not use ipratropium/albuterol?

Allergies to Ingredients. People who are allergic to any of the following should not use ipratropium/albuterol.

  • Combivent Respimat
  • Ipratropium
  • Albuterol
  • Atropine
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific ipratropium/albuterol products they stock.

What should I know about ipratropium/albuterol before using it?

Do not use ipratropium/albuterol unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share ipratropium/albuterol with other people, even if they have the same condition as you. It may harm them.

Keep ipratropium/albuterol out of the reach of children.

Ipratropium/albuterol can cause dizziness and may cause problems seeing. Do not drive or do other activities that require balance and good eyesight until you know how ipratropium/albuterol affects you.

Avoid getting inhaled ipratropium/albuterol into your eyes. Call your healthcare provider right away if you get inhaled ipratropium/albuterol in your eyes and you have eye pain or vision changes, such as blurred vision or seeing halos or circles around lights.

Make sure that you or a caregiver understands how to properly prepare and use ipratropium/albuterol. If you have any questions, talk to your healthcare provider.

Follow the instructions for use of the inhaled ipratropium/albuterol spray when using it for the first time or if you have not used the medicine for more than 3 days. The medicine needs to be primed, so you get the correct dose.

Do not use more than 6 doses within a 24-hour period. Taking more than one dose every 4 hours can lead to serious side effects. Do not stop or change other medicines you take for COPD without talking to your healthcare provider first.

If you use the inhaler, clean the mouthpiece, including the metal part inside the inhaler, with a damp cloth or tissue at least once a week.

What should I tell my healthcare provider before using ipratropium/albuterol?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if ipratropium/albuterol is right for you.

In particular, make sure that you discuss any of the following.

  • Diabetes
  • Thyroid problems
  • Seizures
  • High blood pressure
  • Heart disease or problems, such as an irregular heartbeat
  • Eye problems, such as narrow-angle glaucoma
  • Low potassium levels
  • Bladder problems, such as trouble peeing
  • Benign prostatic hyperplasia (BPH)

Other Medicines and Supplements. Ipratropium/albuterol may interact with other medicines and supplements. Before using ipratropium/albuterol, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how ipratropium/albuterol could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use ipratropium/albuterol while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if ipratropium/albuterol passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop ipratropium/albuterol.

Interactions

Does ipratropium/albuterol interact with foods or drinks?

There are no known interactions between ipratropium/albuterol and foods or drinks.

It is unknown if drinking alcohol will affect ipratropium/albuterol.

Does ipratropium/albuterol interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using ipratropium/albuterol.

  • An inhaled anticholinergic, such as tiotropium (Spiriva Respimat),  umeclidinium (Incruse Ellipta), or aclidinium (Tudorza Pressair), which is a medicine commonly used for COPD 
  • A beta-2 agonist, such as albuterol, levalbuterol (Xopenex HFA), salmeterol (Serevent), arformoterol (Brovana), olodaterol (Striverdi), or formoterol (Perforomist), which is a medicine commonly used for asthma or COPD
  • An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems 
  • A beta-blocker, such as metoprolol (Lopressor), atenolol (Tenormin), or propranolol (Inderal LA), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used to treat depression or Parkinson’s disease
  • A tricyclic antidepressant such as amitriptyline, nortriptyline, or protriptyline within the past 2 weeks, even if it’s not used for depression
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure

This may not be a complete list of medicines that can interact with ipratropium/albuterol. Always check with your healthcare provider.

Does Ipratropium/Albuterol interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much ipratropium/albuterol?

If you or someone else has used too much ipratropium/albuterol, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of ipratropium/albuterol?

If you miss a dose, use it as soon as you remember. At least 4 hours need to pass between each use of ipratropium/albuterol. Do not take double or extra doses.

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