• Basic Info
• Top Questions
• Interactions

What is albuterol and ipratropium inhalation?
Albuterol and ipratropium are bronchodilators that relax muscles in the airways and increase air flow to the lungs. The combination of albuterol and ipratropium inhalation is used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD) who are also using other medicines to control their condition. Albuterol and ipratropium inhalation may also be used for other purposes not listed in this medication guide.

Back to Top

What are the possible side effects of albuterol and ipratropium inhalation?

Stop using this medication and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using albuterol and ipratropium and call your doctor at once if you have any of these serious side effects:

• bronchospasm (wheezing, chest tightness, trouble breathing), especially after starting a new canister of this medicine;

• chest pain and fast, pounding, or uneven heart beats;

• swelling of your ankles or feet;

• pain or burning with urination; or

• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure).

Less serious side effects may include:

• headache, dizziness, nervousness;

• drowsiness or sleep problems (insomnia);

• cough, hoarseness, sore throat, runny or stuffy nose;

• dry mouth, unusual taste in your mouth;

• tremors, numbness or tingly feeling;

• nausea, vomiting, upset stomach, diarrhea, constipation; or

• blurred vision.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Back to Top

How should I use albuterol and ipratropium inhalation?
Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label. This medication may increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Albuterol and ipratropium inhalation comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Back to Top

What is the most important information I should know about albuterol and ipratropium inhalation?
Do not use the albuterol and ipratropium inhaler (Combivent) if you are allergic to soybeans, peanuts, or other food products that contain soya lecithin. Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. If it seems like you need to use more of any of your medications in a 24-hour period, talk with your doctor. Extreme heat can cause the medicine canister to burst. Do not store your inhaler in your car on hot days. Do not throw an empty canister into open flame.

Back to Top

What happens if I miss a dose?
Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

Back to Top

What other drugs will affect albuterol and ipratropium inhalation?
Before using this medication, tell your doctor if you are taking any of the following medicines: atropine (Donnatal, and others); belladonna; clidinium (Quarzan); dicyclomine (Bentyl); glycopyrrolate (Robinul); hyoscyamine (Anaspaz, Cystospaz, Levsin, and others); mepenzolate (Cantil); methantheline (Provocholine); methscopolamine (Pamine), scopolamine (Transderm-Scop); propantheline (Pro-Banthine); a beta-blocker such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor), or propranolol (Inderal);

Back to Top

Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Albuterol-ipratropium has been assigned to pregnancy category C by the FDA. Animal studies with albuterol have demonstrated a teratogenic effect. No evidence of abnormalities have been reported in women receiving albuterol during pregnancy. Albuterol has been given systemically to inhibit preterm labor. Use of albuterol in pregnant women for relief of bronchospasm may interfere with uterine contractility. Pulmonary edema has been associated with intravenous use of albuterol in pregnant women. Metered dose inhalers employ lower doses and result in lower plasma concentrations following administration, thereby producing fewer adverse effects for the mother and fetus. Ipratropium has failed to reveal evidence of teratogenicity in animal studies. There are no controlled data in human pregnancy. Albuterol-ipratropium is only recommended for use during pregnancy when there are no alternatives and benefit outweighs risk.

One malformation, a renal obstruction, occurred with ipratropium use between 1982 and 1994 among 37 women who took this drug during the first trimester according to data taken from a study of Medicaid patients. One study of 12 pregnant asthmatics between 33 and 39 weeks gestation showed no significant effect of inhaled albuterol on maternal or fetal circulations. For the two hours immediately following a dose of two deep inhalations of 0.5% solution, no significant effect was seen on maternal blood pressure or heart rate, umbilical artery systolic/diastolic ratio, fetal aortic velocities or heart rate.

There are no data on the excretion of albuterol or ipratropium into human milk. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Back to Top

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of albuterol and ipratropium can be fatal. Overdose symptoms may include chest pain or heavy feeling, rapid or uneven heart rate, pain spreading to the arm or shoulder, nausea, sweating, weakness, or general ill feeling.

Back to Top

What should I discuss with my healthcare provider before using albuterol and ipratropium inhalation?
Do not use the albuterol and ipratropium inhaler (Combivent) if you are allergic to soybeans, peanuts, or other food products that contain soya lecithin. Before using this medication, tell your doctor if you have: heart disease, high blood pressure, or congestive heart failure; a seizure disorder such as epilepsy; diabetes; overactive thyroid; glaucoma; an enlarged prostate or problems with urination; or liver or kidney disease. If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

Back to Top

Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

Back to Top

I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

Back to Top