albuterol and ipratropium (inhalation)

Pronunciation: al BUE ter ol and IP ra TRO pee um

Brand: Combivent Respimat, DuoNeb

What is the most important information I should know about albuterol and ipratropium inhalation?

Seek medical attention if you think this medication is not working as well as usual. Overuse of albuterol and ipratropium may increase the risk of death. It is critical that you use only the prescribed dose of this medicine.

What is albuterol and ipratropium inhalation?

Albuterol and ipratropium are bronchodilators that relax muscles in the airways and increase air flow to the lungs.

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 purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using albuterol and ipratropium inhalation?

You should not use this medicine if you are allergic to albuterol (Proventil, Ventolin), ipratropium (Atrovent), or atropine.

To make sure albuterol and ipratropium inhalation is safe for you, tell your doctor if you have ever had:

  • heart disease, high blood pressure, coronary artery disease, or heart rhythm disorder;
  • a seizure disorder such as epilepsy;
  • diabetes;
  • overactive thyroid;
  • glaucoma;
  • liver or kidney disease; or
  • enlarged prostate, problems with urination.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Albuterol and ipratropium inhalation can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Albuterol and ipratropium inhalation is not approved for use by anyone younger than 18 years old.

How should I use albuterol and ipratropium inhalation?

Follow the directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Albuterol and ipratropium inhalation is usually used 4 times per day. Follow your doctor's dosing instructions very carefully.

Overuse of this medicine may increase the risk of death. It is critical that you use only the prescribed dose of this medicine.

Albuterol and ipratropium inhalation comes with patient instructions for safe and effective use, and directions for priming the inhaler device. Duoneb and Combivent Respimat have different patient instructions. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

To use the inhaler (Combivent Respimat):

  • You do not need to shake Combivent Respimat before use.
  • Uncap the mouthpiece of the inhaler. Breathe out fully. Put the mouthpiece into your mouth and close your lips. Keep your eyes closed to prevent spraying any medicine into your eyes. Breathe in slowly while pressing the dose-release button on the inhaler. Hold your breath for 10 seconds, then breathe out slowly.
  • Close the cap until you use your inhaler again.
  • Carefully follow all directions for cleaning your specific inhaler device once per week.

Keep track of the number of sprays you have used. Throw away the Combivent Respimat inhaler canister after 3 months or 120 sprays, whichever comes first.

To use the solution with a nebulizer (Duoneb):

  • Open the foil pouch and remove one vial. Squeeze all of the medicine out into the chamber of the nebulizer. Attach the mouthpiece or face mask, then attach the drug chamber to the compressor.
  • Sit upright in a comfortable position. Place the mouthpiece into your mouth or put on the face mask, covering your nose and mouth. Turn on the compressor.
  • Breathe in slowly and evenly until no more mist is formed by the nebulizer and the drug chamber is empty.
  • Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

Use albuterol and ipratropium regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Seek medical attention if you think this medication is not working as well as usual.

While using albuterol and ipratropium, you may need medical tests.

Store at room temperature away from moisture, heat, and light. Keep each Duoneb vial in its foil pouch until you are ready to use it. Do not store Combivent Respimat in your car on hot days. Extreme heat can cause the medicine canister to burst. Do not throw an empty canister into open flame.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Do not use more than 6 inhalations in a 24-hour period.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of albuterol and ipratropium can be fatal. Overdose symptoms may include chest pain, fast or pounding heartbeats, tremors, dry mouth, extreme thirst, muscle weakness or limp feeling, severe headache, pounding in your neck or ears, or feeling like you might pass out.

What should I avoid while using albuterol and ipratropium inhalation?

If this medication gets in your eyes, rinse with water and seek medical attention.

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

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

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • wheezing, choking, or other breathing problems after using this medicine;
  • chest pain;
  • fast or pounding heartbeats, fluttering in your chest;
  • tremors, nervousness;
  • swelling of your ankles or feet;
  • blurred vision, tunnel vision, eye pain, or seeing halos around lights;
  • painful or difficult urination; or
  • low potassium --leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common side effects may include:

  • headache;
  • trouble breathing; or
  • cold symptoms such as stuffy nose, sneezing, cough, or sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect albuterol and ipratropium inhalation?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • a diuretic or "water pill";
  • heart or blood pressure medicine;
  • other beta-blockers; or
  • an antidepressant.

This list is not complete. Other drugs may interact with albuterol and ipratropium, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about albuterol and ipratropium inhalation.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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