Combivent

What is Combivent

Albuterol is a bronchodilator. It relaxes muscles in the airways, which improves breathing. Ipratropium is used to prevent bronchospasm, which narrows airways. By preventing narrowing of the airways, ipratropium increases air flow to the lungs.

Combivent is used to treat chronic obstructive pulmonary disease (COPD).

Combivent may also be used for conditions other than those listed in this medication guide.

General medical information about Combivent

It is very important that the Combivent inhaler or nebulized solution is used properly, so that the medicine gets into the lungs. Your doctor may want you to use a spacer with the inhaler. Talk to your doctor about proper inhaler or nebulizer use.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any chronic obstructive pulmonary disease (COPD) medication in a 24-hour period. An increased need for medication could be an early sign of worsening lung function.

Do not use the Combivent inhaler if you have a soya lecithin allergy (e.g., an allergy to soybeans or peanuts).

What you should discuss with your doctor before using Combivent

Do not use the Combivent Inhaler if you have a soya lecithin allergy (e.g., an allergy to soybeans or peanuts).

Before using this medication, tell your doctor if you have:
- heart disease or high blood pressure,
- epilepsy or another seizure disorder,
- diabetes,
- an overactive thyroid (hyperthyroidism),
- glaucoma (the narrow-angle form),
- an enlarged prostate or a bladder obstruction, or
- liver or kidney disease.

You may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Combivent is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether Combivent passes into breast milk. Do not use Combivent without first talking to your doctor if you are breast-feeding a baby.

How should you use Combivent

Use Combivent exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

To use the inhaler:
- You may want to "test-spray" the inhalation unit three times before using it for the first time and if it has not been used for 24 hours or more. Doing so will ensure that your first dose will deliver the proper amount of medication.
- Shake the inhaler several times and uncap the mouthpiece. Breathe out fully. Put the mouthpiece of the inhaler or spacer into your mouth. Be sure the mouthpiece is above the tongue and past the teeth. Alternatively, place the inhaler (not spacer) several inches in front of your open mouth, if directed to do so by your doctor. Take a deep, slow breath as you push down on the canister. Hold your breath for 10 seconds, then exhale slowly.
- If your doses consist of more than one puff each, wait approximately 2 minutes, shake the inhaler again, then repeat the inhalation procedure.
- Throw the inhaler away after 200 inhalations. The amount of medication in each inhalation cannot be assured after 200 sprays.

To use the solution for nebulization:
- Open one ampule (or the prescribed amount of medication) and empty it into the medication chamber of the nebulizer.
- Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright, in a comfortable position, and put the mouthpiece into your mouth or put the face mask on, covering the nose and mouth. Breathe slowly and evenly until all of the medicine has been inhaled (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.
- Clean the nebulizer after each treatment as directed by the manufacturer.

If you also use a steroid inhaler, use the Combivent inhaler first to open up the airways, then use the steroid inhaler as directed unless otherwise directed by your doctor.

It is important to use Combivent regularly to get the most benefit.

Do not use more of this medication than is prescribed.

Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any medication for chronic obstructive pulmonary disease (COPD) in a 24-hour period. An increased need for medication could be an early sign of worsening lung function.

Your doctor may want you to have lung function tests or other medical evaluations during treatment with Combivent to monitor progress and side effects.

Keep the inhaler clean and dry. Keep the mouthpiece capped to avoid getting dirt inside it. Clean the inhaler when necessary by removing the canister and immersing the mouthpiece in warm water. Allow the parts to dry, then reassemble the inhaler.

Carry the inhaler with you at all times in case of emergencies. Get a refill before you run out of medicine and before going on vacation.

Store the inhaler or solution for nebulization at room temperature protected from light, moisture, and heat.

If you miss a dose:

Use the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.

If you are using Combivent on an as needed basis, use the missed dose when it is needed, then wait the prescribed amount of time before using another dose.

What happens if you overdose:

Seek emergency medical attention if an overdose is suspected.

Symptoms of an overdose of Combivent include angina or chest pain, irregular heartbeats or a fluttering heart, seizures, tremor, weakness, headache, nausea, and vomiting.

What should you avoid while using Combivent

Avoid situations that may trigger an asthma attack, such as exercising in cold, dry air; smoking; breathing in dust; and exposure to allergens such as pet hair.

Avoid getting this medication in your eyes. Albuterol and ipratropium in the eyes may cause eye pain, blurred vision, dilated pupils, and unusual color perception. If medication gets into the eyes, rinse the eyes with water and seek medical attention.

Possible side effects of Combivent

Stop using Combivent and seek emergency medical attention or contact your doctor immediately if you experience any of the following serious side effects:
- an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
- chest pain or irregular heartbeats.

Other, less serious side effects may be more likely to occur. Continue to use Combivent and talk to your doctor if you experience
- headache or dizziness;
- insomnia;
- tremor or nervousness;
- blurred vision;
- nausea, vomiting, diarrhea, or constipation; or
- dry mouth or cough.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Combivent

Before using this medication, tell your doctor if you are taking any of the following medicines:
- a beta-blocker such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor), propranolol (Inderal), and others;
- a diuretic (water pill) such as furosemide (Lasix), bumetanide (Bumex), ethacrynic acid (Edecrin), torsemide (Demadex), hydrochlorothiazide (Hydrodiuril), chlorthalidone (Hygroton, Thalitone), chlorothiazide (Diuril), and others;
- a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor), and others;
- a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);
- a medicine such as atropine, belladonna, clidinium (Quarzan), dicyclomine (Bentyl), scopolamine (Transderm-Scop), propantheline (Pro-Banthine), mepenzolate (Cantil), methantheline (Banthine), methscopolamine (Pamine), and others; or
- caffeine, diet pills, or decongestants.

You may not be able to use Combivent, or you may require a dosage adjustment or special monitoring during treatment.

Drugs other than those listed here may also interact with Combivent, or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals and herbal products.