Combivent

Combivent is a prescription medication used to prevent symptoms associated with chronic obstructive pulmonary disease (COPD). Symptoms of COPD include wheezing, difficulty breathing, chest tightness, and coughing.

It is a single product containing 2 medications: ipratropium and albuterol.

Both ipratropium and albuterol belong to a group of drugs called bronchodilators. Ipratropium is also known as an anticholinergic or antimuscarinic agent, and albuterol is also known as a beta-agonist. Both ingredients work by relaxing and opening the air passages to the lungs, which makes breathing easier.

Combivent is supplied as an aerosol spray to inhale by mouth. It is usually inhaled 4 times a day.

Common side effects of Combivent include respiratory tract infection, headache, cough, and nervousness.

Combivent can also cause blurred vision, drowsiness, and dizziness. Do not drive or operate heavy machinery until you know how Combivent affects you.

Combivent is a prescription medication used to prevent symptoms associated with chronic obstructive pulmonary disease (COPD). Symptoms of COPD include wheezing, difficulty breathing, chest tightness, and coughing.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Boehringer Ingelheim Pharmaceuticals, Inc.

Serious side effects have been reported with Combivent. See the “Combivent Precautions” section.

Common side effects of Combivent include the following:

• headache
• respiratory tract infection
• cough
• shortness of breath

This is not a complete list of ipratropium/albuterol side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take or have recently stopped taking:

• antidepressants such as amitriptyline amoxapine; clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
• beta blockers such as atenolol (Tenormin), labetalol, metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
• diuretics ('water pills')
• epinephrine (Epipen, Primatene Mist)
• medications for colds, irritable bowel disease, Parkinson's disease, ulcers, or urinary problems
• monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar)
• other inhaled medications, especially other medications for asthma such as arformoterol (Brovana), formoterol (Foradil, Perforomist), metaproterenol, levalbuterol (Xopenex), and salmeterol (Serevent, in Advair)
• terbutaline (Brethine)

This is not a complete list of Combivent drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with Combivent including the following:

• Brochospasm. Combivent can cause life-threatening bronchospasm, which is a sudden constriction of the muscles in the walls of the airways leading to the lungs. Bronchospasm is more likely to occur with the first use of a new canister.
• Cardiovascular effects. Combivent can cause changes in blood pressure and heart rate and symptoms including chest pain or past or pounding heartbeat. This medication should be used with caution in patients with cardiovascular disorders.
• Hypersensitivity reactions. Tell your healthcare provider right away if you have any of the following symptoms of a hypersensitivity reaction to ipratropium/albuterol:
  • itching
  • hives
  • rash
  • swelling of the eyes, face, lips, tongue, or throat
  • swelling of the hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing or breathing

Combivent can cause drowsiness, dizziness, and blurred vision. Do not drive or operate heavy machinery until you know how ipratropium/albuterol affects you.

Do not take Combivent if you:

• are allergic to Combivent or to any of its ingredients
• are allergic to peanuts or soybeans
• are allergic to atropine or related medications

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Combivent, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking Combivent, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to Combivent or to any of its ingredients
• are allergic to peanuts or soybeans
• are allergic to atropine or related medications
• have or have had urinary difficulties or prostate problems
• have or have had seizures
• have hyperthyroidism
• have high blood pressure
• have an irregular heartbeat
• have diabetes
• have liver problems
• have heart problems
• have kidney problems
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Combivent falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Combivent crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Combivent.

Use Combivent exactly as prescribed.

Combivent is supplied as an aerosol spray to inhale by mouth. It is usually inhaled 4 times a day.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Combivent at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• how you respond to this medication

The recommended dose of Combivent to prevent symptoms of chronic obstructive pulmonary disease (COPD) is 2 inhalations 4 times daily. Each inhalation contains 18 mcg ipratropium bromide and 103 mcg albuterol sulfate. Additional doses may be taken as needed, but no more than 12 inhalations should be taken per day.

If you take too much Combivent, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If Combivent is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store Combivent at 25°C (77°F).
• Keep this and all medicines out of the reach of children.
• Shake canister vigorously for 10 seconds before use.