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ALBUTEROL; IPRATROPIUM (Combivent®, DuoNeb™) is a combination of bronchodilators, which are medicines that open up your air passages and make breathing easier. The combination is used for patients with lung problems such as chronic bronchitis and emphysema. This medicine controls acute episodes or prevents recurring bouts of bronchospasm due to these conditions. Generic albuterol; ipratropium (Combivent®, DuoNeb™) inhalation aerosols and nebulizer solutions are not yet available.
What should my health care professional know before I use albuterol; ipratropium (Combivent®, DuoNeb™) inhalation?
They need to know if you have any of the following conditions:
•bladder problems or difficulty passing urine
•diabetes
•glaucoma
•heart disease, angina, or irregular heartbeat
•high blood pressure
•liver or kidney disease
•prostate trouble
•overactive thyroid gland
•pheochromocytoma
•seizures (convulsions)
•an unusual or allergic reaction to albuterol, ipratropium, atropine, bromides, soya protein, soybeans or peanuts, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
How should I use this medicine (Combivent Inhaler)?
Albuterol; ipratropium (Combivent®, DuoNeb™) inhalation aerosol or inhalation solutions are for inhalation only, do not swallow. Follow the instructions on your prescription. Do not use more often than directed. If you are using an aerosol inhaler: Shake the canister well. It is recommended that you "test-spray" the inhaler three times into the air before using your inhaler for the first time. You could also "test spray" the inhaler in cases where you have not used it for more than 24 hours.
Tilt your head back slightly. Breathe out fully, emptying as much air as possible from your lungs. Keep the canister upright. Keep the inhaler about 1 inch from your open mouth (or place the mouthpiece loosely between your open lips). Press down on the inhaler (one puff) while breathing in deeply and slowly. If you can, hold your breath to the count of 10 (or as long as you can) and then breathe out (exhale). Wait at least 1 to 2 minutes between puffs.
Your inhaler will come with some instructions. Read the instructions carefully; ask your doctor pharmacist about instructions you do not understand. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
If you are using a nebulizer: Follow your doctor's instructions for use of the inhalation solution in your nebulizer machine. The albuterol; ipratropium nebulizer (Combivent®, DuoNeb™) solution does not need dilution prior to use in the jet nebulizer.
What
if I miss a dose (Combivent Inhaler)?
If you miss a dose, use it as soon as you can. If it is almost time for your
next dose, use only that dose. Do not use double or extra doses.
What
drug(s) may interact with albuterol; ipratropium inhalation
(Combivent®, DuoNeb™)?
•arsenic trioxide
•astemizole
•atropine, hyoscyamine, or related medications
•bepridil
•beta-blockers, often used for high blood pressure or heart problems
•caffeine
•certain antibiotics (such as clarithromycin, erythromycin, gatifloxacin,
gemifloxacin, grepafloxacin, levofloxacin, linezolid, moxifloxacin, sparfloxacin)
•chloroquine
•cisapride
•droperidol
•halofantrine
•levomethadyl
•medicines for colds and breathing difficulties
•medicines for heart disease or high blood pressure
•medicines known as MAO inhibitors, such as phenelzine (Nardil®),
tranylcypromine (Parnate®), isocarboxazid (Marplan®), and selegiline (Carbex®,
Eldepryl®)
•medicines to control heart rhythm (examples: amiodarone, disopyramide,
dofetilide, flecainide, procainamide, quinidine, sotalol)
•medicines for treating depression or mental illness (amoxapine, haloperidol,
maprotiline, pimozide, phenothiazines, risperidone, sertindole, tricyclic
antidepressants, ziprasidone)
•methadone
•pentamidine
•probucol
•some medicines for weight loss (including some herbal products, ephedra,
ephedrine, dextroamphetamine)
•steroid hormones such as dexamethasone, cortisone, hydrocortisone
•terfenadine
•theophylline
•thyroid hormones
•water pills or diuretics
Tell your doctor or health care professional about all other medicines you are
taking, including nonprescription medicines, nutritional supplements, or herbal
products. Also tell your doctor or health care professional if you are a
frequent user of drinks with caffeine or alcohol, if you smoke, or if you use
illegal drugs. These may affect the way your medicine works. Check before
starting or stopping any of your medicines.
What
side effects may I notice from using albuterol; ipratropium inhalation (Combivent®,
DuoNeb™)?
Side effects that you should report to your doctor or health care professional
as soon as possible:
•difficulty breathing, wheezing
•dizziness
•chest pain, fast heartbeat (pounding), or irregular heartbeat
•headache (severe)
•muscle cramps
•numbness in fingers or toes
•skin rash or hives
•swelling of the lips, tongue or face
•vomiting
•unusual weakness or tiredness
Side effects that usually do not require medical attention (report to your
doctor or health care professional if they continue or are bothersome):
•anxiety, nervousness, trembling
•blurred vision
•cough
•difficulty passing urine
•difficulty sleeping
•dry mouth
•mouth sores
•nausea
•stuffy nose
•unusual taste or metallic taste in your mouth
What should
I watch for while taking albuterol; ipratropium inhalation
(Combivent®, DuoNeb™)?
Check with your doctor or health care professional as soon as possible if your
breathing symptoms do not improve or if they get worse. If you find that your
inhalers become less effective in treating your symptoms, you should contact
your health care professional as soon as possible. You may be having an increase
in your bronchitis symptoms. Do not stop using albuterol; ipratropium (Combivent®,
DuoNeb™) except on your doctor's advice.
Do not get the albuterol; ipratropium (Combivent®, DuoNeb™) aerosol spray in
your eyes. It can cause irritation, pain, or blurred vision. If you do get any
in your eyes, rinse out with plenty of cool tap water. Let your doctor know if
you develop vision problems or eye pain.
If you are using other inhaled medicines such as an inhaled steroid, use
albuterol; ipratropium (Combivent®, DuoNeb™) first. Wait at least 5 minutes
before using the other inhaler. Make sure you are using your inhaler
properly. Do not use extra or more frequent inhalations. They will not improve
your condition. Once a day, remove the metal canister and rinse the plastic case
in warm running water. Replace canister gently without using a twisting motion.
Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and
drinking plenty of water, will help.
Where
can I keep my medicine (Combivent®, DuoNeb™)?
Keep out of the reach of children. Store at a room temperature
between 15—30 degrees C (36—86 degrees F); do not freeze. Cold temperature
decreases the effectiveness of this medicine. Avoid excessive humidity. The
albuterol; ipratropium (Combivent®, DuoNeb™) inhaler contains flammable
ingredients under pressure; keep away from heat or flames; do not puncture. Keep
nebulizer solution in the foil package until time of use; protect from light.
Throw away any unused medicine after the expiration date.
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