Ipratropium/Albuterol (By Breathing)

Albuterol (al-BYOO-ter-ol), Ipratropium (i-pra-TROE-pee-um)

Treats asthma and other lung problems such as chronic bronchitis.

Brand Name(s):

Combivent, Duoneb
There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to albuterol (Ventolin®, Proventil®), ipratropium (Atrovent®), levalbuterol (Xopenex™), or atropine. You should not use this medicine if you are allergic to soya lecithin, soybeans, or peanuts.

How to Use This Medicine:

Aerosol

• Your doctor will tell how much medicine to use and how often. You should not use more of the medicine or use it more often than your doctor ordered.
• You will use this medicine with a device called a nebulizer or a metered-dose inhaler. A nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. A metered-dose inhaler fits on the medicine canister and turns the medicine into a fine spray. You may be told to use a spacer tube that is placed between the inhaler and your mouth. Your caregiver will show you how to use your inhaler and the spacer (if needed).
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• Never share your medicine with anyone.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine at room temperature, away from heat and direct light. Vials may be stored in the refrigerator. Do not freeze. Do not keep your inhaler inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine out of the reach of children.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using digoxin (Lanoxin®), or any blood pressure medicines or diuretics (water pills). Tell your doctor if you have used medicine for depression such as amitriptyline or an MAO inhibitor (Eldepryl®, Marplan®, Nardil®, Parnate®) within the past 2 weeks.
• This medicine should not be used together with similar inhaled medicines such as albuterol (Ventolin®), levalbuterol (Xopenex™), isoproterenol (Isuprel®), metaproterenol (Alupent®), pirbuterol (Maxair®), or terbutaline (Brethaire®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have diabetes, heart disease, liver disease, kidney disease, heart rhythm problems, high blood pressure, overactive thyroid, seizures, glaucoma, an enlarged prostate, or problems with urination.
• Take all of your asthma medicines as your doctor ordered. If you use any type of corticosteroid medicine to control your asthma, keep using it as ordered by your doctor. This includes corticosteroid medicines that are taken by mouth or inhaled (such as prednisone, Azmacort®, Flovent®). If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in face or hands, swelling or tingling in the mouth or throat, tightness in chest, trouble breathing
• Chest pain, or fast, pounding, or irregular heartbeat
• Lightheadedness or fainting
• Tremors or shaking
• Worsening asthma symptoms

If you notice these less serious side effects, talk with your doctor:

• Blurred vision
• Dry mouth or throat, cough, sore throat, runny or stuffy nose
• Leg cramps
• Nausea, vomiting, diarrhea, or upset stomach
• Nervousness, trouble sleeping
• Problems with urination

If you notice other side effects that you think are caused by this medicine, tell your doctor.