Adult Dosing
COPD
MDI (Combivent)
- 2 inhalations qid
- Max: 12 inhalations in 24 hrs
Nebulizer (DuoNeb, albuterol/ipratropium)
- 1 vial (3 mL) by nebulizer qid. Max of 6 doses/day
- Note: 500 mcg ipratropium/3 mL = 0.02%; 2.5 mg albuterol/3 mL = 0.083%
MDI (Combivent Respimat)
- 1 inhalation qid
- Max of 6 doses/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
See Supplemental Patient Information
- Immediately discontinue treatment and institute alternative therapy on occurrence of life-threatening paradoxical bronchospasm. Paradoxical bronchospasm associated with inhaled formulations mostly occurs with the first use of a new canister
- Discontinue therapy on development of clinically significant cardiovascular effects as measured by pulse rate, blood pressure and/or symptoms
- Rare occasions of myocardial ischemia are associated with albuterol component of this drug. In addition flattening of the T wave, prolongation of the QTc interval, and ST segment depression has occurred
- Fatalities have occurred on exceeding use of inhaled sympathomimetic drugs, in patients with asthma
- Immediate hypersensitivity reactions have developed after administration of ipratropium bromide or albuterol sulfate
- Severe hypokalemia has occurred in patients
- Safety and efficacy has not been established in patients with hepatic or renal insufficiency
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Cardiovascular disorders
- Coronary insufficiency
- Cardiac arrhythmias
- Hypertension
- Diabetes mellitus
- Convulsive disorders
- Prostatic hyperplasia
- Bladder-neck obstruction
- Prostatic hypertrophy
- Bladder neck obstruction
- Hyperthyroidism
- Narrow-angle glaucoma
- Patients who are unusually responsive to sympathomimetic amine
Supplemental Patient Information
- Advise patients to avoid puncture this product, using or keeping near heat or open flame, exposing to temperatures >120 degree F. Also instruct them to keeping the container away from fire or incinerator and away from children
- Advise patients to avoid spraying the aerosol into their eyes as it may result in precipitation or worsening of narrow-angle glaucoma, mydriasis, increased intraocular pressure, acute eye pain or discomfort, temporary blurring of vision, visual halos or colored images in association with red eyes from conjunctival and corneal congestion. Instruct patients to immediately consult their physician should any combination of these symptoms occur
- Advise mothers carrying lactation and women becoming pregnant to contact their physician
Pregnancy Category:C
Breastfeeding: Safety unknown; No published data exist on the use of albuterol by mouth or inhaler during lactation. Data from the related drug, terbutaline, indicate that very less amount is expected to be excreted into breastmilk. Use of inhaled bronchodilators is acceptable during breastfeeding due to low bioavailability and maternal serum levels. No published data exist on the use of ipratropium. Its use results in negligible maternal serum levels and would not be absorbed by the infant. Low level of risk to the breastfed infant on maternal ipratropium inhalation exists. This information is based on based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 16 February 2011). Unknown whether components of this drug are excreted in human milk. Manufacturer advises to use this drug during pregnancy only if the potential benefit justifies the potential risk to the fetus.
US Trade Name(s)
- Combivent
- Duoneb
- Combivent Respimat
US Availability
albuterol/ipratropium (generic)
- SOLN for INH: 0.083%/0.017%
- SOLN for INH: 0.5 mg/0.017%
Combivent (albuterol/ipratropium)
- MDI: (0.09 mg/metered spray)/(0.018 mg/metered spray)
Duoneb (albuterol/ipratropium)
- SOLN for INH: 0.083%/0.017%
Combivent Respimat (albuterol/ipratropium)
- SOLN for INH: 100 mcg/20 mcg
Canadian Trade Name(s)
- Combivent
- Salvent-ipravent sterules
- Combo sterinebs
- Ipra sal udv
Canadian Availability
Combivent, Salvent-ipravent sterules, Combo sterinebs, Ipra sal udv (salbutamol/ipratropium)
- SOLN for INH: (2.5 mg/0.50 mg)/2.5 mL vial
UK Trade Name(s)
UK Availability
Combivent (salbutamol/ipratropium)
- MDI: (120 mcg/20 mcg)/spray
- SOLN for INH: (2.5 mg/0.50 mg)/2.5 mL vial
Australian Trade Name(s)
Australian Availability
Combivent (salbutamol/ipratropium)
- MDI: (120 mcg/20 mcg)/spray
Pricing data from www.DrugStore.com in U.S.A.
- Combivent 18-103 MCG/ACT AERO [Inhaler] (BOEHRINGER INGELHEIM)
14.7 act = $238.33
44.1 act = $679.95 - DuoNeb 0.5-2.5 (3) MG/3ML SOLN [Plas Cont] (DEY LABS)
90 3ml = $80.86
270 3ml = $228.18 - DuoNeb 0.5-2.5 (3) MG/3ML SOLN [Plas Cont] (DEY LABS)
180 3ml = $148.24
540 3ml = $424.54
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.