Ipratropium; Albuterol Inhalation Spray (Combivent Respimat)

What is this medicine?

IPRATROPIUM; ALBUTEROL (i pra TROE pee um; al BYOO ter ole) has 2 drugs that open up the airways in your lungs to make it easier to breathe. This medicine is used to treat chronic obstructive pulmonary disease (COPD).

How should I use this medicine?

This medicine is for inhalation only. Follow the instructions on your prescription label. Do not use more often than directed. Make sure that you are using your inhaler correctly. Ask you doctor or health care provider if you have any questions.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• changes in vision

• heartbeat rhythm changes (trouble breathing; chest pain; dizziness; fast, irregular heartbeat; feeling faint or lightheaded, falls)

• high blood pressure

• restlessness

• signs and symptoms of low potassium like muscle cramps; muscle pain; chest pain; dizziness; feeling faint or lightheaded, falls; palpitations; breathing problems; or fast, irregular heartbeat

• trouble passing urine or change in the amount of urine

• trouble sleeping

• vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• changes in taste

• cough

• dry mouth

• headache

• nasal congestion (like runny or stuffy nose)

• sore throat

• tremors

What may interact with this medicine?

• atropine

• beta-blockers like metoprolol and propranolol

• certain medicines for allergy, cough, and cold

• certain medicines for bladder problems like oxybutynin, tolterodine

• certain medicines for depression, anxiety, or psychotic disturbances

• certain medicines for stomach problems like dicyclomine, hyoscyamine

• certain medicines for travel sickness like scopolamine

• certain medicines for Parkinson's disease like benztropine, trihexyphenidyl

• diuretics

• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

• some medicines for irregular heartbeat

• stimulant medicines for attention disorders, weight loss, or staying awake

What if I miss a dose?

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.

Where should I keep my medicine?

Keep out of the reach of children.

Store at a room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not freeze. After assembly, the inhaler should be discarded at the latest 3 months after first use or after the inhaler is locked, whichever comes first.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• heart disease

• high blood pressure

• irregular heartbeat

• an unusual or allergic reaction to ipratropium, albuterol, atropine, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Tell your doctor or health care professional if your symptoms do not improve. If your breathing gets worse while you are using this medicine, call your doctor right away. Do not stop using your medicine unless your doctor tells you to.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

You may get dizzy or have blurred vision. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.