Combivent Inhalation : Uses, Side Effects, Interactions & More

Why is this medication prescribed?

Combivent (Albuterol and Ipratropium) is used to prevent wheezing, shortness of breath, chest tightness, and coughing in people with chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways) such as chronic bronchitis ( swelling of the air passages that lead to the lungs) and emphysema (damage to the air sacs in the lungs). Combivent is used by people whose symptoms have not been controlled with a single inhaled medication. Combivent belong to a class of medications called bronchodilators. Combivent works by relaxing and opening the air passages to the lungs to facilitate breathing.

How should this medicine be used?

Combivent (Albuterol and Ipratropium) comes as a solution (liquid) to inhale by mouth with a nebulizer (machine that turns the medicine into a mist that can be inhaled) and as an aerosol form to be inhaled by mouth with an inhaler. . It is usually inhaled four times a day. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any parts you do not understand. Use Combivent exactly as directed. Do not use more or less or use it more often than prescribed by your doctor.

Your doctor may instruct you to use additional inhaled doses of Combivent if you experience symptoms such as wheezing, shortness of breath, or chest tightness. Follow these instructions carefully and do not use extra doses of medicine unless your doctor tells you to. Do not use more than 2 additional doses of the nebulizer solution per day. Do not use the inhalation spray more than six times in 24 hours.

Call your doctor if your symptoms get worse, if you feel that inhaling Combivent is no longer controlling your symptoms, or if you find that you need to use extra doses of the medicine more often.

If you are using the inhaler, your medicine will come in cartridges. Each Combivent inhalation aerosol cartridge is designed to deliver 120 puffs. This medicine is enough for a month if you use one inhalation four times a day. After using all 120 doses, the inhaler will lock up and will not deliver any more medicine. There is a dose indicator on the side of the inhaler that records the amount of medicine left in the cartridge. Check the dose indicator from time to time to see how much medicine is left. When the pointer on the dose indicator enters the red area, the cartridge contains enough medicine for 7 days and it is time to refill your prescription so you don’t run out of medicine.

Take care that Combivent inhalation does not get into your eyes. If Combivent get in your eyes, you can develop narrow-angle glaucoma (a serious eye condition that can cause vision loss). If you already have narrow-angle glaucoma, your condition may get worse. You may experience dilated pupils (black circles in the center of the eyes), eye pain or redness, blurred vision, and vision changes such as seeing halos around lights or seeing unusual colors Call your doctor if Combivent get on you in the eyes or if you develop these symptoms.

The inhaler that comes with the Combivent aerosol is designed to be used only with an Combivent cartridge. Never use it to inhale any other medicine and do not use any other inhaler to inhale the medicine in an Combivent cartridge.

Before using Combivent inhalation for the first time, read the written instructions that come with the inhaler or nebulizer. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using your inhaler or nebulizer while you watch.

To prepare the inhaler for use, follow these steps:

  1. Assemble the inhaler before using it for the first time. To get started, take the inhaler out of the box and keep the orange cap closed. Press the safety latch and remove the clear base from the inhaler. Be careful not to touch the piercing element inside the base
  2. The inhaler should be thrown away three months after assembly. Write this date on the inhaler label so you don’t forget when to throw away your inhaler.
  3. Take the cartridge out of the box and insert the narrow end into the inhaler. You can press the inhaler against a hard surface to make sure it is inserted correctly. Replace the clear plastic base of the inhaler.
  4. Hold the inhaler upright with the orange cap closed. Rotate the clear base in the direction of the white arrows until it clicks.
  5. Flip the orange cap over so it is fully open. Point the inhaler at the ground.
  6. Press the dose release button. Close the orange cap.
  7. Repeat steps 4 through 6 until you see a spray coming out of the inhaler. Then repeat these steps three more times.
  8. The inhaler is now primed and ready to use. You will not need to prime your inhaler again unless you do not use it for more than 3 days. If you do not use your inhaler for more than 3 days, you will need to spray down onto the ground before you start using it again. If you do not use your inhaler for more than 21 days, you will need to follow steps 4-7 to prime the inhaler again.

To inhale the spray using the inhaler, follow these steps:

  1. Hold the inhaler upright with the orange cap closed. Rotate the clear base in the direction of the white arrows until it clicks.
  2. Open the orange cap.
  3. Breathe out slowly and fully.
  4. Put the mouthpiece in your mouth and close your lips around it. Be careful not to cover the air vents with your lips.
  5. Point the inhaler towards the back of your throat and inhale slowly and deeply.
  6. While inhaling, press the dose release button. Keep inhaling while the spray is released into your mouth.
  7. Hold your breath for 10 seconds or as long as you can.
  8. Take the inhaler out of your mouth and close the orange cap. Keep the cap closed until you are ready to use the inhaler again.

To inhale the solution using a nebulizer, follow these steps:

  1. Take one vial of medicine out of the foil pouch. Put the rest of the vials back in the bag until you are ready to use them.
  2. Twist the top of the vial and squeeze all of the liquid into the nebulizer reservoir.
  3. Attach the nebulizer reservoir to the mouthpiece or mask.
  4. Connect the nebulizer reservoir to the compressor.
  5. Put the mouthpiece in your mouth or put on the mask. Sit in an upright, comfortable position and turn on the compressor.
  6. Breathe calmly, deeply and evenly through your mouth for about 5 to 15 minutes until mist stops forming in the nebulizer chamber.

Clean your inhaler or nebulizer regularly. Follow the manufacturer’s directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your inhaler or nebulizer.

Other uses for this medicine

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

What special precautions should I follow?

Before using Combivent inhalation,

  • Tell your doctor and pharmacist if you are allergic to ipratropium (Atrovent), atropine (Atropen), albuterol (Proventil HFA, Ventolin HFA, Vospire ER), levalbuterol (Xoponex), any other medications, or any of the ingredients in Combivent solution or spray. Ask your pharmacist or check the manufacturer’s patient information for a list of ingredients.
  • Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: 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; other inhaled medications, especially other asthma medications such as arformoterol (Brovana), formoterol (Foradil, Perforomist), metaproterenol, levalbuterol (Xopenex), and salmeterol (Serevent, in Advair); and terbutaline (Brethine). Also tell your doctor if you are taking any of the following medications or if you have stopped taking them in the past 2 weeks: antidepressants such as amitriptyline amoxapine; clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); or monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar). Your doctor may need to change the doses of your medications or monitor you closely for side effects.
  • Tell your doctor if you have or have ever had glaucoma (an eye condition); Difficulty urinating a blockage in your bladder; a condition of the prostate (a male reproductive gland); hyperthyroidism seizures (condition in which there is too much thyroid hormone in the body); hypertension; an irregular heartbeat; diabetes; or heart, liver, or kidney disease.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using Combivent, call your doctor.
  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are using Combivent inhalation.
  • You should know that inhaling Combivent sometimes causes wheezing and shortness of breath immediately after inhalation. If this happens, call your doctor immediately. Do not use Combivent inhalation again unless your doctor tells you to.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Use the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for the one you forgot.

What side effects can this medication cause?

This medication may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • headache
  • uncontrollable shaking of a part of the body
  • nervousness

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

  • fast or pounding heartbeat
  • chest pain
  • hives
  • rash
  • itching
  • swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing
  • sore throat, fever, chills, and other signs of infection
  • difficulty urinating

Combivent may cause other side effects. Call your doctor if you have any unusual problems while you are using this medication.

What should I know about storage and disposal of this medication?

Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Keep unused nebulizer solution vials in the foil pouch until you are ready to use them. Store the medicine at room temperature and away from excess heat and moisture (not in the bathroom). Do not allow the inhalation spray to freeze.

Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. Check out the FDA drug safe disposal website ( for more information if you do not have access to a take-back program.

It is important to keep all medicines out of the sight and reach of children, since many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach.

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim collapsed, had a seizure, is having trouble breathing, or is unable to wake up, immediately call 911 for emergency services.

Symptoms of overdose may include the following:

  • chest pain
  • fast heartbeat

What other information should I know?

Keep all your appointments with your doctor.

Don’t let anyone use your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand Names

  • Combivent® Metered Dose Inhaler
  • Combivent Respimat® Inhalation Spray
  • DuoNeb® Inhalant Solution

Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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