Combivent

Combivent is used to treat the symptoms of chronic obstructive pulmonary disease (COPD). It comes in a metered-dose inhaler and is generally used four times a day. Side effects can include bronchitis, headaches, and upper respiratory tract infections. A few of the conditions that you should let your healthcare provider know about before you use the drug include glaucoma, high blood pressure, and seizures.

 

What Is Combivent?

Combivent® (ipratropium and albuterol inhaler) is a prescription medication used to prevent airway spasms (also known as bronchospasms) caused by chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. Combivent contains a combination of two medications: ipratropium bromide (Atrovent®) and albuterol sulfate (Proair®, Proventil®, Ventolin®). It is approved for treating COPD in people who still have breathing problems after trying one of these medications.
 
(Click Combivent Uses for more information, including possible off-label uses.)
 

Who Makes It?

Combivent is made by Boehringer Ingelheim Pharmaceuticals.
 

How Does It Work?

The albuterol component of Combivent belongs to a class of drugs called beta-adrenergic receptor agonists, or beta agonists for short. Beta agonists stimulate beta receptors in the body, including those on the muscles around the airways. This stimulation causes the muscles to relax, which opens up the airways and allows more air into and out of the lungs.
 
The other component of Combivent (ipratropium) belongs to a group of medications known as anticholinergics or antimuscarinics. By binding to specific receptors in the airways, called muscarinic receptors, ipratropium helps to relax the smooth muscle of the airways and allow more air into and out of the lungs.
 

Effects of Combivent

Studies have compared Combivent to its two components (used separately) in people with COPD. These studies have shown that Combivent improved lung function more than when either ipratropium or albuterol were used alone. Also, Combivent began working within 15 minutes, and the effects of a dose lasted about four to five hours, on average.
 

When and How to Take Combivent

General considerations for when and how to take Combivent include the following:
 
  • The medication comes in a metered-dose inhaler (called an "MDI"). It is usually taken four times a day, although sometimes more frequent dosing is necessary.
     
  • You should "test-spray" each Combivent inhaler before your first use of it or if you have not used it for more than 24 hours. To test-spray the inhaler, simply spray it into the air three times by pressing on the top of the canister.
     
  • Make sure to shake the inhaler vigorously for at least 10 seconds just before each spray.
     
  • It is important to learn exactly how to use your inhaler. It may be difficult at first and require some practice.
     
  • The spray should be inhaled into the lungs, not sprayed onto the back of the throat and swallowed. To accomplish this, you will need to breathe in while spraying the inhaler. Hold your breath for 10 seconds after each spray, and wait about two minutes between sprays (don't forget to vigorously shake the canister again).
     
  • Most people put the mouthpiece of the inhaler directly into their mouths. However, many healthcare professionals now recommend placing the inhaler an inch or two away from the mouth. Talk to your healthcare provider about the best way for you to use the inhaler. If you have difficulty using it, your healthcare provider may recommend a spacer, a device that makes it easier to use the inhaler.
     
  • Each inhaler contains 200 sprays. Try to keep track of how many sprays you have used, as it can be difficult to tell if the canister is empty. The canister may keep spraying after 200 sprays, but you cannot be sure that you are getting a full dose of Combivent after 200 sprays have been used.
     
  • For Combivent to work properly, it must be taken as prescribed. The medication will not work if you stop taking it.
     

Dosing Information

There is only one recommended starting dose of Combivent, regardless of your age, weight, or other medical problems. As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 
(Click Combivent Dosage for more information.)
 

Side Effects of Combivent

As with any medicine, side effects are possible with Combivent. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
Common side effects of Combivent include but are not limited to:
 
  • Bronchitis
  • Upper respiratory tract infections (such as the common cold)
  • Headaches
  • Difficulty breathing
  • Coughing.
     
(Click Combivent Side Effects to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
 

Drug Interactions

Combivent can potentially interact with several other medicines (see Combivent Drug Interactions).
 

What Should I Tell My Healthcare Provider Before Taking Combivent?

You should talk with your healthcare provider prior to taking Combivent if you have:
 
Also, let your healthcare provider know if you are:
 
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Combivent Warnings and Precautions for more information on this topic, including information on who should not take the drug.)
 

What If I Take an Overdose?

People who take too much Combivent may have overdose symptoms that could include:
 
  • Shakiness or nervousness
  • Abdominal pain (stomach pain)
  • Nausea
  • Blurred vision
  • Headaches
  • Constipation
  • Dry mouth or eyes
  • Difficulty urinating
  • Chest pain (angina)
  • High blood pressure (hypertension) or low blood pressure (hypotension)
  • A fast heart rate (tachycardia) or an irregular heart rhythm (arrhythmia)
  • Feelings of a rapidly or forcefully beating heart (heart palpitations)
  • Dizziness
  • Insomnia
  • Seizures
  • Fatigue
  • Low potassium in the blood (hypokalemia)
  • Cardiac arrest
  • Loss of life.
     
If you happen to overdose on Combivent, seek immediate medical attention.
 
(Click Combivent Overdose for more information.)
 

How Should Combivent Be Stored?

Store Combivent at room temperature, away from moisture and heat. Do not puncture the canister, and do not store or use it near heat or an open flame.
 
Keep Combivent and all medications out of the reach of children.
 

What Should I Do If I Miss a Dose?

If you do not take your Combivent as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
 

Strengths

Combivent is available in one strength, which contains 200 sprays, with 18 mcg of ipratropium bromide and 90 mcg of albuterol per spray.
 

Generic Combivent

Currently, there are no generic versions of Combivent licensed for sale (see Generic Combivent).
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;