Ipratropium and albuterol: Drug information

(For additional information see "Ipratropium and albuterol: Patient drug information" and see "Ipratropium and albuterol: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)

Brand Names: US

Combivent Respimat

Brand Names: Canada

Apo-Salvent-Ipravent Sterules;
Combivent Respimat;
Combivent UDV;
ratio-Ipra Sal UDV;
Teva-Combo Sterinebs

Pharmacologic Category

Anticholinergic Agent;
Beta₂ Agonist

Dosing: Adult

Asthma, acute moderate to severe exacerbations

Asthma, acute moderate to severe exacerbations (management in primary or acute care settings) (off-label use):

Soft-mist inhaler (ipratropium bromide 20 mcg/albuterol 100 mcg per actuation): Oral inhalation: 4 to 8 inhalations every 20 minutes for 3 doses, then as needed (Ref).

Nebulization solution (ipratropium bromide 0.5 mg/albuterol 2.5 mg per 3 mL vial): Oral inhalation: 1 vial (3 mL) every 20 minutes for 3 doses, then as needed (Ref).

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease:

Acute exacerbation: Note: Although similar efficacy exists among formulations, some experts prefer nebulized therapy during severe chronic obstructive pulmonary disease (COPD) exacerbations (Ref).

Nebulization solution (ipratropium bromide 0.5 mg/albuterol 2.5 mg per 3 mL vial): Oral inhalation: 1 vial every 1 hour (up to 3 doses), then every 2 to 4 hours as needed (Ref).

Soft-mist inhaler (ipratropium bromide 20 mcg/albuterol 100 mcg per actuation): Oral inhalation:

For patients at home or office management: 1 inhalation every 4 to 6 hours as needed (Ref).

For patients requiring emergency department or hospital-based care: 1 inhalation every 1 hour (up to 3 doses), then every 2 to 4 hours as needed (Ref).

Intermittent symptom relief: Note: Use for intermittent symptoms on an as-needed basis rather than regularly scheduled maintenance therapy (Ref).

Soft-mist inhaler (ipratropium bromide 20 mcg/albuterol 100 mcg per actuation): Oral inhalation: 1 inhalation every 4 to 6 hours as needed (maximum: 6 inhalations/day) (Ref).

Nebulization solution (ipratropium bromide 0.5 mg/albuterol 2.5 mg per 3 mL vial): Oral inhalation: 1 vial every 4 to 6 hours as needed (maximum: 6 vials/day) (Ref).

Maintenance: Depending on symptoms and exacerbation risk, preferred therapy is a single long-acting bronchodilator (long-acting beta agonist or long-acting muscarinic antagonist). In patients with more symptoms (eg, group B), preferred therapy is dual long-acting bronchodilator therapy (Ref).

Soft-mist inhaler (ipratropium bromide 20 mcg/albuterol 100 mcg per actuation): Oral inhalation: 1 inhalation 4 times daily; may take up to 2 additional inhalations per day as needed (maximum dose: 6 inhalations/day).

Nebulization solution (ipratropium bromide 0.5 mg/albuterol 2.5 mg per 3 mL vial): Oral inhalation: Initial: 1 vial 4 times daily; may administer up to 2 additional vials per day as needed (maximum dose: 6 vials/day).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Ipratropium and albuterol: Pediatric drug information")

Asthma, acute exacerbation

Asthma, acute exacerbation: Limited data available: Note: Only indicated for severe exacerbations during initial management in an acute care setting (eg, emergency department). Ipratropium has not been shown to provide further benefit (eg, after first 24 hours) once the patient is hospitalized (Ref):

Infants and Children: Nebulization solution (ipratropium bromide 0.5 mg/albuterol 2.5 mg): Oral inhalation: 1.5 to 3 mL every 20 minutes for 3 doses, then as needed for up to 3 hours.

Adolescents: Nebulization solution (ipratropium bromide 0.5 mg/albuterol 2.5 mg): Oral inhalation: 3 mL every 20 minutes for 3 doses, then as needed for up to 3 hours.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Use with caution.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Use with caution.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Also see individual agents.

1% to 10%:

Cardiovascular: Angina pectoris (<2%), cardiac arrhythmia (<2%), chest discomfort (<2%), edema (<2%), hypertension (<2%), palpitations (<2%), tachycardia (<2%)

Central nervous system: Headache (3%), pain (≥2%), dizziness (<2%), fatigue (<2%), insomnia (<2%), nervousness (<2%), voice disorder (<2%)

Dermatologic: Pruritus (<2%), skin rash (<2%)

Endocrine & metabolic: Hypokalemia (<2%)

Gastrointestinal: Constipation (<2%), diarrhea (<2%), dysgeusia (<2%), dyspepsia (<2%), vomiting (<2%), xerostomia (<2%)

Genitourinary: Dysuria (<2%), urinary tract infection (<2%)

Neuromuscular & skeletal: Arthralgia (<2%), asthenia (<2%), muscle spasm (<2%), myalgia (<2%), tremor (<2%)

Ophthalmic: Eye pain (<2%)

Respiratory: Cough (3% to 7%), nasopharyngitis (4%), bronchitis (3%), upper respiratory tract infection (3%), pharyngitis (≥2%), respiratory insufficiency (≥2%), sinusitis (≥2%), dyspnea (2%), bronchospasm (<2%), dry throat (<2%), flu-like symptoms (<2%), increased bronchial secretions (<2%), pharyngolaryngeal pain (<2%), wheezing (<2%)

Frequency not defined: Gastrointestinal: Nausea

<1%, postmarketing, and/or case reports: Accommodation disturbance, anaphylaxis, angioedema, blurred vision, central nervous system stimulation, conjunctival hyperemia, corneal edema, decreased diastolic blood pressure, dry secretions, eye irritation, gastrointestinal motility disorder, glaucoma, hyperhidrosis, hypersensitivity reaction, increased systolic blood pressure, ischemic heart disease, mouth edema, myasthenia, mydriasis, nasal congestion, paradoxical bronchospasm, pharyngeal edema, psychiatric disturbance, stomatitis, throat irritation, urinary retention, visual halos around lights

Contraindications

Hypersensitivity to ipratropium, albuterol, atropine (and its derivatives) or any component of the formulation

Canadian labeling: Additional contraindications (not in US labeling): Cardiac tachyarrhythmias, hypertrophic obstructive cardiomyopathy

Warnings/Precautions

Concerns related to adverse effects:

• Bronchospasm: Paradoxical bronchospasm that may be life-threatening may occur with use of inhaled bronchodilating agents; this should be distinguished from inadequate response. If bronchospasm occurs, discontinue ipratropium/albuterol and institute alternative therapy.

• CNS effects: May cause dizziness and blurred vision; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

• Hypersensitivity reactions: Hypersensitivity reactions (urticaria, angioedema, rash, bronchospasm, oropharyngeal edema), including anaphylaxis have been reported; discontinue therapy immediately if patient develops an allergic reaction.

• Serious effects/fatalities: Do not exceed recommended dose (including doses from other combined inhaled sympathomimetics [eg, short- and/or long-acting beta-agonists]); serious adverse events, including fatalities, have been associated with excessive use of inhaled sympathomimetics.

• Sympathomimetic amines sensitivity: Use albuterol with caution in patients with sensitivity to sympathomimetic amines.

Disease-related concerns:

• Cardiovascular disease: Use albuterol with caution in patients with cardiovascular disease (arrhythmia, coronary insufficiency, hypertension, HF); beta-agonists have been reported to produce ECG changes (flattening of the T wave, prolongation of the QTc interval, ST segment depression) and/or cause elevation in blood pressure, heart rate and result in CNS stimulation/excitation. Beta₂-agonists may also increase risk of arrhythmias and myocardial ischemia. In a scientific statement from the American Heart Association, albuterol has been determined to be an agent that may either cause direct myocardial toxicity or exacerbate underlying myocardial dysfunction (magnitude: moderate to major) (AHA [Page 2016]).

• Diabetes: Use albuterol with caution in patients with diabetes mellitus; beta₂-agonists may increase serum glucose and aggravate preexisting diabetes and ketoacidosis (effect is usually transient).

• Glaucoma: Use ipratropium with caution in patients with narrow-angle glaucoma; may increase intraocular pressure.

• Hyperthyroidism: Use albuterol with caution in hyperthyroidism; may stimulate thyroid activity.

• Hypokalemia: Use albuterol with caution in patients with hypokalemia; beta₂-agonists may decrease serum potassium (effect is usually transient).

• Prostatic hyperplasia/bladder neck obstruction: Use ipratropium with caution in patients with prostatic hyperplasia or bladder neck obstruction; ipratropium may cause urinary retention.

• Seizure disorder: Use albuterol with caution in patients with seizure disorders; beta-agonists may result in CNS stimulation/excitation.

Dosage Forms Considerations

Combivent Respimat 4 g cartridges contain 120 actuations.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, for nebulization:

Generic: Ipratropium bromide 0.5 mg and albuterol (base) 2.5 mg per 3 mL (30s, 60s)

Solution, for oral inhalation [spray]:

Combivent Respimat: Ipratropium bromide 20 mcg and albuterol (base) 100 mcg per inhalation (4 g) [contains benzalkonium chloride]

Generic Equivalent Available: US

Yes: Solution for nebulization

Pricing: US

Aerosol solution (Combivent Respimat Inhalation)

20-100 mcg/ACT (per gram): $146.80

Solution (Ipratropium-Albuterol Inhalation)

0.5-2.5 (3) mg/3 mL (per mL): $0.26 - $0.77

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, for nebulization: Ipratropium bromide 0.5 mg and albuterol (base) 2.5 mg per 2.5 mL

Administration: Adult

Inhalation: For oral inhalation; avoid spraying in eyes.

Nebulization solution: Remove unit-dose vial from foil pouch and squeeze contents into nebulizer reservoir; connect nebulizer to air compressor with a mouthpiece or face mask. Breathe deeply and evenly until all medication has been inhaled; inhalation time is about 5 to 15 minutes. Clean nebulizer after use.

Soft-mist inhaler: Prior to first use insert cartridge into inhaler; prime inhaler (or if not used in >21 days) by pointing towards the ground and actuate until aerosol cloud is seen, then repeat 3 additional times before use. If not used for >3 days; actuate once before use. Clean the mouthpiece (including the metal part inside the mouthpiece) at least once a week with a damp cloth or tissue only.

Administration: Pediatric

Oral inhalation: Nebulization solution: Administer via jet nebulizer to an air compressor with an adequate air flow, equipped with a mouthpiece or face mask.

Use: Labeled Indications

Chronic obstructive pulmonary disease: Treatment of chronic obstructive pulmonary disease (COPD) in those patients who are currently on a regular bronchodilator who continue to have bronchospasms and require a second bronchodilator

Use: Off-Label: Adult

Asthma, acute moderate to severe exacerbations (management in primary or acute care settings)

Medication Safety Issues

Sound-alike/look-alike issues:

DuoNeb may be confused with DuoTrav, Duovent UDV

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Risk C: Monitor therapy

Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Anticholinergic Agents: Ipratropium (Oral Inhalation) may enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Atomoxetine: May enhance the tachycardic effect of Beta2-Agonists. Risk C: Monitor therapy

Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Atosiban: Beta2-Agonists may enhance the adverse/toxic effect of Atosiban. Specifically, there may be an increased risk for pulmonary edema and/or dyspnea. Risk C: Monitor therapy

Beta2-Agonists (Short-Acting): May enhance the adverse/toxic effect of other Beta2-Agonists (Short-Acting). Risk X: Avoid combination

Beta-Blockers (Beta1 Selective): May diminish the bronchodilatory effect of Beta2-Agonists. Of particular concern with nonselective beta-blockers or higher doses of the beta1 selective beta-blockers. Risk C: Monitor therapy

Beta-Blockers (Nonselective): May diminish the bronchodilatory effect of Beta2-Agonists. Risk X: Avoid combination

Botulinum Toxin-Containing Products: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Risk C: Monitor therapy

Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Risk C: Monitor therapy

Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Risk X: Avoid combination

Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Risk D: Consider therapy modification

Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Risk C: Monitor therapy

Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Risk X: Avoid combination

Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Risk C: Monitor therapy

Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor therapy

Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Risk X: Avoid combination

Glycopyrronium (Topical): May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy

Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Risk C: Monitor therapy

Kratom: May enhance the adverse/toxic effect of Sympathomimetics. Risk X: Avoid combination

Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Risk X: Avoid combination

Levothyroxine: May enhance the adverse/toxic effect of Sympathomimetics. Specifically, the risk of coronary insufficiency may be increased in patients with coronary artery disease. Levothyroxine may enhance the therapeutic effect of Sympathomimetics. Sympathomimetics may enhance the therapeutic effect of Levothyroxine. Risk C: Monitor therapy

Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Consider initial dose reductions of sympathomimetic agents, and closely monitor for enhanced blood pressure elevations, in patients receiving linezolid. Risk D: Consider therapy modification

Loop Diuretics: Beta2-Agonists may enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

Loxapine: Agents to Treat Airway Disease may enhance the adverse/toxic effect of Loxapine. More specifically, the use of Agents to Treat Airway Disease is likely a marker of patients who are likely at a greater risk for experiencing significant bronchospasm from use of inhaled loxapine. Management: This is specific to the Adasuve brand of loxapine, which is an inhaled formulation. This does not apply to non-inhaled formulations of loxapine. Risk X: Avoid combination

Methacholine: Ipratropium (Oral Inhalation) may diminish the therapeutic effect of Methacholine. Management: Hold ipratropium for 12 hours before methacholine use. Risk D: Consider therapy modification

Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Risk C: Monitor therapy

Monoamine Oxidase Inhibitors: May enhance the adverse/toxic effect of Beta2-Agonists. Risk C: Monitor therapy

Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor therapy

Opioid Agonists: Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Risk C: Monitor therapy

Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy

Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid combination

Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid combination

Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Risk X: Avoid combination

QT-prolonging Agents (Highest Risk): QT-prolonging Agents (Indeterminate Risk - Caution) may enhance the QTc-prolonging effect of QT-prolonging Agents (Highest Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor therapy

Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Risk C: Monitor therapy

Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Risk X: Avoid combination

Rivastigmine: Anticholinergic Agents may diminish the therapeutic effect of Rivastigmine. Rivastigmine may diminish the therapeutic effect of Anticholinergic Agents. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider therapy modification

Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider therapy modification

Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Risk C: Monitor therapy

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy

Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Theophylline Derivatives: Beta2-Agonists may enhance the adverse/toxic effect of Theophylline Derivatives. Specifically, sympathomimetic effects may be increased. Theophylline Derivatives may enhance the hypokalemic effect of Beta2-Agonists. Risk C: Monitor therapy

Thiazide and Thiazide-Like Diuretics: Beta2-Agonists may enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Risk X: Avoid combination

Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Risk C: Monitor therapy

Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Pregnancy Considerations

Refer to individual monographs.

Breastfeeding Considerations

It is not known if ipratropium or albuterol are present in breast milk.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother. Refer to individual monographs.

Monitoring Parameters

FEV₁, peak flow, and/or other pulmonary function tests; blood pressure, heart rate; CNS stimulation; serum glucose, serum potassium; signs/symptoms of glaucoma; hypersensitivity reactions; urinary retention; shortness of breath

Mechanism of Action

See individual agents.

Pharmacokinetics (Adult Data Unless Noted)

See individual agents.

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Combivent;
(AR) Argentina: Combivent | Maxair | Salbutral ac | Salbutral AC Hfa | Salbutrop;
(AT) Austria: Combivent | Di-promal;
(AU) Australia: Combivent;
(BD) Bangladesh: Combair | Combiver | Ipralin hfa | Iprasol | Salpium | Sulprex | Ventil plus;
(BE) Belgium: Combivent;
(BG) Bulgaria: Combivent;
(BR) Brazil: Combivent;
(CH) Switzerland: Dospir;
(CL) Chile: Combivent;
(CN) China: Combivent | Compound ipratropium bromide | Compound salbutamol sulfate | Ke bi te | Ren shu;
(CO) Colombia: Combivent | Dulocip | Duoastalin;
(CZ) Czech Republic: Combivent;
(DO) Dominican Republic: Albugenol TR | Combivent | I Patrimul Compuesto | Salbutral ac;
(EC) Ecuador: Combivent;
(EE) Estonia: Combivent;
(EG) Egypt: Combivent | Ipravent S;
(ES) Spain: Combivent;
(FR) France: Combivent;
(GB) United Kingdom: Combivent | Salipraneb;
(GR) Greece: Berovent;
(HK) Hong Kong: Combivent;
(HN) Honduras: Butam ip;
(ID) Indonesia: Combivent;
(IE) Ireland: Combivent;
(IN) India: Combimist | Duolin | Salbair-i | Ventipra;
(IT) Italy: Breva | Inasal | Naos | Nefes | Sosaria;
(JO) Jordan: Combivent;
(KE) Kenya: Combair | Combivent udv | Dulocip;
(KR) Korea, Republic of: Combivent;
(KW) Kuwait: Combivent;
(LB) Lebanon: Combivent | Duolin;
(LT) Lithuania: Combivent;
(LU) Luxembourg: Combivent;
(LV) Latvia: Combivent;
(MA) Morocco: Combivent;
(MX) Mexico: Combivent | Lonvitol;
(MY) Malaysia: Combivent;
(NL) Netherlands: Combivent;
(NZ) New Zealand: Combivent;
(PE) Peru: Combivent | Duolin | Salburex duo | Salbutral ac;
(PH) Philippines: Combipul | Combivent | Duavent | I breath plus;
(PL) Poland: Combivent | Iprixon neb;
(PR) Puerto Rico: Combivent | Combivent respimat;
(PT) Portugal: Combivent;
(PY) Paraguay: Combivent | Estraplus | Salbutral ac;
(QA) Qatar: Combivent UDV | Mixvent | Pralas | Salpium Plus;
(RO) Romania: Combivent;
(RU) Russian Federation: Combivent;
(SA) Saudi Arabia: Combivent;
(SG) Singapore: Combivent;
(SK) Slovakia: Combivent;
(TH) Thailand: Combivent;
(TN) Tunisia: Combivent;
(TR) Turkey: Combivent | Ipravent;
(TW) Taiwan: Besmate | Combivent;
(UA) Ukraine: Combivent | Iprixon neb;
(UY) Uruguay: Combivent | Estraplus | Salbutral ac;
(VE) Venezuela, Bolivarian Republic of: Combivent | Duolin;
(VN) Viet Nam: Zencombi;
(ZA) South Africa: Combivent | Duolin | Salipra;
(ZM) Zambia: Salbair 1

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Combivent Respimat (ipratropium bromide and albuterol) [product monograph]. Burlington, Ontario, Canada: Boehringer Ingelheim (Canada) Ltd; November 2019.
Combivent UDV (ipratropium bromide and albuterol) [product monograph]. Burlington, Ontario, Canada: Boehringer Ingelheim (Canada) Ltd; November 2015.
Duoneb (ipratropium bromide and albuterol) [prescribing information]. Napa, CA: Dey Pharma; June 2012.
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Ipratropium and albuterol: Drug information