albuterol and ipratropium inhaler, Combivent, Combivent Respimat

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is albuterol and ipratropium inhaler, and how does it work (mechanism of action)?

Albuterol/ipratropium is a combination product consisting of two bronchodilators, albuterol (Proventil; Ventolin) and ipratropium (Atrovent) that is used in the treatment of chronic obstructive pulmonary disease (bronchitis and emphysema) when there is evidence of spasm (narrowing) of the airways (bronchi). Bronchodilators dilate or enlarge the airways by relaxing the muscles surrounding the airways. Albuterol and ipratropium work by different mechanisms, but both cause the muscles of the airways to relax. Albuterol is a bronchodilator of the beta-2 agonist type. Beta-2 agonists are medications that stimulate beta-2 receptors on the smooth muscle cells that line the airways, causing these muscle cells to relax and thereby opening airways. Ipratropium blocks the effect of acetylcholine in airways and nasal passages. Acetylcholine is a chemical that nerves use to communicate with muscle cells. In chronic obstructive pulmonary disease (COPD), cholinergic nerves going to the lungs cause narrowing of airways by stimulating muscles surrounding airways to contract. The "anti-cholinergic" effect of ipratropium blocks the effect of cholinergic nerves, causing the muscles to relax and airways to dilate. The FDA approved albuterol/ipratropium in October 1996.

What brand names are available for albuterol and ipratropium inhaler?

Combivent Respimat

Is albuterol and ipratropium inhaler available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for albuterol and ipratropium inhaler?

Yes

What are the side effects of albuterol and ipratropium inhaler?

Side effects of albuterol/ipratropium combination products are due to the component drugs. Side effects of albuterol include nervousness, tremor, headache, palpitations, fast heart rate, elevated blood pressure, nausea, dizziness, and heartburn. Throat irritation and nosebleeds also can occur. Worsening of diabetes and lowering of potassium also have been reported.

The most common side effects associated with ipratropium are:

Because of its anticholinergic effect, ipratropium may worsen symptoms of benign prostatic hyperplasia, and narrow-angle glaucoma.

Other important side effects include allergic reactions, which may rarely occur and may manifest as:

In rare patients, albuterol/ipratropium can paradoxically precipitate life-threatening bronchospasm.

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