albuterol and ipratropium inhaler, Combivent, Combivent Respimat (cont.)
Omudhome Ogbru, PharmD
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:
GENERIC AVAILABLE: Yes
PREPARATIONS: Aerosol inhaler: 90/18 mcg or 100/20 mcg (albuterol/ipratropium) per actuation of the inhaler.
STORAGE: The inhaler should be stored at room temperature, 15-30 C (59-86 F) and kept away from moisture.
PRESCRIBED FOR: Albuterol/ipratropium is used in the treatment of bronchospasm or narrowing of the airways caused by emphysema or bronchitis in patients who require a second bronchodilator.
DOSING: The recommended dosing for albuterol/ipratropium is 2 inhalations 4 times daily and as needed not to exceed 12 inhalations per day. The dose of Combivent Respimat is 1 inhalation 4 times daily not to exceed 6 inhalations per day.
DRUG INTERACTIONS: Use with other anticholinergic drugs (for example, atropine) may increase the occurrence of side effects. Tricyclic antidepressants, for example, amitriptyline (Elavil, Endep), monoamine oxidase inhibitors, for example, tranylcypromine, should not be combined with albuterol/ipratropium because of their additive effects on the vascular system (increased blood pressure, heart rate, etc.). A period of two weeks should elapse between treatment with albuterol/ipratropium and tricyclic antidepressants or monoamine oxidase inhibitors.
Use of albuterol/ipratropium with other stimulant medications is discouraged because of their combined effects on heart rate, blood pressure, and the potential for causing chest pain in patients with underlying coronary heart disease. Beta blockers, for example, propranolol (Inderal, Inderal LA) block the effect of albuterol and may induce bronchospasm in asthmatics.
Albuterol/ipratropium may cause hypokalemia (low potassium). Therefore, combining albuterol/ipratropium with loop diuretics which reduce potassium in the body, for example, furosemide (Lasix) may increase the likelihood of hypokalemia.
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