- What is albuterol and ipratropium inhaler, and how does it work (mechanism of action)?
- What brand names are available for albuterol and ipratropium inhaler?
- Is albuterol and ipratropium inhaler available as a generic drug?
- Do I need a prescription for albuterol and ipratropium inhaler?
- What are the side effects of albuterol and ipratropium inhaler?
- What is the dosage for albuterol and ipratropium inhaler?
- Which drugs or supplements interact with albuterol and ipratropium inhaler?
- Is albuterol and ipratropium inhaler safe to take if I'm pregnant or breastfeeding?
- What else should I know about albuterol and ipratropium inhaler?
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 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:
- rash,
- hives,
- swelling,
- bronchospasm, or
- anaphylaxis (shock).
In rare patients, albuterol/ipratropium can paradoxically precipitate life-threatening bronchospasm.
Quick GuideAsthma Symptoms, Causes, and Medications
What is the dosage for albuterol and ipratropium inhaler?
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.
Which drugs or supplements interact with albuterol and ipratropium inhaler?
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.
Is albuterol and ipratropium inhaler safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of albuterol/ipratropium use during pregnancy. Some reports indicate that beta-agonists may interfere with uterine contractility.
It is not known whether albuterol/ipratropium is excreted in human milk.
What else should I know about albuterol and ipratropium inhaler?
What preparations of albuterol and ipratropium inhaler are available?
Aerosol inhaler: 90/18 mcg or 100/20 mcg (albuterol/ipratropium) per actuation of the inhaler.
How should I keep albuterol and ipratropium inhaler stored?
The inhaler should be stored at room temperature, 15 C - 30 C (59 F - 86 F) and kept away from moisture.
Reference: FDA Prescribing Information
Quick GuideAsthma Symptoms, Causes, and Medications
Summary
Albuterol and ipratropium inhaler (Combivent [discontinued], Combivent Respimat) is prescribed for the treatment of bronchospasm or narrowing of the airways caused by emphysema or bronchitis in individuals who require a second bronchodilator. Side effects, drug interactions, warnings and precautions, and pregnancy safety should be reviewed prior to taking this drug.
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Complete List
albuterol
albuterol (Accuneb, Ventolin and Proventil have been discontinued) is a drug used for prevention and relief of bronchospasm in individuals with asthma, exercise induced asthma, emphysema, or chronic bronchitis. Drug interactions include tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and beta blockers. Side effects include tremor, headache, palpitations, and more. Side effects, drug interactions, dosing, and pregnancy safety information should be reviewed prior to taking this medication.Asthma Slideshow
What is asthma? Learn about asthma, a chronic inflammation disorder of the bronchiole tubes (airways). Discover information about an asthma attack, asthma symptoms, prevention and treatments such as asthma medications and inhalers.Take the Asthma Quiz
Asthma is a chronic disease of the airways of the lungs, which can be managed with proper treatment. Triggered by two main causes, asthma symptoms can be brought on by environmental factors and surprising allergens.Asthma: Over The Counter Treatment
Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.Bronchodilators for Asthma
Bronchodilators are prescription medications used to treat
- asthma,
- chronic obstructive pulmonary disease (COPD), and
- allergies.
Side effects depend upon the type of bronchodilator used
- long-acting beta-adrenergic,
- short-acting beta-adrenergic,
- anticholinergic, or
- xanthine derivatives.
Drug interactions and pregnancy and breastfeeding safety information should be reviewed prior to taking any medication.
Chronic Bronchitis
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include
- cough,
- shortness of breath, and
- wheezing.
Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
Chronic Cough
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as
- asthma,
- allergic rhinitis,
- sinus infection,
- cigarette smoking,
- GERD,
- postnasal drip,
- bronchitis,
- pneumonia,
- medications, and
- less frequently tumors or other lung disease. Treatment of chronic cough is dependent upon the cause.
Chronic cough treatment is based on the cause, but may be soothed natural and home remedies.
COPD (Chronic Obstructive Pulmonary Disease)
COPD or chronic obstructive pulmonary disease is a lung condition caused by smoking tobacco, exposure to secondhand smoke, and/or air pollutants. Conditions that accompany COPD include:
- Chronic bronchitis
- Chronic cough
- Emphysema
Symptoms of COPD include:
- Shortness of breath
- Wheezing
- Chronic cough
Treatment of COPD include smoking cessation, medications, and surgery. The life expectancy of a person with COPD depends on the stage of the disease.
Take the COPD Quiz
COPD is a combination of three conditions? Take this quiz to learn the three conditions that make up the pulmonary disease called chronic obstructive pulmonary disease (COPD).Drug Interactions
Drug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.Drugs: What You Should Know About Your Drugs
Important information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.Emphysema (Lung Condition)
Emphysema is a COPD (chronic obstructive pulmonary disease) that often occurs with other obstructive pulmonary problems and chronic bronchitis. Causes of emphysema include chronic cigarette smoking, exposure to secondhand smoke, air pollution, and in the underdeveloped parts of the world. Symptoms of emphysema include chronic cough, chest discomfort, breathlessness, and wheezing. Treatments include medication and lifestyle changes.Emphysema, Chronic Bronchitis, and Colds
If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.Exercise-Induced Asthma
Exercise-induced asthma is asthma triggered by vigorous exercise. Symptoms include coughing, shortness of breath, chest tightness, wheezing, and fatigue while exercising. Preventing exercise-induced asthma attacks involves using inhaled medicines before exercising, performing warm-up exercises and cooling down afterward, avoiding exercising outdoors when pollen counts are high, restricting exercise when you have a viral infection, and wearing a mask over your nose and mouth when exercising in cold weather.How to Stop Coughing
Coughing is a reflex that helps a person clear their airways of irritants. There are many causes of an excessive or severe cough including:
- Irritants like
- cigarette and secondhand smoke
- pollution
- air fresheners
- Medications like beta blockers and ACE inhibitors
- Medical conditions like
- the common cold
- GERD
- lung cancer
- heart disease
Natural and home remedies that help cure and soothe a cough are:
Natural and home remedies to help cure and soothe a cough are:
- Stay hydrated
- Gargle saltwater
- Use cough drops or lozenges
- Use herbs and supplements like ginger, mint, licorice, and slippery elm
- Don't smoke
Over-the-counter products (OTC)to cure and soothe a cough include
- cough suppressants and expectorants, and
- anti-reflux drugs.
Prescription drugs that help cure a cough include
- narcotic medications,
- antibiotics,
- inhaled steroids, and
- anti-reflux drugs like proton pump inhibitors or PPIs, for example,
- omeprazole (Prilosec),
- rabeprazole (Aciphex), and
- pantoprazole (Protonix).
- Irritants like
ipratropium bromide inhaler
Ipratropium bromide inhaler (Atrovent, Atrovent HFA) is a medication prescribed for the treatment of allergic or nonallergic rhinitis and rhinitis due to the common cold. Oral ipratropium is prescribed for the treatment of acute asthma flares and bronchospasms that result from COPD (chronic obstructive pulmonary disease) and emphysema. Side effects, drug interactions, dosing, storage, and pregnancy and breastfeeding safety information is provided.levalbuterol-inhalation solution
