- What is albuterol and ipratropium inhaler, and how does it work (mechanism of action)?
- What are the uses 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 brand names are available for albuterol and ipratropium inhaler?
Combivent Respimat
Is albuterol and ipratropium inhaler available as a generic drug?
Yes
Do I need a prescription for albuterol and ipratropium inhaler?
Yes
What are the uses for albuterol and ipratropium inhaler?
Albuterol and ipratropium inhaler (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.
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.
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.

SLIDESHOW
What is Asthma? Asthma Myths Debunked See SlideshowWhich 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.
Health News
- Weed-Friendly Posts on Social Media Get Teens Using Cannabis
- Deer Carry COVID Variants No Longer Seen in People
- Working Gets Tough When Grieving a Lost Spouse
- Obamacare Helped Women in Some Southern States Get Better Breast Cancer Care
- AHA News: Pregnancy Complications Could Increase Woman's Stroke Risk at Earlier Age
More Health News »
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.
Multimedia: Slideshows, Images & Quizzes
-
What Is Asthma? Symptoms, Causes, and Treatments
What is asthma? What is the main cause of asthma? Learn information about asthma, a chronic disease of the bronchiole tubes....
-
Asthma Quiz
Asthma is a chronic disease of the airways of the lungs, which can be managed with proper treatment. Triggered by two main...
-
COPD (Chronic Obstructive Pulmonary Disease) Quiz
COPD is a combination of three conditions? Take this quiz to learn the three conditions that make up the pulmonary disease called...
Related Disease Conditions
-
Cough: 19 Tips on How to Stop a Cough
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, the common cold, GERD, lung cancer, and heart disease.Natural and home remedies to help cure and soothe a cough include staying hydrated, gargle salt water, use cough drops or lozenges, use herbs and supplements like ginger, mint, licorice, and slippery elm, and 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).
-
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. Chronic cough treatment is based on the cause, but may be soothed natural and home remedies.
-
Emphysema
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.
-
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, and emphysema. Symptoms of COPD include shortness of breath, wheezing, and chronic cough. Treatment of COPD includes GOLD guidelines, smoking cessation, medications, and surgery. The life expectancy of a person with COPD depends on the stage of the disease.
-
Chronic Bronchitis
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least 3 months, 2 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.
-
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.
-
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.
Treatment & Diagnosis
- Asthma FAQs
- COPD (Chronic Obstructive Pulmonary Disease) FAQs
- Prescriptions: Complying with the Doctor's Orders
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Bronchodilators (Drug Class)
- Drug Interactions
- ipratropium bromide inhaler (Atrovent)
- albuterol (Ventolin, Proventil)
- Combivent Respimat (albuterol and ipratropium) Side Effects, Warnings, and Drug Interactions
- Spiriva
- levalbuterol pre-mixed solution - inhalation, Xopenex
- ProAir Respiclick (albuterol sulfate)
- ProAir Digihaler (albuterol sulfate)
Prevention & Wellness

QUESTION
Asthma is a chronic respiratory disease. See AnswerHealth Solutions From Our Sponsors

Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
REFERENCE:
FDA Prescribing Information