Combivent Respimat is a prescription medication sold under the brand name Combivent. The drug is used to treat chronic obstructive pulmonary disease (COPD) in adults. Chronic bronchitis and emphysema are part of COPD. It is a bronchodilator called Combivent Respimat.

Combivent Respimat is a medication consisting of bronchodilators that effectively alleviate airway constriction and enhance airflow to the lungs. It is prescribed to individuals with chronic obstructive pulmonary disease (COPD) who are already utilizing other medications to manage their condition, helping to prevent bronchospasms.

Inhaling this medication opens up breathing passages in your lungs. You must already be using an aerosol bronchodilator before your doctor can prescribe Combivent Respimat. Additionally, you must have bronchospasms (tightening of the muscles in your airways) and require a second bronchodilator. Two drugs are contained in Combivent Respimat. Ipratropium is an anticholinergic drug that belongs to a class called ipratropium. The second drug, albuterol, belongs to a class of drugs called beta2-adrenergic agonists. Inhalers are available for Combivent Respimat. Respimat is the name of the inhaler device.

What is COPD?

COPD stands for chronic obstructive pulmonary disease. It is a chronic lung disease characterized by airflow limitation and difficulty breathing. The two main conditions that contribute to COPD are chronic bronchitis and emphysema. Chronic bronchitis involves inflammation and narrowing of the airways, while emphysema involves damage to the air sacs in the lungs, leading to poor oxygen exchange. COPD is typically caused by long-term exposure to irritants such as cigarette smoke, air pollution, or occupational hazards. Symptoms of COPD include coughing, wheezing, shortness of breath, and chest tightness. It is a progressive disease that requires long-term management and treatment.

Warnings & Precautions

Before initiating medication, ensure you inform your doctor of medical conditions, allergies, medications, pregnancy, breastfeeding, and other relevant health details. Various factors may impact medication use.

Cystic fibrosis may increase the likelihood of stomach discomfort while using this medication. Diabetic individuals may experience changes in blood sugar levels and glucose tolerance. Those with diabetes should monitor blood sugar levels closely.

Dizziness or blurred vision may occur, affecting the ability to drive or operate machinery. Heart conditions may worsen due to increased heart rate and blood pressure. Inhalation-induced bronchospasm may occur; discontinue use if breathing difficulties arise.

Individuals with pheochromocytoma should discuss the medication’s effects and monitoring needs with their doctor. Potassium levels may decrease, requiring monitoring. Overactive thyroid gland and urinary tract problems may require special considerations and monitoring.

Vision concerns, such as glaucoma symptoms, should be reported promptly. Contact your doctor if symptoms worsen or if increased difficulty breathing occurs. Safety during pregnancy and breastfeeding has not been established. The medication’s use in children has not been determined.

If you have a history of allergies to albuterol, ipratropium, or atropine, avoid using this medication. Inform your doctor about your medical history, including heart disease, high blood pressure, epilepsy, diabetes, overactive thyroid, glaucoma, liver or kidney disease, and prostate issues. Notify your doctor if you are pregnant or breastfeeding. This medicine is not intended for individuals under 18 years old.

This medication has the potential to cause dizziness, blurred vision, or changes in vision. It is advised to refrain from activities requiring alertness or clear vision until you can do them safely. Limit alcohol consumption and consult your doctor if using marijuana (cannabis).

Prior to undergoing surgery, inform your doctor or dentist about all the medications and products you are using, including prescription drugs, over-the-counter drugs, and herbal products.

Older adults may be more susceptible to the side effects of this medication, particularly issues with urination or constipation.

Side Effects

Combivent Respimat can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Combivent Respimat. These lists do not include all possible side effects.

For more information on the possible side effects of Combivent Respimat, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Common Side Effects

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist. Please note this list does not include every side effect.

  • Cough
  • Shortness of breath or trouble breathing
  • Headaches
  • Infections that can affect your breathing such acute bronchitis or colds

Serious Side Effects

Serious side effects from Combivent Respimat aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Paradoxical bronchospasm (wheezing or trouble breathing that gets worse)
  • Eye problems. Symptoms can include: glaucoma (increased pressure inside the eye) eye pain halos (seeing bright circles around lights) blurred vision dizziness
  • Trouble urinating or pain while urinating
  • Heart problems. Symptoms can include: faster heart rate chest pain
  • Hypokalemia (low potassium levels). Symptoms can include: fatigue (lack of energy) weakness muscle cramps constipation heart palpitations (feeling of skipped or extra heartbeats)

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Combivent Respimat.  Symptoms of a mild allergic reaction can include:

  • Skin rash
  • Itchiness
  • Flushing (warmth and redness in your skin)
  • Swelling under your skin, typically in your eyelids, lips, hands, or feet swelling of your tongue, mouth, or throat
  • Trouble breathing

Colds

Taking Combivent Respimat may cause you to get a cold. A clinical study looked at people with chronic obstructive pulmonary disease (COPD) who took Combivent Respimat or ipratropium (an ingredient in Combivent Respimat). In this study, 3% of people who took Combivent Respimat had a cold. Three percent of people who took ipratropium also had a cold. A cold can also worsen COPD symptoms, such as trouble breathing, wheezing, and coughing.  This is because colds can affect your lungs. If you develop a cold while taking Combivent Respimat, talk with your doctor or pharmacist. They can give you advice on how to manage your cold and COPD symptoms. You can try to prevent a cold with these tips:

  • Wash your hands often.
  • Limit contact with anyone who’s sick.
  • Avoid sharing personal items, such as drinking glasses and toothbrushes, with other people.
  • Clean door handles and light switches.

Eye problems

Taking Combivent Respimat may cause problems with your eyes, such as new or worsening glaucoma. Glaucoma is an increase in the pressure inside the eye that may lead to eye damage. It’s not known how many people have had eye problems after taking Combivent Respimat. It’s also possible to spray Combivent Respimat in your eyes by accident when you inhale the drug. If this happens, you may have eye pain or blurry vision. So when using Combivent Respimat, try to avoid spraying the drug in your eyes. If you’re taking Combivent Respimat and see halos (bright circles around lights), have blurred vision, or notice other eye problems, tell your doctor. Your doctor may stop Combivent or switch you to another medication. Depending on your symptoms, they may treat your eye problem.

Drug Interactions

Combivent Inhalation Aerosol has been used alongside other medications commonly prescribed for chronic obstructive pulmonary disease (COPD), such as sympathomimetic bronchodilators, methylxanthines, and oral/inhaled steroids. However, the safety and effectiveness of Combivent Inhalation Aerosol in combination with these drugs have not been fully studied, except for albuterol.

Anticholinergic Agents

Using Combivent Inhalation Aerosol with other anticholinergic medications may lead to potential additive interactions. Therefore, it is advised to avoid co-administration of Combivent Inhalation Aerosol with anticholinergic-containing drugs.

Beta-Adrenergic Agents

Exercise caution when combining Combivent Inhalation Aerosol with other sympathomimetic agents, as it may increase the risk of adverse cardiovascular effects.

Beta-Receptor Blocking Agents

The effects of beta-receptor blocking agents and albuterol can inhibit each other. Use beta-receptor blocking agents cautiously in individuals with hyperreactive airways.

Diuretics

Non-potassium sparing diuretics (e.g., loop or thiazide diuretics) can cause ECG changes and/or hypokalemia, which may be worsened by excessive doses of beta-agonists like Combivent Inhalation Aerosol. While the clinical significance of these effects is uncertain, caution is advised when combining beta-agonist-containing drugs with non-potassium sparing diuretics. Monitoring of potassium levels should be considered.

Monoamine Oxidase Inhibitors or Tricyclic Antidepressants

Extreme caution should be exercised when administering Combivent Inhalation Aerosol to patients using monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants, or within two weeks of discontinuing these agents. The cardiovascular effects of albuterol may be potentiated in such cases. Consider alternative therapy for patients taking MAOIs or tricyclic antidepressants (such as Desipramine).

Usage

Please follow all the instructions provided on your prescription label and carefully read the medication guides or instruction sheets. Use the medication exactly as directed.

Typically, Combivent Respimat is used four times a day. Adhere to your doctor’s dosage instructions diligently. Do not exceed six inhalations within a 24-hour period.

Using Combivent Respimat excessively may increase the risk of death. It is crucial to use only the prescribed dose of this medication.

Make sure to read and understand any Instructions for Use that come with your medication. If you have any doubts, consult your doctor or pharmacist.

Always use the new inhaler device that is provided with each refill.

To use the inhaler:

  • There is no need to shake the inhaler before use.
  • Remove the mouthpiece cap of the inhaler. Exhale completely. Place the mouthpiece into your mouth and close your lips. Keep your eyes closed to prevent any medicine from entering your eyes. Inhale slowly while pressing the dose-release button on the inhaler. Hold your breath for 10 seconds, then exhale slowly.
  • Close the cap until you use the inhaler again.

 

Follow the specific cleaning instructions for your inhaler device, performing a weekly cleaning.

Keep track of the number of sprays used. Discard the Combivent Respimat inhaler canister after 3 months or 120 sprays, whichever comes first.

To use the solution with a nebulizer:

  • Open the foil pouch and remove one vial. Empty the contents into the nebulizer chamber. Attach the mouthpiece or face mask, then connect the drug chamber to the compressor.
  • Sit upright in a comfortable position. Place the mouthpiece in your mouth or apply the face mask, covering your nose and mouth. Turn on the compressor.
  • Breathe in slowly and evenly until no more mist is produced by the nebulizer and the drug chamber is empty.
  • Clean the nebulizer after each use, following the cleaning instructions provided with your specific nebulizer.

 

Seek immediate medical attention if your breathing problems worsen rapidly or if you feel that your medications are not working effectively.

To ensure that this medicine does not have any adverse effects on your lungs, you may need to undergo chest X-rays or frequent lung function tests.

Store the medication at room temperature, away from moisture, heat, and light. Do not freeze it. Keep each vial in its foil pouch until ready for use.

Keep the cover on your inhaler when not in use. Keep it away from open flames or high heat, as the canister may explode if exposed to excessive heat. Do not puncture or burn an empty inhaler canister.

Pregnancy

The safety of taking Combivent Respimat during pregnancy is not well established due to insufficient data. Animal studies have shown potential harm to babies from the albuterol component. However, the effects in humans may differ.

If you are pregnant or planning to conceive, consult your doctor to discuss the potential benefits and risks of using this medication during pregnancy.

Overdose

In case of an overdose with severe symptoms like loss of consciousness or difficulty breathing, immediately call 911. Otherwise, contact a poison control center without delay. US residents can reach their local poison control center at 1-800-222-1222. Overdose symptoms may involve chest pain, rapid or irregular heartbeat, and seizures.

Missed Dose

If you forget to take a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Avoid doubling the dose to make up for the missed one.

Storage

Keep the medication at room temperature, avoiding freezing. Store it in a place other than the bathroom. Discard the inhaler when it becomes locked or after 3 months of inserting the cartridge, even if there’s remaining medication. Keep it out of reach of children and pets.

Do not flush medications down the toilet or drain unless instructed. Properly dispose of the product when expired or no longer needed. Consult your pharmacist or local waste disposal company for guidance.

Disposal

When you no longer require Combivent Respimat and have remaining medication, it is crucial to ensure its safe disposal. This prevents accidental ingestion by others, including children and pets, and helps safeguard the environment from potential harm.

For valuable guidance on medication disposal, you can visit the FDA website, which offers a range of helpful tips. Additionally, your pharmacist can provide specific information on how to properly dispose of your medication.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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