Combivent Metered Dose Aerosol

Generic Name: Ipratropium bromide; Salbutamol sulfate
Product Name: Combivent Metered Dose Aerosol

Indication

Used for maintenance treatment in COPD in patients insufficiently controlled by single bronchodilator

Action

• Salbutamol component: Relax bronchial smooth muscle by stimulating beta 2 adrenoreceptors. Onset of action: 5-15 minutes. Short duration of action: 3-6 hours.
• Ipratropium component: Promote bronchodilation by inhibiting cholinergic bronchomotor tone. Duration of action of Ipratropium is approximately 6 hours, thus it can be used to augment the duration of bronchodilatation achieved with beta 2 agonist therapy.

Dose advice

Metered dose inhaler: Ipratropium 20mcg with Salbutamol 100mcg/dose, 200 doses

MDI: 2 inhalations, 4 times daily. Maximum dose 12 inhalations in 24 hours.

Schedule

S4

Common side effects

• Salbutamol component: Tremor Palpitations Headache
• Ipratropium component: Dry mouth Throat irritation

Uncommon side effects

Salbutamol component:

• Increased heart rate (which can also lead to paroxysmal tachyarrhythmias such as atrial fibrillation or paroxysmal supraventricular tachycardia)
• Muscle cramps
• Agitation
• Hyperactivity in children
• Insomnia
• Hyperglycaemia (high blood sugar) and hypokalaemia (low blood potassium) when drug taken in high doses

Ipratropium component:

• Urinary retention (there is a risk of aggravation of symptoms in patients with prostatic hypertrophy)
• Acute angle closure glaucoma (there is a risk of aggravation of symptoms in patients with coexisting glaucoma)
• Constipation
• Allergic reactions (Ipratropium MDI should not be used by patients with allergy to soya lecithin or related food products such as soya bean and peanuts)

For further information talk to your doctor.