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albuterol and ipratropium (inhalation) (cont.)

What should I discuss with my healthcare provider before using albuterol and ipratropium inhalation (Combivent, Combivent Respimat, DuoNeb)?

You should not use this medication if you are allergic to albuterol (Proventil, Ventolin), ipratropium (Atrovent), or atropine (Atreza, Lomotil, Vi-Atro, Sal-Tropine). Do not use Combivent if you are allergic to soybeans, peanuts, or other food products that contain soya lecithin.

To make sure this medication is safe for you, tell your doctor about your other medical conditions, especially:

  • heart disease, high blood pressure, coronary artery disease, or heart rhythm disorder;
  • a seizure disorder such as epilepsy;
  • diabetes;
  • overactive thyroid;
  • glaucoma;
  • enlarged prostate, problems with urination;
  • liver or kidney disease; or
  • if you are allergic to soybeans, peanuts, or other food products that contain soya lecithin.

FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether albuterol and ipratropium passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using this medication.

How should I use albuterol and ipratropium inhalation (Combivent, Combivent Respimat, DuoNeb)?

Follow the directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Overuse of this medicine may increase the risk of death. It is critical that you use only the prescribed dose of this medicine.

This medication comes with patient instructions for safe and effective use, and directions for priming the inhaler device. Duoneb,Combivent, and Combivent Respimat have different patient instructions. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

To use the inhaler (Combivent or Combivent Respimat):

  • Shake the Combivent canister vigorously for at least 10 seconds before each spray. You do not need to shake Combivent Respimat before use.
  • Uncap the mouthpiece of the inhaler. Breathe out fully. Put the mouthpiece into your mouth and close your lips. Keep your eyes closed to prevent spraying any medicine into your eyes. Breathe in slowly while pushing down on the canister. Hold your breath for 10 seconds, then breathe out slowly.
  • If you use more than one inhalation at a time, wait at least 2 minutes before using the second inhalation.
  • Carefully follow all directions for cleaning your specific inhaler device once per week.

To use the solution with a nebulizer (Duoneb):

  • Open the foil pouch and remove one vial. Squeeze all of the medicine out into the chamber of the nebulizer.
  • Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright in a comfortable position. Place the mouthpiece into your mouth or put the face mask on, covering your nose and mouth.
  • Breathe in slowly and evenly until you have inhaled all of the medicine (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.
  • Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

Keep track of the number of sprays you have used.

  • Throw away the Combivent inhaler canister after 200 sprays.
  • Throw away the Combivent Respimat inhaler canister after 3 months or 120 sprays, whichever comes first.

Seek medical attention if you think this medication is not working as well as usual.

While using albuterol and ipratropium, you may need frequent blood tests at your doctor's office.

Use albuterol and ipratropium regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture, heat, and light. Keep each Duoneb vial in its foil pouch until you are ready to use it. Do not store Combivent in your car on hot days. Extreme heat can cause the medicine canister to burst. Do not throw an empty canister into open flame.

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.

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