Albuterol and Ipratropium Oral Inhalation
(al byoo' ter ole) (i pra troe' pee um)
WHY is this medicine prescribed?
The combination of albuterol and ipratropium is used to prevent wheezing, difficulty breathing, chest tightness, and coughing in people with chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways) such as chronic bronchitis (swelling of the air passages that lead to the lungs) and emphysema (damage to the air sacs in the lungs). Albuterol and ipratropium combination is used by people whose symptoms have not been controlled by a single inhaled medication. Albuterol and ipratropium are in a class of medications called bronchodilators. Albuterol and ipratropium combination works by relaxing and opening the air passages to the lungs to make breathing easier.
HOW should this medicine be used?
The combination of albuterol and ipratropium comes as a solution (liquid) to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled) and as a spray to inhale by mouth using an inhaler. It is usually inhaled four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use albuterol and ipratropium exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Your doctor may tell you to use additional doses of albuterol and ipratropium inhalation if you experience symptoms such as wheezing, difficulty breathing, or chest tightness. Follow these directions carefully, and do not use extra doses of medication unless your doctor tells you that you should. Do not use more than 2 extra doses of the nebulizer solution per day. Do not use the inhalation spray more than six times in 24 hours.
Call your doctor if your symptoms worsen, if you feel that albuterol and ipratropium inhalation no longer controls your symptoms, or if you find that you need to use extra doses of the medication more often.
If you are using the inhaler, your medication will come in cartridges. Each cartridge of albuterol and ipratropium inhalation spray is designed to provide 120 inhalations. This is enough medication to last one month if you use one inhalation four times a day. After you use all 120 doses, the inhaler will lock and will not release any more medication, There is a dose indicator on the side of the inhaler that keeps track of how much medication is left in the cartridge. Check the dose indicator from time to time to see how much medication is left. When the pointer on the dose indicator enters the red area, the cartridge contains enough medication for 7 days and it is time to refill your prescription so that you will not run out of medication.
Be careful not to get albuterol and ipratropium inhalation into your eyes. If you get albuterol and ipratropium in your eyes, you may develop narrow angle glaucoma (a serious eye condition that may cause loss of vision). If you already have narrow angle glaucoma, your condition may worsen. You may experience widened pupils (black circles in the center of the eyes), eye pain or redness, blurred vision, and vision changes such as seeing halos around lights, or seeing unusual colors Call your doctor if you get albuterol and ipratropium into your eyes or if you develop these symptoms.
The inhaler that comes with albuterol and ipratropium spray is designed for use only with a cartridge of albuterol and ipratropium. Never use it to inhale any other medication, and do not use any other inhaler to inhale the medication in a cartridge of albuterol and ipratropium.
Before you use albuterol and ipratropium inhalation for the first time, read the written instructions that come with the inhaler or nebulizer. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler or nebulizer while he or she watches.
To prepare the inhaler for use, follow these steps:
To inhale the spray using the inhaler, follow these steps:
To inhale the solution using a nebulizer, follow these steps:
Clean your inhaler or nebulizer regularly. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your inhaler or nebulizer.
Are there OTHER USES for this medicine?
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
What SPECIAL PRECAUTIONS should I follow?
Before using albuterol and ipratropium inhalation,
- tell your doctor and pharmacist if you are allergic to ipratropium (Atrovent), atropine (Atropen), albuterol (Proventil HFA, Ventolin HFA, Vospire ER), levalbuterol (Xoponex), any other medications, or any of the ingredients in albuterol and ipratropium solution or spray. Ask your pharmacist or check the manufacturer's patient information for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin), labetalol, metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); diuretics ('water pills'); epinephrine (Epipen, Primatene Mist); medications for colds, irritable bowel disease, Parkinson's disease, ulcers, or urinary problems; other inhaled medications, especially other medications for asthma such as arformoterol (Brovana), formoterol (Foradil, Perforomist), metaproterenol, levalbuterol (Xopenex), and salmeterol (Serevent, in Advair); and terbutaline (Brethine). Also tell your doctor if you are taking any of the following medications or if you have stopped taking them within the past 2 weeks: antidepressants such as amitriptyline amoxapine; clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); or monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar). Your doctor may have to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had glaucoma (an eye condition); difficulty urinating; a blockage in your bladder; a prostate (a male reproductive gland) condition; seizures; hyperthyroidism (condition in which there is too much thyroid hormone in the body); high blood pressure; an irregular heartbeat; diabetes; or heart, liver, or kidney disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using albuterol and ipratropium, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using albuterol and ipratropium inhalation.
- you should know that albuterol and ipratropium inhalation sometimes causes wheezing and difficulty breathing immediately after it is inhaled. If this happens, call your doctor right away. Do not use albuterol and ipratropium inhalation again unless your doctor tells you that you should.
What SPECIAL DIETARY instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do IF I FORGET to take a dose?
Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.
What SIDE EFFECTS can this medicine cause?
This medication may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- uncontrollable shaking of a part of the body
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- fast or pounding heartbeat
- chest pain
- swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
- sore throat, fever, chills, and other signs of infection
- difficulty urinating
Albuterol and ipratropium may cause other side effects. Call your doctor if you have any unusual problems while you are using this medication.
What should I know about STORAGE and DISPOSAL of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Keep unused vials of nebulizer solution in the foil pouch until you are ready to use them. Store the medication at room temperature and away from excess heat and moisture (not in the bathroom). Do not allow the inhalation spray to freeze. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What should I do in case of OVERDOSE?
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include the following:
- chest pain
- fast heartbeat
What OTHER INFORMATION should I know?
Keep all appointments with your doctor.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
®Metered Dose Inhaler (as a combination product containing Albuterol, Ipratropium)[¶]
- Combivent Respimat
®Inhalation Spray (as a combination product containing Albuterol, Ipratropium)
®Inhalant Solution (as a combination product containing Albuterol, Ipratropium)
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