What is Combivent?
Combivent is a combined drug with a pronounced bronchodilator effect. The active ingredients are ipratropium bromide and salbutamol. These substances have an effect on the smooth muscles of the respiratory tract, causing it to relax and prevent bronchospasm. The drug reduces resistance in the airways, increases lung capacity; prevents the release of leukotrienes, histamine, prostaglandin D2 and other biologically active substances from mast cells. Indications for use include bronchospastic syndrome in patients with chronic obstructive pulmonary disease (COPD) and bronchial asthma.
How to use Combivent?
- Adults (including elderly patients and children over 12 years of age): 1 inhalation 3-4 times a day using a nebulizer;
- Children under 12 years of age: data are not available.
Before buying Combivent Inhaler, you must read the official instructions for use.
- Prepare a nebulizer according to the manufacturer’s instructions;
- Separate the vial with a sterile solution from the unit – to do this, turn and pull it;
- Holding the vial vertically with the cap, break off the cap;
- Squeeze the solution into the nebulizer tank;
- Rinse mouth after inhalation;
- If a mask was used, wash the skin of the face;
- Dispose of the unused solution remaining in the nebulizer chamber;
- Wash the nebulizer thoroughly.
Do not let the solution get in the eyes.
Side effects
- Nervous system and sensory organs: tremor (usually brushes), anxiety, tension, irritability, dizziness, headache, sleep disturbance, short-term cramps;
- Cardiovascular system and blood (hematopoiesis, hemostasis): heartbeat, arrhythmia, dilation of peripheral vessels, tachycardia (during pregnancy – in mother and fetus), a decrease in dAD or increase in sAD, myocardial ischemia, heart failure, cardiopathy;
- Digestive tract: nausea, vomiting, dryness or irritation in the mouth or throat, loss of appetite;
- Other: bronchospasm (paradoxical or caused by hypersensitivity to salbutamol), pharyngitis, difficult urination, sweating, increased blood glucose, free fatty acids, hypokalemia (dose-dependent), allergic reactions in the form of erythema, swollen face, difficulty breathing, physical and mental drug dependence.
Contraindications
Do not use Combivent inhaler if you have any of the following conditions:
- hypersensitivity,
- pregnancy (when used as a bronchodilator), breastfeeding,
- age up to 12 years.
Interactions
- The joint introduction of xanthine derivatives, as well as other beta-adrenergic and anticholinergic, can provoke side effects;
- Hypokalemia caused by beta-agonists may be enhanced by the simultaneous administration of xanthine derivatives, steroids and diuretics. This must be taken into account, especially in patients with severe respiratory disorders. Hypokalemia can lead to an increased propensity for arrhythmias in patients who receive digoxin. In such situations, monitoring of serum potassium is recommended;
- With the concomitant administration of beta-blockers, a serious decrease in the bronchodilatory effect may occur;
- Beta-adrenergic agonists should be used with caution in patients who receive monoamine oxidase inhibitors or tricyclic antidepressants, since the effect of beta-adrenergic agonists may be enhanced;
- Inhalation with halogenated hydrocarbon anesthetics, such as halothane, trichloroethylene and enflurane, may increase the sensitivity to cardiovascular effects of beta-agonists.
Special instructions
It is not recommended to use Combivent in the II and III trimesters of pregnancy and during breastfeeding, except in cases where the expected benefit to the mother outweighs any possible risk to the fetus and baby.
In order to avoid overdosing, it is not recommended to exceed the maximum allowable daily dose.
If larger doses are required than recommended for relief of symptoms of bronchial obstruction (or bronchospasms), the patient’s treatment plan should be reviewed.
In the event of paradoxical bronchospasm, the drug should be canceled immediately. Bear in mind that bronchospasm may be associated with the transition to a new vial of the drug.
Remember that the treatment can cause tachycardia, increased blood pressure, ECG changes (smoothing of the T wave, prolongation of the Q-T interval, reduction of the S-T segment), therefore the medication should be used with caution in CHF, tachyarrhythmias, arterial hypertension.
Eye contact should be avoided.
Data on the impact on the ability to drive motor vehicles and/or other mechanisms are not available. However, since the medication can cause side effects related to the central nervous system, caution should be exercised when driving vehicles and engaging in potentially hazardous activities that require increased concentration and psychomotor reactions.
In the case of acute, rapidly deteriorating shortness of breath or an obvious reduction in the response to the drug, you should consult a doctor.