Combivent (salbuterol, iprotropium bromide) is an inhaler used to help reduce the frequency and severity of flare-ups in COPD. Asthmatic patients also buy Combivent to help manage asthma, though this is an off-label use in some areas.

The inhaler contains two active ingredients:

• Salbuterol, better known as albuterol; and
• Ipratropium bromide.

Both ingredients are bronchodilators which open airways by relaxing bronchial muscles, though they do so in different ways, which provides a greater effect than either medication used independently. Albuterol is one of the most widely-used asthma and COPD treatments in the world.

While some patients use it as such, patients may not want to buy Combivent as a rescue inhaler; it may work slower than other types, such as albuterol-only inhalers like Ventolin. However, some individuals find Combivent works just fine for this purpose.

Treatment Guidelines

As a long-term treatment Combivent should reduce the frequency of COPD flare-ups and asthma attacks, and likely reduce the severity of them when they do occur. It will take several weeks of regular use for significant benefits to be noticeable.

For long-term benefit:

• Standard treatment is 2 inhalations 4 times a day, at evenly-spaced intervals.
• Additional inhalations may be administered as-needed throughout the day, provided 12 inhalations in 24 hours is not exceeded.

It usually takes several weeks to notice significant improvement. Rarely Combivent (or any inhaler) can have the opposite effect and worsen symptoms; if this occurs discontinue use until a doctor can be consulted.

As a rescue inhaler Combivent can be used as-needed, though it is still recommended that patients do not exceed the recommended 12 inhalations in 24 hours.

Consult the insert included with the product for instructions on priming and maintaining the inhaler.

Adverse Effects

Discontinue use of Combivent and contact a doctor immediately if serious side effects develop, such as:

• Worsening of breathing instead of improvement
• Blurry vision, visual halos, or eye pain
• Painful, difficult, or decreased urination

Because the medication in Combivent is delivered directly to the lungs, relatively little is absorbed into the bloodstream. However, enough is present that it can cause potential complications when mixed with other medications. Patients planning to buy Combivent should first discuss risks with a doctor if also taking:

• Anticholinergic agents - Combivent and anticholinergic drugs may amplify the effects of each other, increasing risk of side effects from both.
• Beta-adrenergic agents - Combivent used with beta-adrenergic drugs increases the risk of cardiovascular side effects.
• Beta-receptor blocking agents - Combivent and beta-receptor blocking agents minimize the effect of each drug.
• Diuretics - Non-potassium sparing diuretics can cause undesirable ECG changes which can be intensified by beta-agonists such as Combivent, especially when more than the recommended dose is used. If used together potassium levels should be monitored.
• Monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants - Use of Combivent within two weeks of MAOIs or tricyclic antidepressants increases the effect of Combivent on the cardiovascular system. It is recommended to use extreme caution or to simply find alternative therapies.

Other drug interactions are possible. Always check with a doctor or pharmacist before combining treatments.

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