Combivent is the combination of albuterol and ipratropium which 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.

• Insert the metal canister firmly and fully into the clear end of the Combivent® Inhalation Aerosol mouthpiec
• Remove the cap and look at the mouthpiece to make sure it is clean.
• Shake the inhaler for at least 10 seconds and test spray it in the air 3 times before using it for the first time or if the inhaler has not been used for 24 hours.
• To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright
• Open your mouth and breathe in slowly and at the same time firmly press down once on the top of the canister.
• Hold your breath for about 10 seconds, then breathe out slowly
• When you have finished all of your doses, rinse your mouth with water.
• Clean the inhaler mouthpiece every day with hot water. Dry it thoroughly before use.

• 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
• tell your doctor if you have or have ever had glaucoma, difficulty urinating; a blockage in your bladder; a prostate 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 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

This medication may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

·         headache

·         uncontrollable shaking of a part of the body

·         nervousness

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

·         fast or pounding heartbeat

·         chest pain

·         hives

·         rash

·         itching

·         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 that are not included above. Call your doctor if you have any unusual problems while you are using this medication.

How is this medicine best taken?

Use ipratropium and albuterol inhalation solution as ordered by your doctor. Read all information given to you. Follow all instructions closely.

·         For breathing in only as a liquid (solution) by a special machine (nebulizer) into the lungs.

·         Do not use if the solution is cloudy, leaking, or has particles.

·         Do not use if solution changes color.

·         Do not mix other drugs in nebulizer.

 What do I do if I miss a dose?

·         If you use ipratropium and albuterol inhalation solution on a regular basis, use a missed dose as soon as you think about it.

·         If it is close to the time for your next dose, skip the missed dose and go back to your normal time.

·         Do not use 2 doses at the same time or extra doses.

·         Many times ipratropium and albuterol inhalation solution is used on an as needed basis. Do not use more often than told by the doctor.