Combivent

Combivent is a prescription inhalation medication that combines ipratropium bromide, an anticholinergic bronchodilator, with albuterol sulfate, a short-acting beta-2 agonist. It is available in two inhalation delivery systems: a metered-dose inhaler (Combivent Inhalation Aerosol) and a soft mist inhaler (Combivent Respimat). The product is used to prevent and relieve bronchospasm associated with chronic obstructive pulmonary disease (COPD). It is not intended as a rescue inhaler for rapid relief during a severe COPD or asthma attack; patients should still have a fast-acting bronchodilator available for acute symptoms.

Mechanism of action: ipratropium blocks muscarinic receptors in airway smooth muscle, reducing cholinergic-induced bronchoconstriction, while albuterol stimulates beta-2 receptors to relax airway smooth muscle. The combination provides additive bronchodilation and symptom relief.

Administration and dosing: administration is by inhalation as directed by a clinician. Dosing regimens commonly involve one inhalation every 4 hours as needed, with a maximum of several inhalations per 24-hour period; exact dosing varies between formulations and patient needs, so patients should follow the product labeling and physician guidance.

Contraindications and precautions: contraindicated in individuals with hypersensitivity to ipratropium, albuterol, or any component of the formulation. Use with caution in patients with narrow-angle glaucoma, urinary retention, bladder outlet obstruction, tachyarrhythmias, or uncontrolled hypertension. Caution is advised in elderly patients and those with cardiovascular disease or diabetes. Not recommended for relief of acute severe bronchospasm without a rapid-access inhaled beta-agonist.

Adverse effects: commonly includes dry mouth, throat irritation, cough, and headache; may cause tachycardia, palpitations, tremor, or anxiety. Rare cases of paradoxical bronchospasm or hypersensitivity reactions have been reported.

Pregnancy and lactation: data are limited; use only if potential benefit justifies potential risk to the fetus or infant. Interactions: potential interactions with non-selective beta-blockers, monoamine oxidase inhibitors, or certain antidepressants; consult a clinician about all medicines being used.