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Ipratropium Bromide and Albuterol Sulfate

Combivent Respimat

Combivent Respimat, an FDA-approved medication, combines Ipratropium Bromide and Albuterol Sulfate to ease symptoms of chronic obstructive pulmonary disease (COPD) by relaxing airway muscles. Administered via inhalation, it alleviates shortness of breath and wheezing in moderate to severe COPD. The recommended dosage is usually two inhalations four times daily and varies based on individual needs. Side effects may include dry mouth, throat irritation, coughing, headache, and tremors, while rare instances may lead to rapid heartbeat or high blood pressure. You must inform your healthcare providers of existing conditions and medications. It’s crucial to adhere strictly to prescribed dosages and proper inhalation techniques. Additionally, regular medical supervision is essential for the effectiveness and safety of the treatment.

Product Overview

Combivent Respimat is an FDA-approved medication utilized in the management of chronic obstructive pulmonary disease (COPD). Its active ingredients, Ipratropium Bromide and Albuterol Sulfate, work synergistically to dilate the airways, facilitating easier breathing for individuals with COPD. It is primarily administered through an inhaler device known as the Respimat, delivering a precise dosage of the medication directly to the lungs. It is typically prescribed for individuals who require bronchodilation to alleviate symptoms such as shortness of breath, wheezing, and coughing associated with COPD.

The recommended dosage of Combivent inhaler is typically two inhalations four times a day, with each inhalation delivering a fixed dose of Ipratropium Bromide (20 mcg) and Albuterol Sulfate (100 mcg). However, the dosage may vary depending on the severity of the condition and individual response to treatment. The inhaler is generally well-tolerated; some common side effects may include headache, dizziness, dry mouth, throat irritation, and cough. In rare cases, more severe side effects such as rapid heart rate, palpitations, or difficulty urinating may occur, requiring immediate medical attention.

Precautions should be taken when using Combivent Respimat inhaler, especially for individuals with a history of cardiovascular diseases, glaucoma, or urinary retention. It is essential to inform healthcare providers of any existing medical conditions or medications being taken to avoid potential interactions. Additionally, it’s necessary to use Combivent Respimat precisely as prescribed and to avoid exceeding the recommended dosage. Patients should be educated on proper inhalation techniques to ensure optimal medication delivery and efficacy. 

Uses of Combivent Respimat

Combivent Respimat inhaler is used for the treatment of chronic obstructive pulmonary disease (COPD)

How to Use Combivent Respimat?


Strengths and Forms

Combivent Respimat is available as an inhalation spray in the form of a metered-dose inhaler. It comes in one strength, delivering 20 mcg of ipratropium bromide and 100 mcg of albuterol sulfate per actuation.

Recommended Dosage for Combivent Respimat

It is usually recommended that you breathe in one puff or inhalation about four times a day. You may take more puffs if necessary. Over the course of a 24-hour period, you should not use more than six puffs.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your Combivent inhaler dosage accordingly.]

How to Take It?

Taking a Combivent Respimat inhaler involves several steps to ensure proper administration. Here’s a general step-by-step guide:

Step 1. Before using the inhaler for the first time or if it hasn’t been used for more than three days, prime it by spraying it into the air away from your face. To prime, point the inhaler towards the ground and press the dose-release button. Repeat this process until a fine mist is visible.

Step 2. Shake the Combivent Respimat inhaler well before each use.

Step 3. Hold the inhaler with the cap pointing upwards, and then open the cap until you hear a click. The dose-release button should face you.

Step 4. Breathe out fully, away from the inhaler, to ensure your lungs are empty before inhaling the medication.

Step 5. Put the mouthpiece of the inhaler between your lips, making sure to form a tight seal. Close your lips around the mouthpiece to prevent air from escaping. While pressing down on the dose-release button, inhale slowly and deeply through your mouth. This releases the medication as a slow-moving mist.

Step 6. After inhaling the medication, remove the inhaler from your mouth and hold your breath for 10 seconds or as long as comfortable. This allows the medication to reach deep into your lungs.

Step 7. Close the cap of the inhaler until you hear a click to prevent accidental activation.

[Note: Your doctor will decide the right Combivent Respimat amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Combivent Respimat Work?

Combivent Respimat works through its two active ingredients: Ipratropium Bromide and Albuterol Sulfate (also known as salbutamol). Each of these ingredients plays a role in opening up the airways and making breathing more accessible for individuals with conditions such as chronic obstructive pulmonary disease (COPD).

  1. Ipratropium Bromide: Ipratropium Bromide is an anticholinergic medication. It works by blocking the action of acetylcholine, a neurotransmitter that signals muscles around the airways to contract. By inhibiting this action, ipratropium bromide helps to relax and widen the airways, allowing more air to flow in and out of the lungs.
  2. Albuterol Sulfate: Albuterol Sulfate is a beta-adrenergic agonist, commonly known as a beta-agonist. It acts on beta-2 receptors in the smooth muscle cells of the airways. When these receptors are stimulated, they cause the muscles to relax, leading to bronchodilation (widening of the airways). This helps to relieve symptoms such as shortness of breath, wheezing, and coughing.

Combivent Respimat inhaler combines these two medications to provide a dual-action approach to managing COPD symptoms. By combining an anticholinergic and a beta-agonist, Combivent Respimat addresses both the constriction of airway muscles and inflammation, providing relief from symptoms and improving airflow to the lungs.

Important Safety Information

Side Effects

Common Side Effects

  • Dry mouth
  • Upper respiratory infection (infection usually in the nose, throat, or airways
  • Throat irritation
  • Dyspnea or difficulty breathing
  • Coughing
  • Headache
  • Tremors (shaking of hands or other body parts)

Mild Side Effects

  • Nausea
  • Dizziness
  • Blurred vision
  • Runny nose
  • Flu-like symptoms
  • Chest discomfort
  • Eye pain
  • Racing heart
  • Upset stomach
  • Swelling of the face, lips, eyelids, mouth, or throat
  • Bronchitis (swelling of part of your airways in your lungs

Adverse/Serious Side Effects

  • Rapid or irregular heartbeat
  • Bladder pain
  • Bloody or cloudy urine
  • Blurred vision
  • High blood pressure
  • Difficulty urinating
  • Worsening of symptoms
  • Allergic reactions (rash, itching, swelling of the face, tongue, or throat, severe dizziness, trouble breathing)

[Note: This list may not cover all possible Combivent Respimat side effects. Always consult with your healthcare giver for medical advice about side effects.]


Lung Spasms: A rare side effect of Combivent Respimat is that it can worsen your breathing and even cause more wheezing, which can be life-threatening. Contact your healthcare provider if you notice a worsening of your breathing problems while taking Combivent Respimat.

Heart Problems: It is possible for some people to experience heart problems, such as a fast heart rate and higher blood pressure, when taking Combivent Respimat at the recommended dose. People with high blood pressure or a history of heart problems are more likely to suffer from this condition. Your healthcare provider can help you decide if Combivent Respimat is right for you if you have a history of heart problems or notice changes in your blood pressure or heart rate.

Eye Problems: Your eyes may become more sensitive to Combivent Respimat if they are under pressure. Certain eye conditions, such as glaucoma, can be aggravated or brought on by this. Check with your healthcare provider to see if Combivent Respimat is safe for you if you have glaucoma.

Urination Problems: There is a possibility that Combivent Respimat may make it difficult for you to urinate. It can cause your prostate problems or urination problems worse if you take Combivent Respimat. If you are not sure if Combivent Respimat is right for you, talk to your healthcare provider.

Low Potassium: There is a possibility that Combivent Respimat can cause a drop in potassium levels in your blood. Low potassium can cause exhaustion, weakness, muscle aches or contractions, a racing heart, and a “pins and needles” feeling in the hands and feet. Symptoms such as these should be reported to your healthcare provider if you experience them.


  • Always follow the instructions provided by your healthcare provider or pharmacist regarding the correct usage and dosage of Combivent Respimat.
  • Avoid exceeding the prescribed dosage of Combivent Respimat. Using more than recommended can lead to adverse effects.
  • Ensure that the inhaler mouthpiece remains clean. Regularly clean it as per the instructions provided to prevent contamination and ensure proper functioning.
  • When using Combivent Respimat, avoid getting the medication into your eyes. If accidental contact occurs, rinse your eyes thoroughly with water.
  • If you are pregnant or breastfeeding, consult your healthcare provider before using Combivent Respimat to assess potential risks and benefits.
  • Inform your healthcare provider about any existing medical conditions you have, especially heart conditions, high blood pressure, seizures, thyroid disorders, or diabetes.
  • If you have any known allergies to medications or ingredients in Combivent Respimat, inform your healthcare provider before using it.
  • Be vigilant for any potential side effects while using Combivent Respimat, such as increased heart rate, tremors, or difficulty breathing. If you experience any adverse reactions, seek medical attention promptly.
  • Store Combivent inhaler out of reach of children and pets to prevent accidental ingestion.
  • Do not expose Combivent Respimat to extreme temperatures or direct sunlight. Store it according to the instructions provided.
  • Avoid sharing your Combivent Respimat inhaler with others, even if they have similar symptoms. Each inhaler is prescribed for individual use only.
  • In case of emergencies or severe adverse reactions, keep emergency contact information readily available.

Combivent Respimat Contraindications

Combivent Respimat inhaler is contraindicated:

  • If you are allergic to any of its ingredients, including albuterol, ipratropium, or atropine.
  • If you are allergic to atropine or any of its derivatives.

Missed Dose

If you skipped a dose of Combivent Respimat, take it when you remember. However, if it is nearly time for your next planned dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses to make up for a missed one.

[Note: If you have missed a dose of Combivent Respimat inhaler and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]


Overdosing on Combivent Respimat can lead to severe complications and may require emergency medical intervention. Symptoms of an overdose may include:

  • Severe headache
  • Irregular or rapid heart rate
  • Tremors or shaking
  • Nervousness or anxiety
  • Difficulty breathing
  • Chest pain
  • Dizziness or fainting
  • Blurred vision
  • Nausea or vomiting

[Note: If you consumed more than the recommended dose of Combivent Respimat inhaler, get medical help right away or call the Poison Help line at 1-800-222-1222.]


  • Store Combivent inhaler at room temperature (68°F to 77°F or 20°C to 25°C).
  • Keep away from direct sunlight and heat.
  • Avoid storing in areas with excessive moisture.
  • Do not freeze the inhaler.
  • Ensure the cap is closed when not in use.
  • Keep out of reach of children and pets.

[Note: Discuss with your healthcare professional about the proper disposal of any Combivent Respimat inhaler and any questions you may have regarding its storage.]

Combivent Respimat Interactions

It’s essential to be aware of potential drug interactions when taking Combivent Respimat. Here are some common drug interactions to consider while taking Combivent inhaler:

  • Anticholinergic medications (tiotropium)
  • Beta-blockers (propranolol)
  • Diuretics (furosemide)
  • MAO inhibitors (phenelzine)
  • Tricyclic antidepressants (amitriptyline, nortriptyline, and imipramine)
  • Xanthine derivatives (theophylline)
  • Beta-agonists (salmeterol)
  • Corticosteroids (fluticasone)
  • Other sympathomimetic medications (pseudoephedrine)
  • Antihypertensive medications (lisinopril)

[Note: This isn’t a complete list, and there could be other drugs that interact with Combivent Respimat. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Combivent Respimat Alternatives

  1. DuoResp Spiromax (budesonide/formoterol)
  2. Symbicort (budesonide/formoterol)
  3. Advair Diskus (fluticasone/salmeterol)
  4. Dulera (mometasone/formoterol)
  5. Breo Ellipta (fluticasone/vilanterol)
  6. AirDuo RespiClick (fluticasone/salmeterol)
  7. Anoro Ellipta (umeclidinium/vilanterol)
  8. Trelegy Ellipta (fluticasone/umeclidinium/vilanterol)

[Note: Your doctor will choose what’s the best alternative for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Is Combivent Respimat a steroid?

Combivent Respimat is not a steroid. It is a combination medication that contains two active ingredients: ipratropium bromide and albuterol sulfate. Ipratropium bromide is an anticholinergic bronchodilator, while albuterol sulfate is a beta-adrenergic bronchodilator. These medications work together to help relax the muscles around the airways in the lungs, making it easier to breathe.

How long does a Combivent Respimat inhaler last?

A Combivent Respimat inhaler, when used as directed, typically contains enough medication for approximately 120 inhalations. This duration may vary based on individual usage patterns. It’s important to keep track of the number of doses remaining and obtain a new inhaler before it runs out to ensure uninterrupted treatment for your respiratory condition.

Can Combivent Respimat be used in children?

Combivent Respimat is generally not recommended for use in children under the age of 18. It’s important to consult with a pediatrician or healthcare provider for alternative treatment options suitable for children with respiratory conditions. They can provide personalized guidance based on the child’s specific medical history and needs.

Can I clean the Combivent Respimat inhaler?

No, you should not attempt to clean the Combivent Respimat inhaler. It is designed for single-patient use and should not be cleaned or reused. Using a clean, uncontaminated inhaler for each dose ensures the medication’s effectiveness and reduces the risk of potential complications. If you have any concerns about the cleanliness of your inhaler, consult your healthcare provider or pharmacist for guidance.

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