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Diseases & Conditions

Combination Agents for COPD

What combination agents are used to treat Chronic Obstructive Pulmonary Disease (COPD)?

Combination agents used to treat COPD are Combivent®, Advair®, and Symbicort® Dulera®, and Duoneb® .

  • Combivent is the brand name for albuterol and ipratropium bromide (Atrovent®).
  • Advair is the brand name for a combination of fluticasone propionate (Flovent®) and salmeterol inhalation powder (Serevent®).
  • Symbicort is the brand name for a combination of formoterol (Foradil®) and budesonide (Pulmicort®).
  • Dulera is the brand name for a combination of formoterol and mometasone.
  • Duoneb is the brand name for a combination of ipratropium bromide and albuterol sulfate.

What does Combivent do, and how is it supplied?

Combivent is available as a metered dose inhaler. The medication:

  • Opens up large and small airways
  • Helps decrease coughing, wheezing, and shortness of breath by increasing air flow into the lungs
  • Takes effect more slowly than "fast-acting" bronchodilators, but works for a longer period of time.

What does Advair do, and how is it supplied?

Advair is available as a dry powder inhaler. It prevents airway swelling and spasms.

What does Symbicort do, and how is it supplied?

Symbicort is available as a dry powder inhaler. It also prevents airway swelling and spasms.

What does Dulera do, and how is it supplied?

Dulera is available as a metered dose inhaler. It prevents airway swelling and spasms.

What does Duoneb do, and how is it supplied?

Dulera is available as a nebulizer solution. It opens up large and small airways. It also helps decrease coughing, wheezing and shortness of breath by increasing air flow into the lungs.

What are the possible side effects of combination agents?

The possible side effects of all of these combination agents include:

  • Dizziness, headache, muscle cramps
  • Dry mouth, nausea, vomiting
  • Nervousness, tremor
  • Palpitations, rapid heart beat, increased blood pressure
  • Cough, increased wheezing

Additional side effects where applicable:

Combivent may cause blurred vision if sprayed in the eyes.

Advair may:

  • Prolong recovery from upper respiratory infection or inflammation
  • Cause thrush (a mouth infection)
  • Cause a sore throat, and/or hoarseness
  • Increase the risk of infection

Symbicort may:

  • Prolong recovery from upper respiratory infection or inflammation
  • Cause thrush (a mouth infection)
  • Cause a sore throat, and/or hoarseness
  • Increase the risk of infection

Dulera may cause :

  • Sore throat, and/or hoarseness
  • Sores or white patches in your mouth or throat
  • Skin rash, itching
  • Chest pain

Note: The side effects listed are the most common. Always contact your health care provider if you have questions about your personal situation.

How and when do you take Combivent and Duoneb? Are there special instructions?

  1. Take every day on a routine basis, as prescribed, to control symptoms.
  2. Continue to take as prescribed, even if symptoms are under control.
  3. Your doctor may prescribe a "rescue" inhaler for sudden symptoms.
  4. Notify your doctor if you are allergic to soya, lecithin, soybean protein or peanuts 

How and when do you take Advair, Dulera, and Symbicort? Are there special instructions?

  1. Rinse mouth after use to prevent side effects.
  2. Do not use for quick relief.
  3. Advair will not stop an attack that has already started.
  4. Do not stop taking Advair, Dulera, or Symbicort without talking to your doctor.
References:

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on:12/31/2011…#14314