Ipratropium; Albuterol Metered Dose Inhaler (MDI)

What is this medication?

IPRATROPIUM; ALBUTEROL (i pra TROE pee um; al BYOO ter ole) treats chronic obstructive pulmonary disease (COPD). It works by opening the airways of the lungs, making it easier to breathe. It is a combination of an anticholinergic and a bronchodilator. It is often called a controller inhaler. Do not use it to treat a sudden COPD flare-up.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Combivent Respimat

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Heart disease
• High blood pressure
• Irregular heartbeat
• An unusual or allergic reaction to ipratropium, albuterol, atropine, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is inhaled through the mouth. Take it as directed on the prescription label at the same time every day. Do not use more often than directed. Keep taking it unless your care team tells you to stop.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

What may interact with this medication?

This medication may interact with the following:

• Atropine
• Beta-blockers like metoprolol and propranolol
• Certain medications for allergy, cough, and cold
• Certain medications for bladder problems like oxybutynin, tolterodine
• Certain medications for depression, anxiety, or psychotic disturbances
• Certain medications for stomach problems like dicyclomine, hyoscyamine
• Certain medications for travel sickness like scopolamine
• Certain medications for Parkinson disease like benztropine, trihexyphenidyl
• Diuretics
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Some medications for irregular heartbeat
• Stimulant medications for attention disorders, weight loss, or staying awake

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your care team if your symptoms do not improve. If your breathing gets worse while you are using this medication, call your care team right away. Do not stop using your medication unless your care team tells you to.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

You may get dizzy or have blurred vision. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Increase in blood pressure
• Muscle pain or cramps
• Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
• Trouble passing urine
• Wheezing or trouble breathing that is worse after use

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Constipation
• Cough
• Dry mouth
• Headache
• Sore throat
• Tremors or shaking
• Trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at a room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not freeze. After assembly, the inhaler should be discarded at the latest 3 months after first use or after the inhaler is locked, whichever comes first.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.