Why is this medication prescribed?   

The combination of ipratropium and albuterol 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). Ipratropium and albuterol combination is used by people whose symptoms have not been controlled by a single inhaled medication. Ipratropium and albuterol are in a class of medications called bronchodilators. Ipratropium and albuterol combination works by relaxing and opening the air passages to the lungs to make breathing easier.

How should this medicine be used?  

The combination of ipratropium and albuterol comes as a solution (liquid) to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled) and as an aerosol to inhale by mouth using an inhaler. It is usually inhaled four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ipratropium and albuterol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Your doctor may tell you to use additional doses of ipratropium and albuterol combination if you experience symptoms such as wheezing, difficulty breathing, or chest tightness. Follow these directions carefully, and do not use extra doses of medication unless your doctor tells you that you should. Do not use more than two extra doses of the nebulizer solution per day. Do not use more than 12 puffs of the inhalation aerosol in 24 hours.

Call your doctor if your symptoms worsen or if you feel that ipratropium and albuterol inhalation no longer controls your symptoms. If you were told to use ipratropium and albuterol as needed to treat your symptoms and you find that you need to use the medication more often than usual, call your doctor.

If you are using the inhaler, your medication will come in canisters. Each canister of ipratropium and albuterol aerosol is designed to provide 200 inhalations. After the labeled number of inhalations has been used, later inhalations may not contain the correct amount of medication. You should keep track of the number of inhalations you have used. You can divide the number of inhalations in your inhaler by the number of inhalations you use each day to find out how many days your inhaler will last. Throw away the canister after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed. Do not float the canister in water to see if it still contains medication.

Be careful not to get ipratropium and albuterol into your eyes. If you are using the inhaler, keep your eyes closed when you use the medication. If you get ipratropium and albuterol in your eyes, you may develop narrow angle glaucoma (a serious eye condition that may cause loss of vision). If you already have narrow angle glaucoma, your condition may worsen. You may experience widened pupils (black circles in the center of the eyes), eye pain or redness, blurred vision, and vision changes such as seeing halos around lights. Call your doctor if you get ipratropium and albuterol into your eyes or if you develop these symptoms.

The inhaler that comes with ipratropium and albuterol aerosol is designed for use only with a canister of ipratropium and albuterol. Never use it to inhale any other medication, and do not use any other inhaler to inhale ipratropium and albuterol.

Do not use your ipratropium and albuterol inhaler when you are near a flame or source of heat. The inhaler may explode if it is exposed to very high temperatures.

Before you use ipratropium and albuterol for the first time, read the written instructions that come with the inhaler or nebulizer. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler or nebulizer while he or she watches.

To use the inhaler, follow these steps:

• Hold the inhaler with the clear end pointing upward. Place the metal canister into the clear end of the inhaler. Be sure that the canister is fully and firmly in place.
• Remove the protective dust cap from the end of the mouthpiece. If the dust cap was not placed on the mouthpiece, check the mouthpiece for dirt or other objects.
• If you are using the inhaler for the first time or if you have not used the inhaler in more than 24 hours, you will need to prime it. Shake it well for at least 10 seconds and then press down on the canister three times to release three sprays into the air, away from your face. Be careful not to get ipratropium and albuterol in your eyes.
• Hold the inhaler between your thumb and your next two fingers with the mouthpiece on the bottom, facing you. Shake the inhaler well for at least 10 seconds.
• Immediately breathe out deeply through your mouth.
• Hold the canister with the mouthpiece on the bottom and facing you and the canister pointing upward. Place the open end of the mouthpiece into your mouth. Close your lips tightly around the mouthpiece. Close your eyes.
• Breathe in slowly and deeply through the mouthpiece. At the same time, press down once on the container to spray the medication into your mouth.
• Hold your breath for 10 seconds. Then remove the inhaler, and breathe out slowly.
• If you were told to use two puffs, wait about 2 minutes and then repeat steps 4 to 8.
• Replace the protective cap on the inhaler.

To inhale the solution using a nebulizer, follow these steps:

• Remove one vial of medication from the foil pouch. Put the rest of the vials back into the pouch until you are ready to use them.
• Twist off the top of the vial and squeeze all of the liquid into the reservoir of the nebulizer.
• Connect the nebulizer reservoir to the mouthpiece or face mask.
• Connect the nebulizer reservoir to the compressor.
• Put the mouthpiece in your mouth or put on the face mask. Sit in a comfortable, upright position and turn on the compressor.
• Breathe in calmly, deeply, and evenly through your mouth for about 5 to 15 minutes until mist stops forming in the nebulizer chamber.

Clean your inhaler or nebulizer regularly. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your inhaler or nebulizer.

Other uses for this medicine     

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

What storage conditions are needed for this medicine?     

Keep this medication in the container it came in, tightly closed, and out of reach of children. Keep unused vials of nebulizer solution in the foil pouch until you are ready to use them. Store the medication at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. Do not puncture the aerosol canister, and do not discard it in an incinerator or fire.

In case of emergency/overdose     

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• chest pain
• fast heartbeat

What other information should I know?     

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names