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Country
  • India
  • New Zealand
  • United Kingdom
Brand
  • Combimist L
  • Combivent Vials
  • Duolin
Strength
  • 100/20mcg
  • 3mg/500mcg
  • 50/20mcg
Name Country Strength Pack Size USD Cart
Combimist L - levosalbutamol / iprotropium bromide - 50/20mcg - 1 Pack Combivent/​Combimist L levosalbutamol / iprotropium bromide Generic India 50/20mcg 1 Pack DR $25.00 Add
Combimist L - levosalbutamol / iprotropium bromide - 50/20mcg - 3 Pack Combivent/​Combimist L levosalbutamol / iprotropium bromide Generic India 50/20mcg 3 Pack DR $49.99 Add
Combimist L - levosalbutamol / iprotropium bromide - 50/20mcg - 12 Pack Combivent/​Combimist L levosalbutamol / iprotropium bromide Generic India 50/20mcg 12 Pack DR $199.99 Add
Combivent Vials - salbutamol/ipratropium bromide - 3mg/500mcg - 2.5ml x 60 Combivent Vials salbutamol/ipratropium bromide Brand United Kingdom 3mg/500mcg 2.5ml x 60 DR $87.69 Add
Duolin - salbutamol / iprotropium bromide - 100/20mcg - 3 Pack Combivent/​Duolin salbutamol / iprotropium bromide Brand New Zealand 100/20mcg 3 Pack RX $50.92 Add

Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional. Brands and generics both contain the same active ingredient(s) and are medically equivalent. Some brands are marketed under different names by the same manufacturer depending on the country of origin. Images are provided as a reference only, the received medicine may vary in packaging, color, pill shape, etc, from one batch to the next. For an item marked "generic" any quality brand may be sent, however you will always receive the active ingredients ordered in the strength(s) ordered.

Combivent (salbuterol, iprotropium bromide) is an orally-inhaled bronchodilator, used in long-term treatment of bronchospasm in conditions such as chronic obstructive pulmonary disease (COPD).

The medication works by relaxing and dilating the bronchi in the lungs while minimizing mucus secretion, making it easier to breathe. Combivent provides a number of benefits:

  • Improves breathing
  • Reduces frequency and severity of flare-ups
  • Can be used with other medications
  • Convenient and easy to use

Combivent is intended for long-term management. It is not intended to replace the use of a rescue inhaler such as epinephrine or albuterol in an emergency situation.

Breathing Easier with Combivent

Combivent is an inhaler that delivers the medication directly to the lungs, which provides more rapid results than other administration methods and reduces risk of side effects compared to administration by injection or tablet.

The inhaler contains two active ingredients:

Both ingredients are bronchodilators which open airways by relaxing bronchial muscles, though they do so in different ways, which provides a greater effect than either medication used independently. They are both used independently, though, as well as in combinations.

Following standard guidelines for use, administration is simple:

  • Inhalers should be primed before first use or if it hasn't been used for several days; simply spray it three times into the air.
  • Shake inhaler vigorously for ten seconds prior to use.
  • Standard treatment is 2 inhalations 4 times a day, at evenly-spaced intervals.
  • Additional inhalations may be administered as-needed throughout the day, provided 12 inhalations in 24 hours is not exceeded.

Used regularly Combivent should reduce the frequency of COPD flare-ups, and likely reduce the severity of them when they do occur. It will take several weeks of regular use for significant benefits to be noticeable. Treatment may continue for as long as it provides benefit.

Combivent & Asthma

In some places Combivent is not approved by regulatory agencies for use in asthma or use as a rescue inhaler in any condition, but in real-world practice it is commonly used for both. As is the case with any asthma treatment, it works well for some, but doesn't work well for others. In rare cases it can worsen asthma.

Some patients find reduced frequency of asthma attacks if Combivent is used in the standard 2 inhalations 4 times a day guidelines for COPD. Others notice no difference. This seems to be simply individual response; effects are similar with inhaled steroids---it works for some but not others, for reasons not fully understood.

A concern often cited in using Combivent for asthma, particularly as a rescue inhaler, is paradoxical bronchospasm, in which the medication causes airways to close rather than open. This can occur even if the medication has been used without issue for a long time, though it is by far more commonly experienced with the first use of a medication.

Ironically it is salbuterol (albuterol) that poses the paradoxical bronchospasm risk in Combivent; albuterol is one of the most widely-used asthma treatments in the world, and it's a rare asthmatic who hasn't had experience with it. This risk is present with albuterol-only inhalers as well as some other, non-albuterol inhalers. Paradoxical bronchospasm is rare, but it does happen and it can be life threatening.

The final significant concern with Combivent in asthma is simply the speed with which it works; it can take up to 30 minutes to provide significant relief, though it may work much quicker, too; response to treatment depends on a number of variables. If a faster-acting rescue treatment is unavailable a slow-acting treatment is preferable to none; however, it may be wise to keep a faster-acting alternative on hand.

We are not trying to persuade or dissuade patients from using Combivent for asthma or other off-label purposes; the above is simply an explanation to why patients often find conflicting information about this product.

Other Considerations

Combivent inhalers should be cleaned on a weekly basis following instructions on the package insert. Keep the cap over the mouthpiece when not in use to prevent dust, microbes and other unpleasantries from coating the mouthpiece.

As it will take a few weeks for significant long-term results to be seen, use should not be discontinued even if it doesn't appear to be having the intended effect. On the other hand, if the condition worsens, use should discontinue until a doctor can be consulted.

Do not spray the inhaler near open flame.

Do not puncture the inhaler or store it in a hot location, such as a vehicle on a hot day; overheating or puncturing can cause the inhaler to explode.

When the dose indicator has counted down to empty the inhaler should be replaced; metered doses can no longer be counted on.

Combivent Vials

Combivent contains albuterol sulfate and ipratropium bromide. It is both a beta2-adrenergic bronchodilator and an anticholinergic bronchodilator. Patients with lung disease, emphysema, bronchitis, and chronic obstructive pulmonary disease (COPD) are prescribed Combivent to treat and prevent wheezing and breathlessness.

Mode of action

The anticholinergic (parasympatholytic) property of ipratropium bromide is a result of its quaternary ammonium composition. There has been some evidence that it inhibits vagal reflexes by inhibiting acetylcholine release from the vagus nerve. In the bronchial smooth muscle, acetylcholine interacts with muscarinic receptors to increase intracellular Ca++ concentration. An anticholinergic inhibits this reaction.

Diacylglycerol (DAG) is a second messenger that induces Ca++ release via inositol triphosphate (IP3). As a result of inhaling ipratropium bromide, bronchodilation is primarily localized to the lung.

A beta-adrenergic agent, salbutamol sulfate, acts on airway smooth muscle to relax it. By relaxing all smooth muscles, salbutamol protects against all threats to bronchoconstriction.

The simultaneous use of ipratropium bromide and salbutamol sulfate in this medication produces bronchodilation not experienced with either drug alone.

Method of administration

Medical supervision is recommended when using the treatment, such as in the hospital setting. In exceptional cases, home-based treatment may be recommended.

Combivent may only be administered using an intermittent positive pressure ventilator or by nebulizer. The dose units must never be swallowed or injected.

When using a nebulized solution, the lowest recommended dose should always be used. A second unit dose vial may be necessary in extremely severe cases. When symptoms are sufficiently relieved, treatment should be discontinued.

Nebulization does not require dilution of the contents of unit dose vials.

Make sure to follow the manufacturer or physician's instructions when preparing the nebulizer to be filled.

  • Remove one unit dose by tearing the pouch foil
  • Twist the top of the vial firmly to open it
  • Fill the nebulizer reservoir with the contents of the unit dose vial
  • Nebulizers should be assembled and used according to instructions
  • If any solution remains in the reservoir after use, remove it and follow the manufacturer's instructions to clean the nebulizer

For safety against microbial contamination, it is essential to use the vial contents within 48 hours of opening it. Patients should ensure to use a new vial each time.

Dosage:

Patients older than 12 years and elderly patients:

Three or four single-dose units per day.

Combivent side effects

  • Dizziness
  • Headache
  • Dry mouth
  • Nausea
  • Nervousness
  • Shaking or rumors
  • Cold symptoms such as sore throat

Alternatives

Spiriva: This medication is prescribed for the management of COPD. There are also other uses for Spriviva.

Advair Diskus: This medication is prescribed for asthma and COPD maintenance. There may be other uses for Advair as well.

Contraindications

  • Patients with tachyarrhythmia or HOC--hypertrophic obstructive cardiomyopathy
  • Anyone who has ever experienced sensitivity to atropine and its derivatives

Precautions

In rare cases, urticaria, rash, angioedema, and bronchospasm have occurred after the administration of Combivent.

Combining Combivent with certain medicines may cause paradoxical bronchospasms. A substitute therapy should be employed in the event of paradoxical bronchospasm caused by Combivent.

When the medication has touched the eyes, there have been isolated cases of increased intraocular pressure,  mydriasis, eye pain, and narrow-angle glaucoma.

It is important not to let the solution or mist get into the eyes. Glaucoma patients should specifically take precautions to protect their eyes.

In a nebulizer containing Combivent, adding other drugs is strongly discouraged.

Interactions

Anticholinergic medications should not be taken in conjunction with Combivent.

The side effects due to concomitantly administering xanthine derivatives and beta-adrenergics or anticholinergics may be greater.

Hypokalaemia caused by beta2 agonists may be aggravated by concomitant administration of diuretics, glucocorticoids, and xanthine derivatives.

Hypokalemia can increase the risk of arrhythmias in people taking digoxin. This is a situation where serum potassium levels need to be monitored.

It has been suggested that the cardiovascular effects of beta-agonists may be exacerbated by the use of halogenated hydrocarbon anesthetics enflurane, halothane, and trichlorethylene.

Combivent and numerous prescription and nonprescription medications can be purchased on Kiwi Drug at affordable rates. Licensed pharmacists and physicians are on standby to help customers with a treatment plan or prescription refill. Worldwide shipping is available on all orders.

Combivent (salbuterol, iprotropium bromide) is an orally-inhaled bronchodilator, used in long-term treatment of bronchospasm in conditions such as chronic obstructive pulmonary disease (COPD).

The medication works by relaxing and dilating the bronchi in the lungs while minimizing mucus secretion, making it easier to breathe. Combivent provides a number of benefits:

  • Improves breathing
  • Reduces frequency and severity of flare-ups
  • Can be used with other medications
  • Convenient and easy to use

Combivent is intended for long-term management. It is not intended to replace the use of a rescue inhaler such as epinephrine or albuterol in an emergency situation.

Breathing Easier with Combivent

Combivent is an inhaler that delivers the medication directly to the lungs, which provides more rapid results than other administration methods and reduces risk of side effects compared to administration by injection or tablet.

The inhaler contains two active ingredients:

Both ingredients are bronchodilators which open airways by relaxing bronchial muscles, though they do so in different ways, which provides a greater effect than either medication used independently. They are both used independently, though, as well as in combinations.

Following standard guidelines for use, administration is simple:

  • Inhalers should be primed before first use or if it hasn't been used for several days; simply spray it three times into the air.
  • Shake inhaler vigorously for ten seconds prior to use.
  • Standard treatment is 2 inhalations 4 times a day, at evenly-spaced intervals.
  • Additional inhalations may be administered as-needed throughout the day, provided 12 inhalations in 24 hours is not exceeded.

Used regularly Combivent should reduce the frequency of COPD flare-ups, and likely reduce the severity of them when they do occur. It will take several weeks of regular use for significant benefits to be noticeable. Treatment may continue for as long as it provides benefit.

Combivent & Asthma

In some places Combivent is not approved by regulatory agencies for use in asthma or use as a rescue inhaler in any condition, but in real-world practice it is commonly used for both. As is the case with any asthma treatment, it works well for some, but doesn't work well for others. In rare cases it can worsen asthma.

Some patients find reduced frequency of asthma attacks if Combivent is used in the standard 2 inhalations 4 times a day guidelines for COPD. Others notice no difference. This seems to be simply individual response; effects are similar with inhaled steroids---it works for some but not others, for reasons not fully understood.

A concern often cited in using Combivent for asthma, particularly as a rescue inhaler, is paradoxical bronchospasm, in which the medication causes airways to close rather than open. This can occur even if the medication has been used without issue for a long time, though it is by far more commonly experienced with the first use of a medication.

Ironically it is salbuterol (albuterol) that poses the paradoxical bronchospasm risk in Combivent; albuterol is one of the most widely-used asthma treatments in the world, and it's a rare asthmatic who hasn't had experience with it. This risk is present with albuterol-only inhalers as well as some other, non-albuterol inhalers. Paradoxical bronchospasm is rare, but it does happen and it can be life threatening.

The final significant concern with Combivent in asthma is simply the speed with which it works; it can take up to 30 minutes to provide significant relief, though it may work much quicker, too; response to treatment depends on a number of variables. If a faster-acting rescue treatment is unavailable a slow-acting treatment is preferable to none; however, it may be wise to keep a faster-acting alternative on hand.

We are not trying to persuade or dissuade patients from using Combivent for asthma or other off-label purposes; the above is simply an explanation to why patients often find conflicting information about this product.

Other Considerations

Combivent inhalers should be cleaned on a weekly basis following instructions on the package insert. Keep the cap over the mouthpiece when not in use to prevent dust, microbes and other unpleasantries from coating the mouthpiece.

As it will take a few weeks for significant long-term results to be seen, use should not be discontinued even if it doesn't appear to be having the intended effect. On the other hand, if the condition worsens, use should discontinue until a doctor can be consulted.

Do not spray the inhaler near open flame.

Do not puncture the inhaler or store it in a hot location, such as a vehicle on a hot day; overheating or puncturing can cause the inhaler to explode.

When the dose indicator has counted down to empty the inhaler should be replaced; metered doses can no longer be counted on.

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