Salbutamol and ipratropium

  • If you experience a rash, swelling of the tongue, lips or face or your breathing gets worse after using your nebuliser you should speak to your doctor or go to the accident and emergency department of your local hospital immediately.
  • Do not allow the vapour from the nebuliser to get in your eyes, if you are using a mask to inhale through make sure that it fits you properly.
Type of medicine Bronchodilator
Used for Chronic obstructive pulmonary disease (COPD)
Also called Combivent®
Ipramol® Steri-Neb
Salipraneb®
Available as Nebuliser solution

This is a combination medicine containing both salbutamol and ipratropium, which can be used to help relieve the symptoms of chronic obstructive pulmonary disease (COPD).

Salbutamol and ipratropium are different types of bronchodilator. Bronchodilators work by opening up the air passages in the lungs so that air can flow into the lungs more easily. In doing so they help to ease symptoms such as coughing, wheezing and shortness of breath.

Before using salbutamol and ipratropium make sure your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have hyperthyroidism (an overactive thyroid).
  • If you have heart problems including an irregular heartbeat.
  • If you have high blood pressure, glaucoma or diabetes.
  • If you have prostate problems.
  • If you have difficulty passing urine.
  • If you have cystic fibrosis.
  • If you have phaeochromocytoma (a tumour on your adrenal gland).
  • If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
  • If you have ever had an allergic reaction to this or to any other medicine.
  • Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
  • Follow your doctor's instructions carefully and make sure you know how to use your nebuliser properly. If you are not sure, ask your doctor, nurse or pharmacist to show you.
  • Do not allow the vapour from the nebuliser to get in your eyes, if you are using a mask to inhale through make sure that it fits you properly.
  • The usual dose is the contents of one single dose unit, three or four times a day.
  • Keep your regular doctor's appointments so your progress can be monitored.
  • If you feel your medication is not working as well as usual, or your breathing is getting worse, let your asthma nurse or doctor know straight away.
  • Do not smoke. Smoking causes severe irritation and damage to the lungs. It will make your condition worse and will reduce the beneficial effects of your medication.
  • If you have diabetes, tell your doctor if you notice any changes in your blood glucose tests, as this preparation can affect the level of sugar in your blood.
  • If you buy any medicines, check with a pharmacist that they are safe to take with salbutamol and ipratropium.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common side-effects What can I do if I experience this?
Feeling or being sick Eat little and often and stick to simple foods
Dry mouth, cough Try sugar-free gum or sweets and make sure you drink plenty of water
Constipation Try to eat a well-balanced diet containing plenty of fibre and drink 6-8 glasses of water each day
Headache Ask your pharmacist to prescribe a suitable painkiller. If your headache continues, speak with your doctor
Dizziness Make sure your reactions are normal before doing any jobs which could be dangerous if you were not fully alert
Blurred vision Take care to protect your eyes when using your nebuliser. Don't drive or use tools or machines if you are affected
Feeling shaky This sensation should pass

Important: if you experience eye problems or a fast or fluttering heartbeat, you should see your doctor as soon as possible.
Important: If you experience a rash, swelling of the tongue, lips or face or your breathing gets worse after using your nebuliser, you should speak to your doctor or go to the accident and emergency department of your local hospital immediately.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • Never take more than the prescribed dose. If you suspect that you have taken, or someone else has taken, an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • If you are having an operation or dental treatment tell the person carrying out the treatment which medicines you are taking.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
  • Manufacturer's PIL, Combivent® UDVs; Manufacturer's PIL, Combivent® UDVs, Boehringer Ingelheim Ltd, electronic Medicines Compendium. Dated January 2011.
Original Author: Helen Allen Current Version: Peer Reviewer: Prof Cathy Jackson
Last Checked: 15/11/2011 Document ID: 3798  Version: 26 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

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