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Combivent

What is COPD?

Chronic obstructive pulmonary disease (COPD) is comprised primarily of three related conditions - chronic bronchitis, chronic asthma, and emphysema. In each condition there is chronic obstruction of the flow of air through the airways and out of the lungs, and the obstruction generally is permanent and may be progressive over time.

While asthma features obstruction to the flow of air out of the lungs, usually, the obstruction is reversible. Between "attacks" of asthma the flow of air through the airways typically is normal. These patients do not have COPD. However, if asthma is left untreated, the chronic inflammation associated with this disease can cause the airway obstruction to become fixed. That is, between attacks, the asthmatic patient may then have abnormal air flow. This process is referred to as lung remodeling. These asthma patients with a fixed component of airway obstruction are also considered to have COPD.

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Combivent

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Combivent®
(ipratropium bromide and albuterol sulfate)

Inhalation Aerosol

Bronchodilator Aerosol
For Oral Inhalation Only

DRUG DESCRIPTION

COMBIVENT (ipratropium bromide and albuterol sulfate) Inhalation Aerosol is a combination of ipratropium bromide (as the monohydrate) and albuterol sulfate.

Ipratropium bromide is an anticholinergic bronchodilator chemically described as 8-azoniabicyclo[3.2.1] octane, 3-(3-hydroxy-1-oxo-2-phenylpropoxy)-8-methyl8-(1-methylethyl)-, bromide monohydrate, (3-endo, 8-syn)-: a synthetic quaternary ammonium compound chemically related to atropine. Ipratropium bromide is a white to off-white crystalline substance, freely soluble in water and methanol, sparingly soluble in ethanol, and insoluble in lipophilic solvents such as ether, chloroform, and fluorocarbons.

The structural formula is:

Ipratropium bromide Structural Formula Illustration

C20H30BrNO3•H2O ipratropium bromide Mol. Wt. 430.4

Albuterol sulfate, chemically known as (1,3-benzenedimethanol, α'-[[(1,1dimethylethyl) amino] methyl]-4-hydroxy, sulfate (2:1)(salt), (±)- is a relatively selective beta2-adrenergic bronchodilator. Albuterol is the official generic name in the United States. The World Health Organization recommended name for the drug is salbutamol. Albuterol sulfate is a white to off-white crystalline powder, freely soluble in water and slightly soluble in alcohol, chloroform, and ether. The structural formula is:

Albuterol sulfate Structural Formula Illustration

(C13H21NO3)2•H2SO4 albuterol sulfate Mol. Wt. 576.7

Combivent® (ipratropium bromide and albuterol sulfate) Inhalation Aerosol contains a microcrystalline suspension of ipratropium bromide and albuterol sulfate in a pressurized metered-dose aerosol unit for oral inhalation administration. The 200 inhalation unit has a net weight of 14.7 grams. Each actuation meters 21 mcg of ipratropium bromide and 120 mcg of albuterol sulfate from the valve and delivers 18 mcg of ipratropium bromide and 103 mcg of albuterol sulfate (equivalent to 90 mcg albuterol base) from the mouthpiece. The excipients are dichlorodifluoromethane, dichlorotetrafluoroethane, and trichloromonofluoromethane as propellants and soya lecithin.

What are the precautions when taking ipratropium bromide and albuterol sulfate (Combivent)?

Before using this product, tell your doctor or pharmacist if you are allergic to ipratropium or albuterol (salbutamol); or to atropine or other belladonna-type drugs; or if you have any other allergies. This product may contain inactive ingredients (such as soy lecithin from soybeans), which can cause allergic reactions or other problems. Some people who are allergic to peanuts may also be allergic to soy. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood pressure, heart disease (such as chest pain, heart attack, irregular heartbeat), glaucoma (narrow-angle), difficulty urinating (for example, due to enlarged prostate), seizure, overactive thyroid (hyperthyroidism),...

Read All Potential Precautions of Combivent »

Last reviewed on RxList: 5/24/2011
This monograph has been modified to include the generic and brand name in many instances.

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