Combivent Inhaler (Ipratropium / Albuterol)

Combivent Respimat (ipratropium bromide and albuterol) is a combination inhaler for adults with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is typically used when other bronchodilators are not working well enough to control breathing problems. Combivent combines an anticholinergic (ipratropium) and a beta-agonist (albuterol) to relax the muscles around the airways. It comes as a Respimat inhaler that produces a slow, soft mist.

Directions

Combivent Respimat is breathed in through the mouth only. The usual adult dose is 1 puff, 4 times per day, with a maximum dosage of 6 puffs in 24 hours.

Before using it for the first time, put the cartridge into the inhaler and spray it toward the ground until you see a mist, then spray 3 more times.

If you have not used it for more than 3 days, spray it once before using. If more than 21 days have passed since the last use, repeat the full priming process again.

Do not spray it into your eyes. Use it exactly as prescribed, and do not take extra puffs or use it with other inhalers that contain similar active ingredients unless your doctor tells you to.

Ingredients

The active ingredients in Combivent Respimat are ipratropium bromide and albuterol sulfate. Inactive ingredients in the solution include benzalkonium chloride, edetate disodium, hydrochloric acid, and water for injection.

Cautions

Before using this medication, you may want to consult a healthcare provider about the following:

• Any existing health conditions.
• Any allergies.
• A list of all medications currently being taken.

Combivent Respimat is not a rescue inhaler. If symptoms suddenly worsen or it stops managing symptoms long-term, stop using it and seek medical attention due to potential paradoxical bronchospasm or worsening COPD.

Use it with caution if you have heart problems, including coronary artery disease, irregular heart rhythms, or high blood pressure, since albuterol can increase heart rate, blood pressure, and cause ECG changes in some people.

Avoid getting the spray in your eyes. The ipratropium component can increase pressure inside the eye and trigger or worsen narrow-angle glaucoma. Tell your healthcare provider right away about any eye pain, blurred vision, or halos around lights.

Use carefully if you have an enlarged prostate (benign prostatic hyperplasia) or any bladder-neck obstruction because ipratropium may make it harder to urinate.

Stop using Combivent Respimat and get medical help right away if you develop signs of an allergic reaction such as hives, swelling of the lips, face, tongue, or throat, trouble breathing, or a rash.

Use with caution if you have a seizure disorder, an overactive thyroid (hyperthyroidism), diabetes, or a sensitivity to sympathomimetic medications like albuterol.

Albuterol can lower blood potassium levels, especially at higher doses or in combination with certain diuretics, which may affect the heart.

Avoid using Combivent Respimat together with other anticholinergic inhalers (such as tiotropium) or other short-acting beta-agonists (such as a different albuterol inhaler) unless your provider specifically instructs you to, as combining them can increase side effects.

Tell your provider if you take beta-blockers, diuretics, monoamine oxidase inhibitors (MAOIs), or tricyclic antidepressants, since these can interact with the albuterol component.

Use during pregnancy or while breastfeeding should be discussed with a healthcare provider due to potential risks.

Contraindications

Avoid taking or using this medication if any of the following apply:

• A known allergy or hypersensitivity to ipratropium bromide, albuterol sulfate, or any of the other ingredients in Combivent Respimat.
• A known hypersensitivity to atropine or any of its derivatives, since ipratropium is chemically similar to atropine.

Side Effects

Common side effects of Combivent Respimat include:

• Upper respiratory infection (cold-like symptoms)
• Nasopharyngitis (stuffy or runny nose with sore throat)
• Cough
• Bronchitis
• Headache
• Shortness of breath (dyspnea)
• Dry mouth
• Dizziness or tremor
• Nausea, diarrhea, or constipation
• Muscle cramps or muscle aches

Stop using Combivent Respimat and seek medical attention if you have signs of a serious allergic reaction such as hives, swelling of the face, lips, tongue, or throat, or trouble breathing.

Other serious side effects can include sudden worsening of wheezing or shortness of breath right after a dose (paradoxical bronchospasm), chest pain, fast or irregular heartbeat, very high blood pressure, eye pain or sudden vision changes, trouble urinating, and a severe drop in blood potassium that can cause weakness or abnormal heart rhythms.

References

• Combivent Respimat Highlights of Prescribing Information. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; 2025.
• Combivent Respimat Drug Label Information. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; 2025.