Combimist

Management of bronchospasm in patients suffering from COPD who require regular treatment w/ both ipratropium & salbutamol.

Treatment w/ nebuliser soln in UDVs Initially 1 UDV (lowest recommended dose). Very severe cases 2 UDVs for symptom relief. Adult (including elderly & childn > 12 yr) 1 single dose unit tid or qid.

Hypersensitivity to ipratropium Br, salbutamol sulfate, or to atropine. Patients w/ hypertrophic obstructive cardiomyopathy or tachyarrhythmia.

For inhalation only. Immediate hypersensitivity reactions. Discontinue immediately if paradoxical bronchospasm occurs. Do not allow soln or mist to enter the eyes particularly in patients pre-disposed to glaucoma. Should only be used after careful risk/benefit assessment in conditions eg, insufficiently controlled DM, recent MI &/or severe organic heart or vascular disorders, hyperthyroidism, pheochromocytoma, risk of narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction. Patients w/ underlying severe heart disease (eg, ischaemic heart disease, arrhythmia or severe heart failure) who are receiving salbutamol for resp disease, should seek medical advice if chest pain or other symptoms of worsening heart disease is experienced. Concomitant treatment w/ xanthine derivatives may potentiate severe airway obstruction. Dyspnoea. Monitor for the development of elevated serum lactate & consequent metabolic acidosis. Monitor serum K levels; potentially serious hypokalaemia. Patients w/ cystic fibrosis may be more prone to GI motility disturbances. May lead to +ve results w/ regards to salbutamol in tests for non-clinical substance abuse, eg, in the context of athletic performance enhancement (doping). Should not be used during pregnancy (especially in 1st trimester) & lactation. Childn < 12 yr.

Headache, throat irritation, cough, dry mouth, GI motility disorders (including constipation, diarrhoea & vomiting), nausea, dizziness.

Chronic concomitant use w/ other anticholinergic drugs is not recommended. Enhanced effect w/ additional β-agonists, xanthine derivatives & corticosteroids. Increased severity of side effects w/ concurrent administration of other β-mimetics, systemically absorbed anticholinergics & xanthine derivatives. Potentially serious reduction in effect may occur during concurrent administration of β-blockers. Enhanced action of β2-adrenergic agonists in patients being treated w/ MAOIs & TCAs. Increased susceptibility to the CV effects of β-agonists w/ inhalation of halogenated hydrocarbon anaesth eg, halothane, trichloroethylene & enflurane.

Antiasthmatic & COPD Preparations

R03AL02 - salbutamol and ipratropium bromide ; Belongs to the class of combination of adrenergics with anticholinergics, that may also include a corticosteroid. Used in the treatment of obstructive airway diseases.

Rx