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Combivent (Levosalbutamol)
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Combivent

Combivent is used to treat chronic obstructive pulmonary disease (COPD). Combivent is more popular than other beta agonist/anticholinergic combinations. There are currently no generic alternatives to Combivent.

Other names for this medication:
Levosalbutamol

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Also known as: Levosalbutamol

Description

Combivent Respimat contains a combination of albuterol and ipratropium. Albuterol and ipratropium are bronchodilators that relax muscles in the airways and increase air flow to the lungs.

Combivent Respimat is used to prevent bronchospasm (tightening and narrowing of the airways) in people with chronic obstructive pulmonary disease (COPD) who are also using other medicines to control their condition.

Dosage

This section provides information on the proper use of a number of products that contain ipratropium and albuterol. It may not be specific to Combivent Respimat. Please read with care.

This medicine usually comes with patient directions or instructions. Read them carefully before using the medicine. If you do not understand the directions or you are not sure how to use the inhaler or nebulizer, ask your doctor to show you how to use it.

Use this medicine only as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. Also, do not stop using this medicine without telling your doctor. To do so may cause your lung condition to become worse.

When you use the inhalation solution, make sure you use a jet nebulizer that is connected to an air compressor with a good air flow. Use a face mask or mouthpiece to inhale the medicine.

Keep the spray away from your eyes. This medicine may cause eye pain or discomfort, irritation, blurred vision, or start seeing halos or odd colors when you look at things. If it does come into contact with your eyes, check with your doctor right away.

To use the Combivent® inhaler:

Insert the metal canister firmly and fully into the clear end of the Combivent® Inhalation Aerosol mouthpiece. This mouthpiece should not be used with other inhaled medicines. Remove the cap and look at the mouthpiece to make sure it is clean. Shake the inhaler for at least 10 seconds and test spray it in the air 3 times before using it for the first time or if the inhaler has not been used for 24 hours. To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright. Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down once on the top of the canister. Hold your breath for about 10 seconds, then breathe out slowly. If you are supposed to use more than one puff, wait 1 to 2 minutes before inhaling the second puff. Repeat these steps for the second puff, starting with shaking the inhaler. When you have finished all of your doses, rinse your mouth with water. Clean the inhaler mouthpiece every day with hot water. Dry it thoroughly before use.

To use the Combivent® Respimat® spray:

Insert the cartridge into the Combivent® Respimat® inhaler. Before using the inhaler, prime it by spraying the medicine towards the ground (away from your face), until an aerosol cloud is visible. Repeat 3 more times. The inhaler is now ready for use. If the inhaler is not used for more than 3 days, prime the inhaler once to prepare it for use. If it not used for more than 21 days, prime the inhaler 3 times. To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down once the release button of the inhaler. Hold your breath for about 10 seconds, then breathe out slowly. After using the inhaler, clean the mouthpiece with a damp cloth or tissue at least once a week. This inhaler has a dose indicator window that shows how much medicine is left. When the pointer enters the red area of the scale, it is time that you need to refill your prescription. Throw away the inhaler 3 months from its first use or when the inhaler is locked (after 60 or 120 puffs).

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For symptoms of chronic obstructive pulmonary disease (COPD): For inhalation aerosol dosage form (used with an inhaler): Adults—2 puffs four times a day and as needed. Do not use more than 12 puffs in any 24-hour period. Children—Use and dose must be determined by your doctor. For inhalation solution dosage form (used with a nebulizer): Adults—Use one 3 milliliter (mL) vial in the nebulizer four times a day. You may use 2 additional treatments per day if needed. Children—Use and dose must be determined by your doctor. For inhalation spray dosage form (used with an inhaler): Adults—One puff four times a day. You may take additional doses per day if needed. Do not use more than 6 puffs in any 24-hour period. Children—Use and dose must be determined by your doctor.

Overdose

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Combivent Respimat can be fatal. Overdose symptoms may include chest pain, fast or pounding heartbeats, tremors, dry mouth, extreme thirst, muscle weakness or limp feeling, severe headache, pounding in your neck or ears, or feeling like you might pass out.

Storage

Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.

Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Detailed Combivent Respimat dosage information

Side effects

The most common side effects associated with Combivent are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

You should not use Combivent Respimat if you are allergic to albuterol, ipratropium, or atropine.

To make sure Combivent Respimat is safe for you, tell your doctor if you have ever had:

heart disease, high blood pressure, coronary artery disease, or heart rhythm disorder; a seizure disorder such as epilepsy; diabetes; overactive thyroid; glaucoma; liver or kidney disease; or enlarged prostate, problems with urination.

Tell your doctor if you are pregnant or breastfeeding.

Combivent is not approved for use by anyone younger than 18 years old.

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The reaction in the presence of maleic anhydride and dimethyl fumarate gave single 1,3-dipolar cycloadducts 11 and 13, respectively, indicating that a single conformer, the sterically unstable endo-aryl-endo-cyanostyryl carbonyl ylide 14 (15), is initially formed in the reaction of 1 with 2. Wheat plants growing in microcosms inoculated with various bead types from day 0 to day 30 exhibited high levels of histosphere colonization, nitrogenase activity (in situ) measured by acetylene reduction assay, plant dry mass and total N content but no symptoms of mottled stripe disease were observed. Atmospheric CO2 concentration (CC) near land surface and meteorological variables have been measured at four sites, named Yeniugou (alpine meadow and permafrost), Xishui (mountainous forest), Linze (oasis edge) and Ejina (lower desert), respectively, in Heihe River Basin, northwest China. They suggest that widespread, safe, and less expensive amniocentesis-abortion facilities may be attractive to a large group of women, based on the attitudes expressed in the Bijnor study. Brain activity was assessed during a stressful public speaking task by means of positron emission tomography before and after an 8 week treatment period. Pre-column derivatization high-performance liquid chromatographic method for determination of cysteine, cysteinyl-glycine, homocysteine and glutathione in plasma and cell extracts. Whether this will lead to a generally accepted treatment of chronic active hepatitis is difficult to say at this moment. Usefulness of magnetocardiography for the investigation of fetal arrhythmias. The mammalian kidney plays a key role in whole-body magnesium homeostasis, but the molecular and cellular mechanisms that underlie renal epithelial magnesium reabsorption are poorly understood. This results in a persistent source of imprecision in the calculation of dietary energy that at least can be partially corrected.

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Adolescent depression, family psychopathology and parent/child relations: a case control study. The present studies provided further evidence that this coronavirus-like agent is different from the two known porcine coronaviruses, transmissible gastroenteritis virus and hemagglutinating encephalomyelitis virus. It was found that the grown ZnO nanorods are of a single-crystalline hexagonal structure and preferred c-axis growth orientation. CT angiogram at one month post-procedure revealed persistent occlusion of the aneurysm. By applying the accelerated MD simulation method to liquid water, we observed that this new simulation technique accelerates the molecular motion without losing its microscopic structure and equilibrium properties. When compared to N, H had greater spontaneous ventricular beating rates and, when paced with field stimuli, higher systolic pressures, longer relaxation times and mechanical refractory periods, and greater oxygen consumption. Counts were highest for females in a room containing both fruit volatiles and male pheromone, lowest for females in a room containing neither volatiles nor pheromone, and intermediate for females in rooms containing either volatiles or pheromone but not both. Electrophoresis in sodium dodecyl sulfate in the absence of reducing agents showed the presence of two subunit bands with Mr 170 000 and 34 000. Risk and developmental heterogeneity in previously institutionalized children.

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Synthesis of 1,1-disubstituted alkyl vinyl sulfides via rhodium-catalyzed alkyne hydrothiolation: scope and limitations. Elevated doses of tranexamic acid in cardiac bypass surgery appear to significantly reduce bleeding in the first hours after surgery compared to low doses. Laboratory processes automation, including patient result verification, has greatly improved laboratory test throughput while decreasing turn-around-times, enabling critical results to reach physicians rapidly for improved clinical outcomes. coli O157:H7 concentrations in manures and composts before their sale and use as soil amendments and for measuring the effectiveness of manure treatment processes to reduce or inactivate this pathogen. This indicates a tissue-specific expression of post-translational regulatory systems responsible for P450 stabilization. A primary care/prevention intervention may be acceptable and favorably impact risk factors for depression. Efficacy of lactic acid against Listeria monocytogenes attached to poultry skin during refrigerated storage. The high efficiency and selectivity is attributed to the large effective surface area of the porous structure, plentiful hydroxyl groups, and basic sites on the Pr(OH)(3) surface. Transition and transfer from pediatric to adult care of the young adult with complex congenital heart disease. The haemodynamic changes by vascular stenoses and obstructions with the possibilities of their recognition are discussed in detail, in which especially examinations under load and phasic measurements of flow are taken into consideration.

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We evaluated the clinical training and academic productivity of a unique minimally invasive urological oncology fellowship performed in 3-month rotations at 4 institutions. In combination with color-doppler flow imaging the method allows the differentiation of transvalvular and perivalvular regurgitation. By using a promoter-lacZ fusion approach and bioinformatics tools, we found that Rv0586 represses the expression of Mce2 proteins and of a putative endonuclease IV, encoded by end (Rv0670) gene. We propose that the sigma E regulon is involved in processes that occur in extracytoplasmic compartments and that these two heat-inducible regulons may have distinct but complementary roles of monitoring the state of proteins in the cytoplasm (sigma 32) and outer membrane (sigma E). Malpighian epithelioma developed on prethoracic esophagus made out of a cutaneous tube. All temperatures remained below 15 degrees C (p less than 0,01).

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