From the Guidelines
Combivent inhaler is primarily used as a rescue inhaler for quick relief of symptoms, not as a daily preventive medication. It contains two bronchodilators (ipratropium bromide and albuterol sulfate) that work together to relax airway muscles and improve breathing in people with COPD (Chronic Obstructive Pulmonary Disease) 1. The typical dosage is 1-2 inhalations four times daily as needed, with a maximum of 12 inhalations in 24 hours. Unlike controller medications that are taken daily to prevent symptoms, Combivent is designed for immediate symptom relief when breathing difficulties occur. It works quickly because albuterol acts within minutes to open airways, while ipratropium provides additional bronchodilation that lasts longer.
Some key points to consider when using Combivent inhaler include:
- It is used for quick relief of symptoms, not for daily prevention of symptoms 1
- It contains two bronchodilators that work together to relax airway muscles and improve breathing 1
- The typical dosage is 1-2 inhalations four times daily as needed, with a maximum of 12 inhalations in 24 hours
- Patients should keep track of how often they use Combivent, as increasing reliance might indicate worsening disease that requires adjustment of their overall treatment plan 1
- Side effects may include dry mouth, throat irritation, headache, and increased heart rate
According to the most recent and highest quality study, Combivent inhaler is recommended for use as a rescue inhaler, rather than as a daily preventive medication 1. This is because it is designed to provide quick relief of symptoms, rather than to prevent symptoms from occurring in the first place. However, it is essential to note that the frequency of use should be monitored, and if the patient finds themselves relying on it more frequently, it may indicate a need to reassess and adjust their treatment plan to better manage their condition and improve their quality of life.
From the FDA Drug Label
Ipratropium bromide and albuterol sulfate inhalation solution is used to help treat airway narrowing (bronchospasm) that happens with chronic obstructive pulmonary disease (COPD) in adult patients who need to use more than one bronchodilator medicine
The Combivent inhaler is used for everyday prevention of airway narrowing (bronchospasm) in patients with COPD, as it contains two bronchodilators that work together to help open the airways in the lungs.
- It is not explicitly stated as a rescue inhaler, but rather for regular use as needed to control symptoms. 2 2
From the Research
Combivent Inhaler Usage
- The Combivent inhaler is a combination of ipratropium and albuterol, used for the treatment of chronic obstructive pulmonary disease (COPD) 3.
- Studies have shown that the combination of ipratropium and albuterol is more effective than either agent alone in improving lung function and symptoms in patients with COPD 3, 4.
- The Combivent inhaler is typically used four times daily, in addition to other medications such as oral theophylline and corticosteroids as required 3.
- The advantage of the combination of ipratropium and albuterol is apparent primarily during the first 4 hours after administration, suggesting that it can be used as a rescue inhaler or for everyday prevention 3.
- However, the study by 4 compared the efficacy of fluticasone propionate/salmeterol with ipratropium bromide/albuterol in COPD patients and found that the former was more effective in improving lung function and symptoms, suggesting that Combivent may be more suitable for rescue or short-term use.
Mechanism of Action
- Ipratropium bromide is an anticholinergic bronchodilator that produces bronchodilation in patients with obstructive airways disease, although it is somewhat less effective than beta 2-adrenoceptor agonist drugs such as salbutamol or fenoterol in patients with asthma 5.
- The combination of ipratropium and albuterol has a longer duration of effect (about 4 to 6 hours) compared to isoprenaline, and the onset of maximum effect is slower (about 1.5 to 2 hours) 5.
- Studies have shown that concomitant use of ipratropium and other agents such as beta 2-adrenoceptor agonists, theophylline, or sodium cromoglycate, can result in a greater response in many patients than with single drug therapy 6, 5.