Ipratropium/salbutamol

Ipratropium/salbutamol
Combination of
Ipratropium bromideMuscarinic antagonist
SalbutamolShort-acting β2-adrenergic agonist
Names
Trade namesCombivent, DuoNeb, Breva, others
Clinical data
WHO AWaReUnlinkedWikibase error: ⧼unlinkedwikibase-error-statements-entity-not-set⧽
Pregnancy
category
  • US: C (Risk not ruled out)[1]
    Routes of
    use    		Inhalation
    Defined daily dosenot established[2]
    External links
    AHFS/Drugs.comProfessional Drug Facts
    MedlinePlusa601063
    Legal
    License data
    Legal status
    • AU: S3 (Pharmacist only)
    • UK: POM (Prescription only)
    • US: ℞-only

    Ipratropium/salbutamol, sold under the brand name Combivent among others, is a combination medication used to treat chronic obstructive pulmonary disease (COPD).[3][4] It contains ipratropium (an anticholinergic) and salbutamol (albuterol, a β2-adrenergic agonist).[3] It is taken by inhalation.[5]

    Common side effects include sore throat, muscle cramps, and nausea.[3] Other side effects may include bronchospasm, allergic reactions, and upper respiratory tract infections.[3] Safety in pregnancy is unclear.[1] Each medication typically decreases bronchospasm and does so via different mechanisms.[3]

    The combination was approved for medical use in the United States in 1996.[5] It is available as a generic medication.[4] Sixty doses in the United Kingdom costs the NHS about 18 £ as of 2019.[4] In the United States the wholesale cost of this amount is about US$9.50.[6] In 2017, it was the 172nd most commonly prescribed medication in the United States, with more than three million prescriptions.[7][8]

    Medical uses

    Dosage

    It may be used as 1 inhalation every 4 to 6 hours for COPD.[9] It is available under the brand Combivent Respimat.[9]

    The defined daily dose is not established.[2]

    Society and culture

    Inhalers prior to 2013 contained a chlorofluorocarbon (CFC) based propellant; however, these were removed from the market and replaced with ones that do not contain CFCs.[10] The new version also releases little green house gases, as opposed to single medication salbutamol or ipratropium MDIs.[9]

    Cost

    In Canada 120 doses costs about 50 CAD as of 2023.[9] Sixty doses in the United Kingdom costs the NHS about 18 £ as of 2019.[4] In the United States the wholesale cost of this amount is about US$9.50.[6]

    • Albuterol/ipratropium costs (US)
      Albuterol/ipratropium costs (US)
    • Albuterol/ipratropium prescriptions (US)
      Albuterol/ipratropium prescriptions (US)

    Usage

    In 2017, it was the 172nd most commonly prescribed medication in the United States, with more than three million prescriptions.[7][8]

    References

    1. 1 2 "Albuterol / ipratropium Use During Pregnancy". Drugs.com. Archived from the original on 19 April 2019. Retrieved 19 April 2019.
    2. 1 2 "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 1 July 2021. Retrieved 9 September 2020.
    3. 1 2 3 4 5 "DailyMed - ipratropium bromide and albuterol sulfate inhalant". dailymed.nlm.nih.gov. Archived from the original on 17 May 2020. Retrieved 18 April 2019.
    4. 1 2 3 4 British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 247. ISBN 9780857113382.
    5. 1 2 "Ipratropium and Albuterol - FDA prescribing information, side effects and uses". Drugs.com. Archived from the original on 19 April 2019. Retrieved 18 April 2019.
    6. 1 2 "NADAC as of 2019-02-27". Centers for Medicare and Medicaid Services. Archived from the original on 2019-03-06. Retrieved 3 March 2019.
    7. 1 2 "The Top 300 of 2020". ClinCalc. Archived from the original on 12 February 2021. Retrieved 11 April 2020.
    8. 1 2 "Albuterol Sulfate; Ipratropium Bromide - Drug Usage Statistics". ClinCalc. Archived from the original on 11 April 2020. Retrieved 11 April 2020.
    9. 1 2 3 4 "BC Inhalers". www.bcinhalers.ca. Archived from the original on 30 June 2023. Retrieved 30 June 2023.
    10. ↑ Research, Center for Drug Evaluation and (3 November 2018). "Phase Out of Combivent Inhalation Aerosol - Questions and Answers". FDA. Archived from the original on 27 March 2023. Retrieved 30 June 2023.
    Identifiers:
    • DailyMed Archived 2020-05-17 at the Wayback Machine
    • Consumer Medication Information from PubMed Archived 2012-12-03 at the Wayback Machine
    • National Asthma Education and Prevention Program Expert Panel 3. Expert panel report 3: guidelines for the diagnosis and management of asthma. Bethesda (MD): National Institutes of Health. National Heart, Lung, and Blood Institute; 2007 Aug. NIH Publication No. 07-4051.
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