What is Combivent Respimat: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Combivent Respimat is a short-acting COPD medication that helps keep airways open. Doctors prescribe it as an add-on maintenance treatment when long-acting medications aren’t enough to keep airways open. It is not intended as a quick relief or rescue inhaler. It contains two active ingredients, albuterol and ipratropium. Both are bronchodilators that relax the muscles in the airways. Doses are taken every six hours.

Combivent Respimat overview

BRAND NAMES:

  • Combivent Respimat

Generic Names:

  • Ipratropium bromide-albuterol sulfate

Uses:

  • Treats chronic obstructive pulmonary disease (COPD).

Therapeutic Classes:

  • Bronchodilator, short-acting anticholinergic and short-acting beta 2 agonist (SABA) combination

Forms:

  • Aerosol

How it’s taken:

  • Inhalation

What is Combivent Respimat used for?

The FDA has approved Combivent Respimat as an add-on treatment for chronic obstructive pulmonary disease (COPD). Doctors prescribe it to patients who are already using a long-acting bronchodilator but still have problems with airway closure (bronchospasm).

What form(s) does Combivent Respimat come in

  • Inhaler

    • 20 mcg ipratropium/100 mcg albuterol per actuation

What are common Combivent Respimat doses?

For the adjuvant treatment of COPD: One inhalation four times daily

Common Combivent Respimat prescriptions

  • Combivent Respimat
    4gm of 20-100mcg/act (120 inhalations) inhaler

How to take Combivent Respimat

  • Your doctor will tell you how much medicine to use. Do not use more than directed.

  • Read and follow the Instructions for Use that come with the inhaler.

  • Doses are taken four times daily. Do not take more than six doses in 24 hours.

  • Inserting the cartridge:

    • Do not remove the cap from the mouthpiece.

    • Press the safety catch and pull off the inhaler’s clear base.

    • Write the discard date on the label (three months after the cartridge is inserted).

    • Insert the narrow end of the cartridge into the inhaler.

    • With the inhaler on a firm surface, press down on the top until it clicks. 

    • The cartridge is now in place.

    • Put the clear base back on the inhaler. Turn it in the direction of the arrows until it clicks.

  • Priming the inhaler:

    • Follow the step-by-step directions in the Instructions for Use.

    • If the inhaler isn’t used for three days, prime it again by spraying just once towards the ground.

    • If the inhaler isn’t used for 21 days or more, prime the inhaler again following the original procedure.

  • Taking a dose:

    • To take a dose, turn the clear base half a turn in the direction of the arrows until it clicks. The inhaler is now ready to deliver one inhalation.

    • Open the cap.

    • Breathe out slowly and fully.

    • Completely close your lips around the mouthpiece but don’t cover the air vents.

    • Take a slow, deep breath and press the dose release button while inhaling. 

    • Hold your breath for 10 seconds. Breathe out.

    • Replace the cap.

  • Refilling the prescription:

    • The dose indicator shows the number of puffs in the inhaler. One puff equals one dose.

    • When the dose indicator is in the red zone, refill your prescription.

    • When the dose indicator is at zero, the inhaler will stop working.

  • Clean the mouthpiece at least once weekly with a damp cloth or tissue.

  • Store Combivent Respimat at room temperature. Do not freeze the cartridge or inhaler.

  • Throw away the inhaler three months after its first use or when it runs out of doses, whichever comes first.

What to do if you miss a dose of Combivent Respimat

  • Ask the prescriber how to manage a missed dose.

  • Do not take an extra dose to compensate for a missed dose.

Combivent Respimat contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have had an allergic reaction to albuterol, ipratropium, or atropine.

Combivent Respimat warnings

  • Call the doctor if your COPD medications are not helping with COPD symptoms. 

  • The prescribing healthcare provider will need to regularly visit with you and may need lab tests. Keep all appointments.

  • Tell any doctor or other healthcare provider who treats you that you are using Combivent Respimat. 

  • Before starting Combivent Respimat, tell the prescriber if you are pregnant, breastfeeding, or have:

    • Heart or heart rhythm problems

    • High blood pressure

    • Kidney problems

    • Liver problems

    • Problems urinating because of an enlarged prostate or blockage

    • Thyroid problems

    • A history of seizures

    • Diabetes

    • Narrow-angle glaucoma

    • Low potassium

    • Any other medical condition

  • Combivent Respimat can cause serious problems including:

    • Asthma-like attacks (bronchospasm) that can be life-threatening

    • Worsening of narrow-angle glaucoma

    • Worsening of urinary retention

    • Blood sugar changes (in people with diabetes)

    • Serious or life-threatening allergic reactions

  • Combivent Respimat can cause heart side effects including:

    • Chest pain

    • Palpitations

    • Racing heartbeats

  • Avoid getting Combivent in the eyes. Call a doctor if this happens.

  • Combivent Respimat can cause dizziness or vision problems. Be cautious when driving or engaging in any other potentially hazardous activity that requires attention and alertness.

  • Overdosing on albuterol can be fatal. Do not exceed the recommended dosage.

  • Do not use this medicine for a sudden COPD attack. Make sure you always have your rescue medicine with you to treat sudden symptoms.

Combivent Respimat interactions

  • Because of possible drug interactions, tell the prescriber about all the prescription medications, over-the-counter drugs, or supplements you take or about to take, particularly:

  • Tell other healthcare providers who treat you about Combivent and other inhaled medications before they start you on a new medication.

Combivent Respimat side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect including:

  • Trouble breathing, cough, wheezing, chest tightness

  • Chest discomfort, fast, pounding, or uneven heartbeat

  • Lightheadedness, dizziness, or fainting

  • Dry mouth, increased thirst, muscle cramps, nausea, vomiting

  • Blurred vision, eye pain, halos around lights, redness or swelling of the eye

  • Decrease in how much or how often you urinate

  • Allergic reaction: hives, rash, swelling in your face, mouth, or tongue, difficulty breathing, trouble swallowing, wheezing, shortness of breath

Less serious side effects

  • Upper respiratory infections

  • Stuffy nose and sore throat

  • Cough

  • Bronchitis

  • Headache

  • Trouble breathing

  • Nervousness

  • Shakiness

Sources:

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