combination

Albuterol / Ipratropium

DuoNeb / Combivent Respimat

Route: inhaled (SVN) · inhaled (MDI — Combivent Respimat)
Onset: 15 minutes (ipratropium component limits early onset)
Duration: 4–6 hours

Mechanism of action

Combination of beta-2 agonist (albuterol) and anticholinergic (ipratropium). Dual bronchodilation via complementary mechanisms: albuterol relaxes smooth muscle via cAMP; ipratropium blocks muscarinic bronchoconstriction.

Dosing

Adult: DuoNeb SVN: 3 mg albuterol / 0.5 mg ipratropium per 3 mL unit dose q6h. Combivent Respimat MDI: 1 inhalation QID

Acute COPD: may administer q4h during exacerbation

Indications

COPD exacerbation (acute and maintenance)
Severe acute bronchospasm requiring additive bronchodilation

Contraindications

Hypersensitivity to albuterol, ipratropium, atropine, or soya lecithin
Acute narrow-angle glaucoma (avoid eye contact)

Side effects

Combined side effects of both agents
Dry mouth
Tachycardia
Tremor
Urinary retention
Paradoxical bronchospasm

Monitoring parameters

Heart rate
SpO2 and breath sounds
Urinary output
Intraocular pressure (glaucoma patients)

Drug interactions

Same as individual agents
Other anticholinergics (additive)
Beta-blockers (antagonize albuterol)

All Drugs