Combivent Respimat

Note: This document contains side effect information about albuterol / ipratropium. Some of the dosage forms listed on this page may not apply to the brand name Combivent.

Applies to albuterol / ipratropium: inhalation aerosol powder, inhalation solution, inhalation spray

Along with its needed effects, albuterol/ipratropium may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking albuterol/ipratropium:

More common

• Body aches or pain
• chills
• cough
• cough producing mucus
• difficulty with breathing
• ear congestion
• fever
• headache
• loss of voice
• runny nose
• sneezing
• sore throat
• stuffy nose
• tightness in the chest
• unusual tiredness or weakness

Less common

• Bladder pain
• bloody or cloudy urine
• blurred vision
• burning while urinating burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• chest pain
• congestion
• diarrhea
• difficult, burning, or painful urination
• dizziness
• fainting
• fast, slow, irregular, pounding, or racing heartbeat or pulse
• frequent urge to urinate
• general feeling of discomfort or illness
• hoarseness
• increased sputum
• joint pain
• loss of appetite
• lower back or side pain
• muscle aches and pains
• nausea
• nervousness
• noisy breathing
• pain
• pain or tenderness around the eyes and cheekbones
• pounding in the ears
• shakiness in the legs, arms, hands, or feet
• shivering
• sweating
• swelling
• tender, swollen glands in the neck
• trembling or shaking of the hands or feet
• trouble sleeping
• trouble swallowing
• voice changes
• vomiting

Rare

• Skin rash or hives
• swelling of the face, lips, eyelids, mouth, or throat

Incidence not known

• Chest discomfort
• decrease in the frequency of urination
• decrease in urine volume
• difficulty in passing urine (dribbling)
• itching skin
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• pain or discomfort in the arms, jaw, back, or neck
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• redness of the skin
• welts

Some side effects of albuterol / ipratropium may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Acid or sour stomach
• bad, unusual, or unpleasant (after) taste
• belching
• change in taste
• diarrhea
• difficulty with moving
• dry mouth
• heartburn
• indigestion
• muscle pain or stiffness
• stomach discomfort, upset, or pain
• voice changes

Incidence not known

• Bigger, dilated, or enlarged pupils (black part of the eye)
• blindness
• change in near or distance vision
• decreased vision
• difficulty in focusing eyes
• dry throat
• eye pain
• increased sensitivity of the eyes to light
• itching, redness, tearing, or other sign of eye irritation not present before use of this medicine or becoming worse during use
• lack or loss of strength
• noisy breathing
• redness of the white part of the eyes or inside of the eyelids
• swelling of the eye
• swelling or inflammation of the mouth
• tearing

Applies to albuterol / ipratropium: inhalation aerosol, inhalation solution

Common (1% to 10%): Cough, dyspnea, bronchitis, nasopharyngitis, upper respiratory infection, pharyngolaryngeal pain, wheezing, respiratory disorder, sinusitis, bronchospasm, dysphonia, increased sputum

Rare (less than 0.1%): Laryngospasm

Postmarketing reports: Throat irritation, paradoxical bronchospasm, nasal congestion, pharyngeal edema

Common (1% to 10%): Headache, dizziness, tremor, nervousness, insomnia

Postmarketing reports: Central nervous system stimulation, mental disorder

Common (1% to 10%): Asthenia, influenza -like illness, chest discomfort

Common (1% to 10%): Hypertension, palpitations, tachycardia, arrhythmia, angina, systolic blood pressured increased

Rare (less than 0.1%): Diastolic blood pressure decreased

Postmarketing reports: Myocardial ischemia, supraventricular tachycardia and/or atrial fibrillation

Postmarketing reports: Rash, pruritus, and urticaria (including giant urticaria), angioedema including that of tongue, lips and face, laryngospasm, and anaphylactic reaction

Common (1% to 10%): Eye pain

Postmarketing reports: Glaucoma, blurred vision, mydriasis, conjunctival hyperemia, halo vision, accommodation disorder, ocular irritation, corneal edema, intraocular pressure increased

There are numerous case reports in the literature of precipitation of glaucoma with the use of ipratropium and albuterol via nebulized solution. This is thought to occur through direct contact with the eyes, and is seen with the combination since both beta agonists and anticholinergics can increase intraocular pressure. There is one report of glaucoma associated with the use of nebulized albuterol and ipratropium aerosol in an emergency department. Caution is warranted when the combination is used in patients predisposed to glaucoma. Extra care should be taken to avoid contact with the eyes.

Common (1% to 10%): Diarrhea, nausea, dry mouth, constipation, vomiting, dyspepsia, taste perversion, dry throat

Postmarketing reports: Gastrointestinal motility disorder (e.g., diarrhea), drying of secretions, stomatitis, mouth edema

Common (1% to 10%): Muscle spasms, myalgia, arthralgia

Postmarketing reports: Muscular weakness

Common (1% to 10%): Hypokalemia

Frequency not reported: Lactic acidosis

Common (1% to 10%): Pruritus, rash

Postmarketing reports: Angioedema, hyperhidrosis, skin reaction

Common (1% to 10%): Urinary tract infection, dysuria

Postmarketing reports: Urinary retention