Combivent inhalers combine albuterol and ipratropium, which are both bronchodilators, or drugs that open the airways. Doctors prescribe Combivent when chronic obstructive pulmonary diseases, or COPD, like emphysema and chronic bronchitis aren't controlled by a single bronchodilator. Combivent inhalers dispense a measured amount of both drugs when patients place them in their mouths and press down on the body of the inhaler.
One Product
According to Combivent manufacturer Boehringer Ingelheim, the canister of inhalable Combivent is available in only one strength. Every canister contains 200 inhalations, or puffs. Although it's a single product, there are two doses listed for the canister. The first dose, which indicates the amount of drug that's sent through the valve on the canister, is 120 mcg of albuterol and 21 mcg of ipratropium. The second dose indicates the amount of each drug that's delivered through the mouthpiece of the inhaler, which equals 103 mcg of albuterol and 18 mcg of ipratropium.
Dose
The recommended dose of Combivent is two puffs four times a day, says RxList. Patients may take additional inhalations as needed to control COPD symptoms, but the total number of puffs should be fewer than 13 in a 24-hour period.
Proper Technique
In order to obtain the full prescribed dose of albuterol and ipratropium, Combivent users need to prime the inhaler by spraying it into the air several times before the first use or when the inhaler hasn't been used for 24 hours. The inhaler should be shaken for 10 seconds before use, says RxList. People who have difficulty using Combivent properly may want to consider using a spacer, a device between the inhaler and the mouth that holds the drug so it can be inhaled more easily.
Tips
Combivent canisters have a dose counter that begins with 200 actuations and automatically displays the number of remaining doses each time the inhaler is used. When the number drops to zero, it's time to discard the inhaler and reach for a new one, says Boehringer Ingelheim. Although there may still be medication in the canister, there's no guarantee that each puff will have the prescribed amount of albuterol and ipratropium.
Warnings
Boehringer Ingelheim warns that excessive use of Combivent can be fatal. Although the exact cause of death due to an overdose is unknown, the manufacturer postulates that individuals who overdose have a severe asthmatic crisis, experience a severe loss of oxygen in their blood and then go into cardiac arrest.
