People with chronic obstructive pulmonary disease (COPD; a group of illnesses that affect the lungs and airways), including chronic bronchitis (swelling of the air passages that lead to the lungs), and emphysema, can use the combination of albuterol and ipratropium to prevent wheezing, difficulty breathing, chest tightness, and coughing (damage to the air sacs in the lungs). Those whose symptoms have not been managed by a single inhalation drug utilise the combination of albuterol and ipratropium. Ipratropium and albuterol belong to the group of drugs known as bronchodilators. In order to facilitate breathing, the combination of albuterol and ipratropium relaxes and opens the airways to the lungs.

A nebulizer (device that transforms medication into a mist that can be inhaled) or an inhaler can be used to administer the combination of albuterol and ipratropium as a solution (liquid) for oral inhalation. Four times per day is typically plenty. Ask your doctor or pharmacist to explain any instructions on your prescription label that you do not understand, and carefully follow their instructions. Use ipratropium and albuterol precisely as prescribed. Use only as directed by your doctor, neither more nor less of it, nor more frequently.

If you have symptoms like wheezing, breathing difficulties, or chest tightness, your doctor could advise you to use additional doses of albuterol and ipratropium inhalation. Pay close attention to the advice above, and only take extra medication as directed by your doctor. The nebulizer solution should not be administered more than twice daily. Using the inhalation spray more than six times in a day is not advised.

If your symptoms worsen, you believe that albuterol and ipratropium inhalation no longer controls them, or you discover that you need to use additional doses of the medication more frequently, call your doctor right once.

Your medication will arrive in cartridges if you use an inhaler. The inhalation spray with albuterol and ipratropium has a 120-inhalation capacity per cartridge. If you use one inhalation of this drug four times every day, it will last you a month. There is a dose metre on the side of the inhaler that keeps track of how much medication is left in the cartridge. Once you have used all 120 doses, the inhaler will lock and stop releasing medication. To find out how much medication is still in the bottle, periodically check the dose indication. It is time to refill your prescription so that you won’t run out of medication when the dose indicator’s pointer reaches the red zone, which indicates that the cartridge has enough medication for 7 days.

Avoid breathing inhalation of ipratropium and albuterol into your eyes. You could develop narrow angle glaucoma if you accidentally get albuterol and ipratropium in your eyes (a serious eye condition that may cause loss of vision). Your narrow angle glaucoma may get worse if you already have it. Eye pain or redness, enlarged pupils (black circles in the middle of the eyes), blurred vision, and vision alterations like seeing haloes around lights or strange colours are possible symptoms. If you get these symptoms or if you accidentally get albuterol or ipratropium in your eyes, call your doctor right once.

Only an albuterol and ipratropium cartridge can be used with the inhaler that comes with the albuterol and ipratropium spray. Never use it to inhale any other medications, and never use any other inhaler to inhale the albuterol and ipratropium in a cartridge.

Read the printed directions that come with the inhaler or nebulizer before using albuterol and ipratropium for the first time. To learn how to use it, ask your physician, pharmacist, or respiratory therapist. When he or she observes, practise using the nebulizer or inhaler.

To get the inhaler ready for usage, do the following:

• Before using the inhaler for the first time, put it together. Start by removing the inhaler from the packaging and securing the orange cap. Pull off the clear base of the inhaler while depressing the safety catch. Avoid touching the piercing component inside the base.
• Three months after you put the inhaler together, it must be thrown away. To help you remember when it’s time to throw away your inhaler, write this date on the label.
• Remove the cartridge from its packaging, then place its thin end into the inhaler. To confirm that the inhaler is inserted properly, press it against a hard surface. Replace the inhaler’s transparent plastic base.
• With the orange cap closed, hold the inhaler upright. Until it clicks, turn the transparent base in the direction of the white arrows.
• Turn the orange cap around until it is completely open. The inhaler should be pointed down.
• Dose release button: press it. Snap the orange cap shut.
• Until you see a spray coming from the inhaler, repeat steps 4-6. Follow these instructions three more times.
• Now that the inhaler is primed, you can use it. Unless you don’t use it for more than three days, you won’t need to prime your inhaler again. You must spray one spray towards the ground before using your inhaler again if it has been more than three days since your last use. You must repeat steps 4 through 7 to prime your inhaler if it has been more than 21 days since your last use.

Use the inhaler as directed to inhale the spray:

• With the orange cap closed, hold the inhaler upright. Until it clicks, turn the transparent base in the direction of the white arrows.
• Slide off the orange cap.
• Let your breath out fully and gently.
• Close your lips around the mouthpiece after placing it in your mouth. Avoid putting your lips over the air vents.
• Breathe in gently and deeply while aiming the inhaler at the back of your throat.
• Press the dose release button as you take a breath in. While the spray is delivered into your mouth, keep inhaling.
• Hold your breath for as long as you can comfortably do so, up to 10 seconds.
• Remove the inhaler from your mouth, then screw on the orange cap. Retain the cap on the inhaler until you’re ready to use it again.

Follow these instructions to use a nebulizer to inhale the solution:

• Take one medicine vial out of the foil wrapper. Until you are ready to use them, place the remaining vials back inside the pouch.
• Squeeze all of the liquid from the vial into the nebulizer’s reservoir after twisting off the vial’s top.
• Attach the face mask or mouthpiece to the nebulizer reservoir.
• Attach the compressor to the nebulizer reservoir.
• Put on the face mask or insert the mouthpiece. Turn on the compressor while sitting comfortably and upright.
• During around 5 to 15 minutes, inhale steadily, evenly, and deeply via your mouth until mist no longer forms in the nebulizer chamber.

Regularly clean your nebulizer or inhaler. If you have any concerns about cleaning your inhaler or nebulizer, carefully follow the manufacturer’s instructions and see your doctor or pharmacist.

Other prescriptions for this drug are possible. For more information, consult your physician or pharmacist.

Before using albuterol and ipratropium inhalation,

• If you have any allergies to any medications, including ipratropium (Atrovent), atropine (Atropen), albuterol (Proventil HFA, Ventolin HFA, Vospire ER), levalbuterol (Xoponex), or any of the ingredients in albuterol and ipratropium solution or spray, let your doctor and pharmacist know right once. For a list of the ingredients, consult your pharmacist or the manufacturer’s patient information.
• Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Incorporate any of the following: Diuretics (‘water pills’); epinephrine (Epipen, Primatene Mist); beta blockers like atenolol (Tenormin), labetalol, metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); other inhaled medications, particularly additional asthma medications like arformoterol (Brovana), formoterol (Foradil, Perforomist), metaproterenol, levalbuterol (Xopenex), and salmeterol (Serevent, in Advair); medications for colds, irritable bowel disease, Parkinson’s disease, ulcers, or urinary problems; likewise terbutaline (Brethine). Moreover, let your doctor know if you are currently taking any of the following drugs or if you recently stopped taking them: amitriptyline and amoxapine, which are antidepressants; doxepin (Silenor), imipramine (Tofranil), clomipramine (Anafranil), desipramine (Norpramin), protriptyline (Vivactil), and trimipramine (Surmontil); or monoamine oxidase (MAO) inhibitors such selegiline, tranylcypromine, phenelzine, and marplan (isocarboxazid) (Eldepryl, Emsam, Zelapar). Your doctor might need to adjust the dosage of your drugs or keep a close eye out for any negative effects.
• Inform your doctor if you have or have ever had diabetes, high blood pressure, an irregular heartbeat, glaucoma (an eye condition), difficulty urinating, a blockage in your bladder, a condition of the prostate (the male reproductive gland), seizures, hyperthyroidism (a condition in which there is too much thyroid hormone in the body), heart, liver, or kidney disease.
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while taking ipratropium and albuterol.
• Inform the surgeon or dentist that you are using albuterol and ipratropium inhalation if you are having surgery, including dental surgery.
• You should be aware that breathing difficulties and wheezing might occasionally occur right after inhaling ipratropium and albuterol. Make a quick call to your doctor if this occurs. Albuterol and ipratropium inhalation should not be used again unless your doctor instructs you to.

Keep eating normally unless your doctor instructs you otherwise.

The missed dose should be taken as soon as you remember. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

There may be negative effects with this drug. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Headache
• Body part shaking that is uncontrollable
• Nervousness

Certain adverse effects can be very harmful. Call your doctor right away if you have any of the following symptoms:

• Hammering or rapid heartbeat
• Chest ache
• Hives
• Rash
• Itching
• Swelling of the hands, feet, ankles, or lower legs as well as the eyes, face, lips, tongue, and throat
• Breathing or swallowing challenges
• Infection symptoms such as a sore throat, fever, chills, and others
• Having trouble urinating

Ipratropium and albuterol may also have other adverse effects. If you experience any strange issues while taking this medicine, contact your doctor right away.

Keep this medication tightly closed in the original container and out of the reach of children. Nebulizer solution vials should be stored in the foil pouch until you’re ready to use them. Keep the drug away from excess heat and moisture at room temperature (not in the bathroom). The inhaling spray must not freeze.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Symptoms of overdose may include the following:

• Chest pain
• Rapid heartbeat

Keep all of your doctor’s appointments.

Do not share your medication with anybody else. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.