Usual Adult Dose for Chronic Obstructive Pulmonary Disease - Maintenance

Inhalation Aerosol:
1 inhalation (albuterol-ipratropium bromide 100 mcg-20 mcg) orally four times a day. Additional inhalations can be taken as required.
Maximum dose: 6 inhalations in 24 hours

Inhalation solution:
One 3 mL vial (albuterol-ipratropium bromide 2.5 mg-0.5 mg) four times a day via nebulization
Maximum dose: Up to 2 additional 3 mL doses per day, if needed

Comments:

• The inhalation solution can be continued as medically indicated to control recurring bouts of bronchospasm.
• If a previously effective regimen fails to provide the usual relief, medical advice should be sought immediately, as this is often a sign of worsening COPD and may require reassessment of therapy.

Renal Dose Adjustments

This drug has not been studied in patients with renal dysfunction. Caution is recommended.

Liver Dose Adjustments

This drug has not been studied in patients with hepatic dysfunction. Caution is recommended.

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients
• Hypersensitivity to atropine and its derivatives

Dialysis

Data not available

Other Comments

Administration advice:

• For oral inhalation only.
• Inhalation solution: It should be administered via jet nebulizer connected to an air compressor with an adequate air flow, equipped with a mouthpiece or suitable face mask.
• Inhalation aerosol: Prior to first use or if not used for more than 21 days, prime the device by spraying the inhaler toward the ground until an aerosol cloud is visible and then repeat the process three more times. If not used for more than 3 days, spray the inhaler once before use.
• Safety and efficacy of additional doses, extra doses, or increased frequency of administration beyond the recommended doses has not been studied. DO NOT use more frequently than recommended.
• The manufacturer product information should be consulted.

• Metabolic: Potassium levels
• Ocular: Patients with narrow-angle glaucoma

• Avoid spraying into the eyes as it may result in precipitation or worsening of narrow angle glaucoma, mydriasis, increased intraocular pressure, acute eye pain or discomfort, temporary blurring of vision, visual halos or colored images in association with red eyes from conjunctival and corneal congestion. Consult a physician immediately if any of these symptoms occur.
• Use with caution when engaging in activities requiring balance and visual acuity such as driving a car or operating appliances or machinery.
• Consult a physician if experiencing difficulty urinating.
• If the treatment becomes less effective for symptomatic relief, symptoms become worse, and/or need to use the product more frequently than usual, medical attention should be sought immediately.
• Other inhaled drugs should be taken only as directed by a physician while in treatment with this combination drug.