Uses of Combivent Respimat:

• It is used to open the airways in lung diseases where spasm may cause breathing problems.

What do I need to tell my doctor BEFORE I take Combivent Respimat?

• If you have an allergy to ipratropium, albuterol, or any other part of Combivent Respimat (ipratropium and albuterol inhalation spray).
• If you are allergic to Combivent Respimat (ipratropium and albuterol inhalation spray); any part of Combivent Respimat (ipratropium and albuterol inhalation spray); or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you take other drugs called anticholinergics, like ipratropium or oxybutynin. Ask your doctor if you are not sure if any of your drugs are anticholinergic.
• If you are breast-feeding or plan to breast-feed.

This is not a list of all drugs or health problems that interact with Combivent Respimat (ipratropium and albuterol inhalation spray).

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Combivent Respimat (ipratropium and albuterol inhalation spray) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Combivent Respimat?

• Tell all of your health care providers that you take Combivent Respimat (ipratropium and albuterol inhalation spray). This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert or have clear eyesight until you see how Combivent Respimat (ipratropium and albuterol inhalation spray) affects you.
• Do not take more of Combivent Respimat (ipratropium and albuterol inhalation spray) or use it more often than you have been told. Deaths have happened when too much of Combivent Respimat (ipratropium and albuterol inhalation spray) was taken. Talk with your doctor.
• Call your doctor right away if your normal dose does not work well, if your signs get worse, or if you need to use Combivent Respimat (ipratropium and albuterol inhalation spray) more often than normal.
• If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
• Do not get Combivent Respimat (ipratropium and albuterol inhalation spray) in the eyes.
• If Combivent Respimat (ipratropium and albuterol inhalation spray) gets in the eyes, rinse with water right away. Call the doctor right away if Combivent Respimat (ipratropium and albuterol inhalation spray) gets in the eyes and blurred eyesight, worsened glaucoma, or eye pain happens.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using Combivent Respimat (ipratropium and albuterol inhalation spray) while you are pregnant.

How is this medicine (Combivent Respimat) best taken?

Use Combivent Respimat (ipratropium and albuterol inhalation spray) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• For breathing into the lungs.
• Prepare the inhaler before first use. Spray towards the ground until mist is seen. Once the mist is seen, spray 3 more times. If it has been more than 3 days since it has been used, spray once at the ground. If not used in more than 21 days, you will need to prepare the inhaler again. Spray until mist is seen then spray 3 more times.
• Put the cap back on after you are done using your dose.
• If you are using more than 1 inhaled drug, ask the doctor which drug to use first.
• After all sprays have been used, the inhaler will lock.

What do I do if I miss a dose?

• If you use Combivent Respimat (ipratropium and albuterol inhalation spray) on a regular basis, use a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not use 2 doses at the same time or extra doses.
• Many times Combivent Respimat (ipratropium and albuterol inhalation spray) is used on an as needed basis. Do not use more often than told by the doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
• Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
• Chest pain or pressure or a fast heartbeat.
• A heartbeat that does not feel normal.
• Change in eyesight, eye pain, or very bad eye irritation.
• Seeing halos or bright colors around lights.
• Red eyes.
• Trouble passing urine, pain when passing urine, passing urine in a weak stream or drips, or passing urine more often.
• Very bad dizziness or passing out.
• This medicine can cause very bad breathing problems right after you take a dose. Sometimes, this may be life-threatening. If you have trouble breathing, breathing that is worse, wheezing, or coughing after using Combivent Respimat (ipratropium and albuterol inhalation spray), use a rescue inhaler and get medical help right away.

What are some other side effects of Combivent Respimat?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Feeling nervous and excitable.
• Headache.
• Shakiness.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Combivent Respimat?

• Store at room temperature. Do not freeze.
• Protect from light.
• After putting together, throw away the inhaler 3 months after first use or when the inhaler locks.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer Information Use and Disclaimer

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about Combivent Respimat (ipratropium and albuterol inhalation spray), please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.