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The eMC  

Last Updated 25 Nov 2014

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Combivent nebuliser liquid 2.5ml UDVs

Combivent (Kom-bee-vent) is a medicine which is used in chronic obstructive pulmonary disease. Combivent contains ipratropium/salbutamol. It is supplied by Boehringer Ingelheim Limited.

The information in this Medicine Guide for Combivent varies according to the condition being treated and the particular preparation used.

Combivent nebuliser liquid 2.5ml UDVs

Information specific to Combivent nebuliser liquid 2.5ml UDVs when used in chronic obstructive pulmonary disease

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Your medicine

In chronic obstructive pulmonary disease, Combivent relaxes the air passages of the lungs. It helps to keep the airways open, making it easier to breathe.

Combivent will not give you immediate relief of your symptoms once an attack of breathlessness started. You must use your fast-acting inhaled bronchodilator to relieve an attack of breathlessness. Ask your prescriber or nurse for advice on what to do if you have an attack of breathlessness.

You need to take Combivent as prescribed in order to get the best results from using it. It is a good idea to make it part of your routine and to take it at the same time or times every day.

Do not share your medicine with other people. It may not be suitable for them and may harm them.

The pharmacy label on your medicine tells you how much medicine you should use. It also tells you how often you should use your medicine. This is the dose that you and your prescriber have agreed you should use. You should not change the dose of your medicine unless you are told to do so by your prescriber.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber.

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When to take your medicine

Some medicines work best if they are taken at a specific time of day. Getting the most from your medicine can also be affected by what you eat, when you eat and the times at which you take other medicines. Make sure you follow any specific instructions given to you by your prescriber or that are in the Patient Information Leaflet that comes with this medicine.

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How to take your medicine

Some medicines have specific instructions about how to take them. This is because they work better when taken correctly. These instructions can include getting the right dose and special instructions for preparing the medicine.

In the case of Combivent:

  • breathe in Combivent through the mouth, it must not be swallowed
  • follow your doctor's instructions, the medicine label and the patient information leaflet that comes with your medicine for advice on the best techniques for taking and when to take your medicine
  • if you are unsure how to use your nebuliser or are having problems you should discuss these difficulties with your prescriber, pharmacist or nurse
  • do not mix Combivent with other nebules in the same nebuliser
  • you should always try to use your medicine in a well ventilated room
  • do not allow your medicine or the mist to come into contact with your eyes as the mist can cause eye problems
  • use immediately after opening
  • use a fresh nebule each time to avoid bacterial contamination
  • dispose of any remaining solution after using Combivent

If you are having problems taking this form of Combivent, you should talk to your prescriber or pharmacist. They may be able to give you advice on other ways to take your medicine or other preparations that are easier for you to take.

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Taking too much of your medicine

Taking extra doses of some medicines can be harmful. In some cases even one extra dose can cause you problems. If you take extra doses of your medicine, you must get medical advice immediately. You may need a test to assess the effect of taking extra doses. This is because the effects of taking too much medicine are very complex so it is very important that you seek medical advice.

Contact your prescriber, pharmacist, specialist clinic or call 111 for advice.

Make sure you take all of your medicine containers with you if you are advised to go to hospital.

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Stopping your medicine

Suddenly stopping your medicine may cause your original condition to return. This is why you must speak to your prescriber if you are having any problems using your medicine.

If you are not having any problems taking this medicine then do not stop using it, even if you feel better, unless advised to do so by your prescriber.

If you are in any doubt, contact your prescriber, pharmacist, specialist clinic or call 111.

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Looking after your medicine

The instructions on how you should keep your medicine are on the pharmacy label. You should keep your medicine in the original container. This will help to keep your medicine in the best condition and also allow you to check the instructions. Do not take the medicine if the packaging appears to have been tampered with or if the medicine shows any signs of damage. Make sure that the medicine is out of the sight and reach of children.

In the case of Combivent:

  • you must not freeze this medicine
  • do not store in temperatures above 25°C
  • store the medicine in the outer carton to protect it from light

You must not take the medicine after the expiry date shown on the packaging. If you have any unused medicine, return it to your pharmacist who will dispose of it safely.

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Whether this medicine is suitable for you

Combivent is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

Furthermore the prescriber may only prescribe this medicine with special care or may not prescribe it at all for a child who is under the age of 12 years.

Over time it is possible that Combivent can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Combivent has become unsuitable, it is important that the prescriber is contacted immediately.

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Side-effects

A medicine is only made available to the public if the clinical trials have shown that the benefits of taking the medicine outweigh the risks.

Once a medicine has been licensed, information on the medicine's effects, both intended and unintended, is continuously recorded and updated.

Some side-effects may be serious while others may only be a mild inconvenience.

Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. The important thing is to tell your prescriber or pharmacist if you are having problems with your medicine.

Uncommon: More than 1 in 1000 people who use Combivent:

Rare: More than 1 in 10,000 people who use Combivent:

  • anaphylactic reactions
  • angioedema of the tongue or face
  • blood pressure changes
  • bronchospasm - if you develop an increase in wheezing or shortness of breath immediately after using your inhaler you must treat this immediately with a fast-acting inhaled bronchodilator and then seek immediate medical advice
  • constipation
  • diarrhoea
  • dry throat
  • eye or eyesight problems - if you have pain or discomfort in the eye, increased eye pressure, glaucoma, enlargement of the pupil of the eye, a red eye, blurred vision or other eye or eyesight problems, you should seek immediate medical advice. To help protect your eyes from some of these problems, do not allow Combivent come into contact with your eyes
  • gastrointestinal problems
  • heart or circulation problems - seek medical advice if you develop chest pain, breathing difficulties, have an irregular heart rate or worsening of existing heart or circulation problems
  • hypersensitivity reactions
  • increased sweating
  • inflammation of the mouth
  • itching
  • laryngeal spasm
  • mental health problems
  • metabolic problems
  • muscle pain or tenderness
  • muscle spasm
  • muscle weakness
  • oedema of the mouth
  • pharyngeal oedema
  • skin rash or rashes
  • urinary retention
  • urticaria
  • vomiting
  • weakness

The frequency of these side-effects is unknown:

  • may affect the results for certain drug tests in sports

If you feel unwell or if you have concerns about a side-effect, you will need to seek advice. If you feel very ill, get medical help straight away. Contact your prescriber, pharmacist, nurse or call 111.

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Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Combivent:

  • enflurane
  • halothane
  • trichloroethylene

The following types of medicine may interact with Combivent:

If you are taking Combivent and one of the above medicines or types of medicines, make sure your prescriber knows about it.

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Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins. In general, there is not much information available about interactions between medicines and complementary preparations or vitamins.

If you are planning to take or are already taking any complementary preparations and vitamins you should ask your prescriber whether there are any known interactions with Combivent.

Your prescriber can advise whether it is appropriate for you to take combinations that are known to interact. They can also discuss with you the possible effect that the complementary preparations and vitamins may have on your condition.

If you experience any unusual effects while taking this medicine in combination with complementary preparations and vitamins, you should tell your prescriber.

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Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

In the case of Combivent:

  • this medicine could affect your ability to drive or operate machinery

You should see how this medicine affects you before you judge whether you are safe to drive or operate machinery. If you are in any doubt about whether you should drive or operate machinery, talk to your prescriber.

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Diet

Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Combivent:

  • there are no specific foods that you must exclude from your diet when using Combivent
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Alcohol

Alcohol can interact with certain medicines.

In the case of Combivent:

  • there are no known interactions between alcohol and Combivent

 

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Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Combivent:

  • you should only use this medicine during pregnancy if your doctor thinks that you need it

You need to discuss your specific circumstances with your doctor to weigh up the overall risks and benefits of taking this medicine. You and your doctor can make a decision about whether you are going to take this medicine during pregnancy.

If the decision is that you should not have Combivent, then you should discuss whether there is an alternative medicine that you could take during pregnancy.

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Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Combivent:

  • you should only use this medicine while breast-feeding if your doctor thinks you need it

Before you have your baby you should discuss breast-feeding with your doctor or midwife. They will help you decide what is best for you and your baby based on the benefits and risks associated with this medicine. You should only breast-feed your baby while taking this medicine on the advice of your doctor or midwife.

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Ingredients of your medicine

Medicines contain active ingredients. They may also contain other, additional ingredients that help ensure the stability, safety and effectiveness of the medicine. They are also added to improve the medicine's taste and appearance and to make it easier to take. Some may be used to prolong the life of the medicine.

You should check that you are able to take the ingredients in your medicine, especially if you have any allergies.

Combivent contains:

If you are not able to take any of the ingredients in your medicine, talk to your prescriber or pharmacist to see if they can suggest an alternative medicine. If you have reacted badly to Combivent before, do not use Combivent. Talk to your prescriber, pharmacist or nurse as soon as possible.

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Combivent, Version 16, last updated 25 Nov 2014