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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Adrenergics in combination with anticholinergics incl. triple combinations with corticosteroids
salbutamol and ipratropium bromide
R03AL02
Forms & Strengths
- Inhalation aerosol: 90 mcg salbutamol base / 18 mcg ipratropium bromide per actuation
- Inhalation solution: 2.5 mg salbutamol base / 0.5 mg ipratropium bromide per 3 mL vial
Adult Dosing
- Inhalation aerosol: 2 inhalations (180 mcg / 36 mcg) qid; may repeat as needed up to max 6 times in 24 hours
- Inhalation solution: 1 vial (3 mL) administered via nebulizer qid, up to q4h as needed
Pediatric Dosing
- Safety and efficacy not established in children under 12 years of age
- Adolescents >= 12 years: Same as adult dosing
Indications
- Bronchospasm associated with chronic obstructive pulmonary disease (COPD) in patients requiring concurrent regular use of both agents
Mechanism of Action
- Salbutamol: Stimulates beta-2 adrenergic receptors in bronchial smooth muscle, causing relaxation and bronchodilation
- Ipratropium: Antagonizes acetylcholine at muscarinic receptors in bronchial smooth muscle, blocking bronchoconstriction and reducing secretions
Contraindications
- Hypersensitivity to salbutamol, ipratropium, atropine, or its derivatives
- Patients with hypertrophic obstructive cardiomyopathy or tachyarrhythmias
Adverse Reactions
- Tremor
- Nervousness
- Dry mouth
- Cough
- Tachycardia / Palpitations
- Bronchospasm (paradoxical)
- Hypokalemia
- Urinary retention
Drug Interactions
- Beta-blockers: May diminish the bronchodilatory effect and provoke severe bronchospasm
- Diuretics, corticosteroids, or xanthine derivatives: May potentiate hypokalemia and/or ECG changes
- Anticholinergic drugs: May additive-increase anticholinergic adverse effects
- MAO inhibitors and tricyclic antidepressants: Potentiate cardiovascular effects of beta-agonists
Curated Content: Needs Vetting Before Put to Clinical Use