Drug Title

Combimist L Inhaler (Levosalbutamol and Ipratropium Bromide)

Common use

Combimist L Inhaler is composed out of the following active ingredients:
Levosalbutamol – 50 mg and Ipratropium bromide – 20 mg

Be aware that this cure might be available in various strengths for each of these two active ingredients.

Combimist L Inhaler works with the system in charge with relaxing the airways and muscles; it helps the lungs to open the air passages.

levosalbutamol is a short-acting ß2-adrenergic receptor agonist, asthma approved and it is part of the bronchodilators medication family. It helps relaxing the muscles of the airways and as a result, it allows the air to flow smoothly through the lungs.

Ipratropium bromide is part of the bronchodilator faimily as well and provides similar ways of action in relation with the disease. It may not be used in treating bronchospasms attacks  as a “blitz cure”

Dosage and direction

Combimist L Inhaler is available only in the form of a nasal spray but must be used through the mouth, inhaled.
The inhalation is recommended up to 3 times a day with a maximum dosage of 42 mcg per nostril (~two sprays)

Contraindications

Ipratropium bromide is not to be used on patients with knows hypersensitivity to atropine and all of its derivates.
Using Ipratropium bromide in relation with curing the bronchospasm in acute COPDS exacerbation if not firmly studied.

Other drugs with faster effect might be used as an alternative.

Combining Ipratropium bromide and beta agonists is not known as a better effective combination than when using the drug alone when it comes to curing the bronchospasm in association with the acute COPD exacerbation.

Some rapid hypersensitivity reaction might come after taking Ipratropium bromide, thing which is proved by rare cases of urticaria, angioedema, rash, oropharyngeal edema and bronchospasm.

Drug interraction

Ipratropium bromide is known to be a non toxic and very efficient solution when used in combination with beta adrenergic bronchodilators. Ipratropium bromide is also in use with other pulmonary medications, such as  methylxanthines and corticosteroids, without any adverse drug interactions.

Missed dose

Always take the missed dose when you remember. If that time is closer to the next dose than the forgotten one, skip the missed dose and proceed to the next one. Never take 2 doses in the same time and never take extra volume of this drug. Get in touch with your doctor if you feel insecure about your actions.

Overdose

In case you feel an overdose has occurred, always call your local poison control center or Hospital, first thing.

The following are signs of possible over dose reaction:

•     wheezing;
•     chest tightness;
•     fever;
•     itching;
•     bad cough;
•     blue or gray skin color;
•     seizures;
•     or swelling of face, lips, tongue, or throat;
•     trouble breathing;
•     sudden change in eyesight, eye pain, or irritation;
•     any rash.

Storage

Keep Combimist L Inhaler out of the reach of children and pets, in dry places and at temperatures not higher than 25 C/77 F. The product may be used at temperatures from 15 C to 30 C (59 F to 86F) but for short periods of time. Keep the product safe from extreme heat and moisture.

Precautions

Please contact your doctor in advance of using this product, Combimist L Inhaler, and let him know about any of yout allergies, other prescriptions, already installed diseases, current health situation, etc. In case of allergy to  ipratropium or levosalbutamol, it is highly recommended to tell that to your doctor. You might experience intense side effects when the product interacts with some health conditions.

Always take Combimist L Inhaler according to your doctor prescription and always read the inside information printed on the box.

The daily dosage is based on your condition. Do no hesitate to contact your doctor or pharmacist in case you notice or feel any sign of allergy during usage of Combimist L Inhaler. The types of allergies can be: rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

Let your doctor know in case the situation gets worse than a simple allergy.

Studies on animals have failed to prove any kind of risk related to pregnancy, there fore proper information about using  Combimist L Inhaler when being pregnant is non acurate and the risk of using the product is not known.

Possible side effect

Is well known that levosalbutamol is well tolerated. General side effects may include: Faster heart rate, muscle pain and dysfunction of the gastric system.

The following points are part of a list which includes some side effect that may occur when using Combimist L Inhaler.

The list is not yet completed but these available side effects are not always to take place. Some might be very rare although serious. Get in touch with your doctor in case of any signs of such side effects, especially in the cases when it gets worse.

•     Severe hypokalemia
•     Tremors especially of hands
•     Vomiting
•     Diarrhea
•     Tiredness
•     Urge to vomit
•     Dizziness
•     Muscle cramps

In case of other side effects than the ones presented in the list, always contact your doctor before using  Combimist L Inhaler. Would be much appreciated of you would report these new side effects to your local FDA administration.