This medication belongs to the group of medications called bronchodilators. It is used to treat severe, acute attacks of asthma or chronic obstructive lung conditions, such as emphysema and chronic bronchitis. It contains two ingredients that work by opening the airways.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
Each mL of clear, colourless solution contains 0.125 mg of ipratropium bromide and 0.3125 mg of fenoterol hydrobromide. Nonmedicinal ingredients: hydrochloric acid to adjust the pH, and sodium chloride.
This medication is used in a nebulizer. Treatment is usually started in a hospital setting. The usual adult dose (for those 12 years and over) is 4 mL (one unit dose vial) of ipratropium – fenoterol solution inhaled via a nebulizer. Treatment may be repeated after 6 hours if necessary. If less than 4 mL of solution is to be used at one time as prescribed by your doctor, use a syringe to transfer the necessary amount to the nebulizer chamber. Discard any solution left in the plastic vial, as the solution does not contain preservatives.
If less than 2 mL of solution is to be nebulized, a sterile, preservative-free saline or another suitable nebulizer solution should be used to make up the total volume to between 2 mL and 5 mL. Follow the instructions found with the medication and with your nebulizer for proper treatment, care, maintenance, and equipment cleaning procedures. It is very important to adjust the face mask, if required, to prevent the mist from getting into your eyes.
If this medication does not relieve your symptoms within 10 minutes after the nebulization is finished, if the dosage of medication does not provide relief for longer than 3 hours, or if you experience a worsening of your symptoms, contact your doctor or go to the nearest hospital, as these are signs that your condition may be worsening and that you need to be reassessed by a doctor.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not double a dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Do not use ipratropium – fenoterol if you:
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Additional treatment: Like other inhalation solutions that contain beta agonists, ipatropium – fenoterol solution should not be used on a regular basis for the treatment of asthma without using appropriate inhaled anti-inflammatory medication (such as budesonide or fluticasone) at the same time.
Cystic fibrosis: People with cystic fibrosis may be more likely to have stomach discomfort (due to changes in how quickly food moves through the stomach and intestines) while using this medication.
Diabetes: Ipratropium – fenoterol solution may cause a loss of blood glucose control, and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Eye concerns: Take care to ensure that the nebulizer mask fits your face properly and that nebulized solution does not escape into the eyes. If you have glaucoma or narrow anterior chambers, avoid using a combined ipratropium and beta-2-agonist solution by nebulizer unless you take measures (e.g., use of swimming goggles or use of a nebulizer with a mouthpiece) to ensure that nebulized solution does not reach the eye. There have been reports of eye complications (e.g., mydriasis, increased eye pressure, angle-closure glaucoma) when nebulized ipratropium, either alone or in combination with an adrenergic beta-2-agonist solution, comes into contact with the eyes.
Heart conditions: This medication can cause increased heart rate and blood pressure, making certain heart conditions worse. If you have heart disease, high blood pressure, irregular heart beat, heart failure, or have had a recent heart attack, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pheochromocytoma: If you have been diagnosed with pheochromocytoma (a tumour of the adrenal gland), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Potassium levels: Decreases in blood levels of potassium may occur with the use of this medication. This rarely causes problems, but potassium levels should be monitored by your doctor. If you experience unexplained muscle cramps, weakness, fatigue, or constipation, contact your doctor.
Urinary tract problems: Ipratropium – fenoterol solution can cause difficulty with starting the flow of urine. If you have an enlarged prostate or bladder retention, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Worsening of symptoms: Some people who receive inhaled beta-agonists have developed severe worsening of breathing. The cause of this is unknown. If it occurs, stop using this medication immediately and talk to your doctor about an alternative therapy as soon as possible.
Pregnancy: The safety of this medication for use while pregnant has not been established. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if ipratropium – fenoterol solution passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: Ipratropium – fenoterol is not currently recommended for use by children under 12 years of age, as its safety and dosing regimen for this age group have not been established.
There may be an interaction between ipratropium – fenoterol inhalation solution and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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