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Introduction About COMBIMIST L RESPULE
COMBIMIST L RESPULE is a combination of Ipratropium and Levosalbutamol which belongs to the group of medicines called Bronchodilator agents and Adrenergic beta-agonists, respectively. COMBIMIST L RESPULE is used to manage bronchospasm (tightened airway muscles) associated with chronic obstructive pulmonary disease (inflammatory lung disease) in patients who require more than one bronchodilator (medication) to help them in easy of breathing.
COMBIMIST L RESPULE is not recommended for use in patients allergic to ipratropium, levosalbutamol, and/or atropine.
Before using COMBIMIST L RESPULE, inform your doctor if you have high blood pressure, seizures, diabetes, narrow angle glaucoma (increased eye pressure), lung problems (such as asthma), heart problems (such as coronary insufficiency, cardiac arrhythmias), kidney problems (such as renal impairment), and/or liver problems (such as hepatic impairment).
COMBIMIST L RESPULE should be used with caution during pregnancy and in women planning for pregnancy. It is also used with caution in breastfeeding women only if necessary.
COMBIMIST L RESPULE is not recommended for use in children (aged less than 6 years). It should be used with caution in children and adolescents (aged 6 to 18 years). Consult your doctor before administering COMBIMIST L RESPULE.
The most common side effects of using COMBIMIST L RESPULE are headache, dizziness, nervousness, cough, sore throat, local irritation, dry mouth, nausea, and/or diarrhoea. Consult your doctor if any of these symptoms worsens.
Uses Of COMBIMIST L RESPULE
- Manage bronchospasm associated with chronic obstructive pulmonary disease (inflammatory lung disease) in affected individuals
How COMBIMIST L RESPULE Works
COMBIMIST L RESPULE provides ease in breathing from bronchospasm (constricted airway muscles), where Ipatropium and Levosalbutamol work together to relax airway muscles which results in widening of airways providing relief from obstructive airflow and easy in breathing from bronchospasm associated with chronic obstructive pulmonary disease in affected individuals.
How to use COMBIMIST L RESPULE
COMBIMIST L RESPULE should be administered only by a nebulizer (with a face mask connected to an air compressor) under the direction of a physician. It is for inhalation use only. Remove the pouch and tear one respule. Twist the cap to open the respule. Squeeze the content into the reservoir of nebulizing chamber and discard the respule after use. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
Side Effects Of COMBIMIST L RESPULE
Common
- headache, dizziness
- tremor, nervousness, pain
- cough, sore throat, local irritation
- dry mouth, upset stomach, nausea, constipation, diarrhoea, vomiting
- urinary tract infection
- leg cramps
- voice changes
- racing heartbeat, fast heart rate
Uncommon
- red itchy welts
- accommodation disturbances, narrow angle-glaucoma (increased eye pressure)
- fast heart rate
- spasm of larynx
- diffuse skin rash
Rare
- signs of anaphylactic reaction (life threatening allergic reaction) such as wheezing, faint, breathing difficulties, and/or fast heartbeat
- swelling of tongue/lips/face
- eye pain, dilate pupil
- irregular heartbeats
- urinary retention
Stop using COMBIMIST L RESPULE and contact your doctor immediately if you experience any of the following side effects:
- signs of paradoxical bronchospasm (sudden constriction of airways after using medicine) such as shortness of breath, coughing, and/or wheezing
- signs of sudden hypersensitivity reaction (immune mediated allergic reaction) such as red itchy welts, swelling of face/mouth/tongue, bronchospasm (tighten airways), and/or rash
- signs of significant cardiovascular effects measured by pulse rate, blood pressure, and/or other symptoms
How To Manage Side Effects
Dry mouth:
Try to drink plenty of cold water and sip on cold unsweetened drinks and use lip balm if your lips are dry. Brush your teeth twice a day and use mouthwash. Consult and inform your doctor if the symptom gets worse.
Dizziness:
Try to rest and get enough sleep. Try to avoid driving or operating any tools or machines while you feel dizzy. Limit consumption of alcohol, as it can aggravate dizziness. Consult and inform your doctor if the symptom worsens.
Headache:
If COMBIMIST L RESPULE causes headache, then take rest and drink plenty of fluids. Try to avoid drinking alcohol. Ask your doctor to recommend a painkiller. Headaches should usually go away after the first week of taking COMBIMIST L RESPULE. If it lasts more than a week or severe, inform your doctor.
Nausea and vomiting:
Take COMBIMIST L RESPULE with or just after a meal. Stick to simple meals. Avoid eating oil rich or spicy foods, sugary snacks and drinks. Avoid drinking too much liquid along with your meals, drink slowly in between meals. Inform your doctor if the condition worsens.
Constipation:
Try to eat high-fiber foods such as vegetables, cereals, fresh fruit, and drink plenty of water. Involve in regular exercise (going for a daily walk or run) and if this does not help, consult and inform your doctor for receiving alternate managements for constipation.
Diarrhoea:
Drink plenty of water and stay hydrated. Try to avoid taking any medicine on your own to manage diarrhea. Consult and inform your doctor if the symptom worsens.
Warning & Precautions
Pregnancy
COMBIMIST L RESPULE should be used with caution during pregnancy and in women planning for pregnancy only if it is clearly necessary. Consult your doctor before using the medicine.
Breastfeeding
COMBIMIST L RESPULE should be used with caution in breastfeeding women only if necessary since it is not known whether the medicine pass through breast milk. Consult your doctor before using the medicine.
Driving and Using Machines
Do not drive/operate machines if COMBIMIST L RESPULE affects your ability to drive/operate machines.
Kidney
COMBIMIST L RESPULE should be used with caution in patients with kidney problems such are renal impairment. Consult your doctor before using the medicine.
Liver
COMBIMIST L RESPULE should be used with caution in patients with liver problems such as hepatic impairment. Consult your doctor before using the medicine.
Allergy
Do not take COMBIMIST L RESPULE if you are allergic to ipratropium, levosalbutamol, atropine, and/or any other ingredients of the medicine.
Lungs
COMBIMIST L RESPULE should be used with caution in patients with lung problems such as asthma. Consult your doctor before using the medicine.
Heart Disease
COMBIMIST L RESPULE should be used with caution in patients with heart problems such as coronary insufficiency, cardiac arrhythmias. Consult your doctor before using COMBIMIST L RESPULE.
Others
Before using COMBIMIST L RESPULE inform your doctor if you:
- have high blood pressure
- have seizures
- suffer from hyperthyroidism (overactive thyroid)
- have diabetes
- have narrow angle glaucoma (increased eye pressure)
- suffer from prostatic hypertrophy (enlarged prostate gland)
- suffer from bladder-neck obstruction.
Use in Paediatrics:
COMBIMIST L RESPULE is not recommended for use in children (aged less than 6 years). It should be used with caution in children and adolescents (aged 6 to 18 years). Consult your doctor before administering COMBIMIST L RESPULE.
Use in Geriatrics:
COMBIMIST L RESPULE should be used with caution in elderly patients (aged above 65 years). Consult your doctor before using COMBIMIST L RESPULE.
Interactions
A. Drug-Drug interactions:
Before using COMBIMIST L RESPULE, inform your doctor if you are taking any of the following medicine:
- short acting bronchodilators (used to quickly relieve/stop sudden asthma symptoms) Ex. albuterol, levalbuterol
- medicines used to manage high blood pressure such as beta-adregenic/receptor blocking agents (Ex. propanolol, metoprolol, atenolol)
- diuretics (used to manage high blood pressure) Ex. chlorothiazide, chlorthalidone
- digoxin (used to manage irregular heartbeats)
- monoamine oxidase inhibitors/tricyclic antidepressants (medicines used to manage depression) Ex. selegiline, phenelzine, amitriptyline, imipramine
- anticholinergic agents (medicines used to block acetylcholine) Ex. atropine, benztropine
Overdosage:
If you or anyone else accidentally take too much of COMBIMIST L RESPULE, then consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are seizures, chest pain, high/low blood pressure, fast heartbeat, irregular heartbeat, nervousness, headache, tremor, dry mouth, pounding heartbeat, nausea, dizziness, fatigue, weakness, sleeplessness, hypokalaemia (low potassium level in blood), fast breathing, high fever, restlessness, hallucinations, confusion, and/or cardia arrest.
Synopsis
| Drug | : | Ipratropium bromide, Levosalbutamol |
| Pharmacological Category | : | Bronchodilator agents, Adrenergic beta-agonists |
| Therapeutic Indication | : | Bronchospasm associated with chronic pulmonary disease |
| Dosage Forms | : | Rotacap, Inhalation Capsule, Inhaler, Respules, Smartule, Mistpules, Transpule |
More Information
- Keep COMBIMIST L RESPULE out of reach of children
- Store COMBIMIST L RESPULE above 25°C
FAQs About COMBIMIST L RESPULE
What is COMBIMIST L RESPULE used for?
COMBIMIST L RESPULE is used to manage bronchospasm (tightened airway muscles) associated with chronic obstructive pulmonary disease (inflammatory lung disease) in patients who require more than one bronchodilator (medication) to help them in easy of breathing.
What are the side effects of COMBIMIST L RESPULE?
The most common side effects of using COMBIMIST L RESPULE are headache, dizziness, nervousness, cough, sore throat, local irritation, dry mouth, nausea, and/or diarrhoea. Consult your doctor if any of these symptoms worsens.
How COMBIMIST L RESPULE works?
COMBIMIST L RESPULE provides ease in breathing from bronchospasm (constricted airway muscles), where Ipatropium and Levosalbutamol work together to relax airway muscles which results in widening of airways providing relief from obstructive airflow and easy in breathing from bronchospasm associated with chronic obstructive pulmonary disease in affected individuals.
How COMBIMIST L RESPULE is administered?
COMBIMIST L RESPULE should be administered only by a nebulizer (with a face mask connected to an air compressor) under the direction of a physician. It is for inhalation use only. Remove the pouch and tear one respule. Twist the cap to open the respule. Squeeze the content into the reservoir of nebulizing chamber and discard the respule after use. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
Can COMBIMIST L RESPULE be used in pregnant and breastfeeding women?
Yes, COMBIMIST L RESPULE can be used but with caution in pregnant and breastfeeding women. Consult your doctor before using COMBIMIST L RESPULE.
References
1. K.D. Tripathi. Anticholinergic Drugs and Drugs Acting on Autonomic Ganglia. Essentials of medical pharmacology. Seventh edition. 2013. Page- 116.
2. A S Hossain, U K Barua, G C Roy, S R Sutradhar, I Rahman, G Rahman. Comparison of salbutamol and ipratropium bromide versus salbutamol alone in the treatment of acute severe asthma. NIH National Library of Medicine. National Center for Biotechnology Information. PubMed.gov. [Revised in April 2013] [Accessed on 30th May 2022] https://pubmed.ncbi.nlm.nih.gov/23715360/
3. Chemo Biological. DUOCOPID-3 RESPULES. [Accessed on May 30th May 2022] https://chemobiological.in/duocopid-3-respules/
4. Lupin Limited. Salbair I Neb Transpules 0.63. [Accessed on May 30th May 2022] https://www.lupin.com/our-products/product-finder/?searchkey=salbair
5. JB Pharma. Dutaresp. [Accessed on May 30th May 2022] https://jbpharma.com/our-therapies/
6. Glenmark Pharma. NEBZMART. [Accessed on May 30th May 2022] https://glenmark.b-cdn.net/gpl_pdfs/products/Glenmark%20Pharmaceuticals%20Ltd-%20Product%20List%20as%20on%20October%202022.pdf
7. CiplaMed. DUOLIN LD Respules. [Revised in August 2020] [Accessed on May 30th May 2022] https://www.ciplamed.com/content/duolin-ld-respules
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