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As you may be aware, combivent inhalation aerosol inhaler is being phased out in favor of the new,combivent respimat inhalation spray 20 mcg ipratropium bromide monohydrate and100 mcg albuterol equivalent to 120 mcg albuterol sulfate per actuation because the original inhaler contained ozone damaging chlorofluorocarbons cfc as a propellant.

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There are numerous case reports in the literature of precipitation of glaucoma with the use of ipratropium and albuterol via nebulized solutionThis is thought to occur through direct contact with the eyesand is seen with the combination since both beta agonists and anticholinergics can increase intraocular pressureThere is one report of glaucoma associated with the use of nebulized albuterol and ipratropium aerosol in an emergency departmentCaution is warranted when the combination is used in patients predisposed to glaucomaExtra care should be taken to avoid contact with the eyesRef]

Some side effects of albuterolipratropium may occur that usually do not need medical attentionThese side effects may go away during treatment as your body adjusts to the medicineAlsoyour health care professional may be able to tell you about ways to prevent or reduce some of these side effectsCheck with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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it is also combined with salbutamol albuterol usan under the trade names combivent a non-aerosol metered-dose inhaler or mdi and duoneb nebulizer for the management of copd and asthma, and with fenoterol trade names duovent and berodual n for the management of asthma.