Proper Use of This Medicine

This medicine usually comes with patient directions. Read them carefully before using this medicine. If you do not understand the directions or you are not sure how to use the inhaler or nebulizer, ask your doctor, nurse, or pharmacist to show you how to use it.

When you use the inhaler for the first time, or if you have not used it for more than 24 hours, the inhaler may not give the right amount of medicine with the first puff. Therefore, before using the inhaler, prime it by spraying the medicine into the air three times. The inhaler will now be ready to give the right amount of medicine when you use it.

When you use the inhalation solution, make sure you use a jet nebulizer that is connected to an air compressor with a good air flow. Use a face mask or mouthpiece to inhale the medicine.

Keep the spray away from the eyes because this medicine may cause irritation or blurred vision. This is especially important for people with glaucoma. Closing your eyes while you are inhaling this medicine may help keep it out of your eyes.

It is very important that you use ipratropium and albuterol combination only as directed. Do not use more of it and do not use it more often than directed. To do so may increase the chance of serious side effects.

Dosing—The dose of ipratropium and albuterol combination will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

• For inhalation aerosol dosage form :
  • For symptoms of chronic obstructive pulmonary disease:
    • Adults—2 puffs four times a day and as needed. No more than a total of 12 puffs should be used in any twenty-four-hour period.
    • Children—Use and dose must be determined by your doctor.

• For inhalation solution dosage form (used with a nebulizer):
  • For symptoms of chronic obstructive pulmonary disease:
    • Adults—Use one 3 mL (milliliter) vial in the nebulizer 4 times a day. You may have 2 additional treatments per day if needed.
    • Children—Use and dose must be determined by your doctor.

Missed dose—If you are using ipratropium and albuterol combination regularly and you miss a dose, use it as soon as possible. Then use any remaining doses for that day at regularly spaced intervals.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light. Keep unused vials of inhalation solution in the foil pouch or carton.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.