|BRAND NAME: Combimist L Inhaler
Generic Combimist-L Inhaler is a combination of Ipratropium bromide and Levosalbutamol. This bronchodilator is used to relieve symptoms of bronchospastic syndrome in patients with chronic obstructive pulmonary disease and bronchial asthma (wheezing, shortness of breath, chest tightness, breathing difficulties, coughing, etc).
Ipratropium bromide is an anticholinergic agent which blocks M3-cholinergic receptors of the smooth muscles of the tracheobronchial tree (mainly large and medium bronchi), suppresses reflex bronchoconstriction, reduces the secretion of the glands of the respiratory tract mucosa. It is its competitive antagonist. The agent prevents bronchial constriction resulting from the inhalation of cigarette smoke, cold air, the action of various bronchospasm agents, and also eliminates bronchospasm associated with the influence of the vagus nerve.
Levosalbutamol is a beta2-adrenergic agent that acts on the smooth muscles of the respiratory tract, causing it to relax and prevent bronchospasm. It reduces airway resistance, increases lung capacity, prevents the release of histamine, leukotrienes, prostaglandin D2 and other biologically active substances from mast cells.
Joint inhalation of Ipratropium bromide and Levosalbutamol has a simultaneous local effect on muscarinic and beta2-adrenergic receptors in the lungs, resulting in an enhanced bronchodilator effect. Systemic absorption during joint inhalation of Ipratropium bromide and Levosalbutamol does not increase.
Contraindications for use include hypertrophic obstructive cardiomyopathy, tachyarrhythmia, pregnancy (I trimester), children’s age (age under 12 years), hypersensitivity to levosalbutamol, ipratropium bromide, atropine or their derivatives. The medicine is used with caution in patients with angle-closure glaucoma, obstruction of the urinary tract, severe organic cardiovascular disorders, pheochromocytoma, hyperthyroidism, insufficiently controlled diabetes mellitus, cystic fibrosis, myocardial infarction (recently transferred). It is not recommended to use Generic Combimist-L Inhaler in the II and III trimesters of pregnancy and during breastfeeding, except in cases where the expected benefit to the mother outweighs any possible risk to the fetus and infant.
The most common side effects reported in clinical studies were headache, throat irritation, cough, dry mouth, constipation, diarrhea, vomiting, nausea, dizziness, rash, itching, blurred vision, mydriasis, increased intraocular pressure, eye pain, increased heart rate, swelling and dryness of the pharyngeal mucosa, swelling of the oral mucosa, urinary retention.
Long-term joint use of Generic Combimist-L Inhaler with other anticholinergic drugs has not been studied, therefore, long-term joint use is not recommended. Beta-adrenergic agents and xanthine derivatives can enhance the bronchodilator effect of the drug. The anticholinergic effect is enhanced when used simultaneously with antiparkinsonian drugs, quinidine, tricyclic antidepressants.
The dosing regimen is set individually. During treatment, patients should be under medical supervision. The recommended daily dose should not be exceeded during both acute and maintenance therapy.
If the treatment does not lead to a significant improvement or the patient’s condition worsens, it is necessary to change the therapy plan. In the event of a sudden or rapid increase in shortness of breath (difficulty breathing), you should immediately consult a doctor.
When using the drug, avoid getting the solution into the eyes.
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