Introduction About COMBIMIST L RESPICAP

COMBIMIST L RESPICAP is a combination of Ipratropium and Levosalbutamol which belongs to the group of medicines called Bronchodilator agents and Adrenergic beta-agonists, respectively. COMBIMIST L RESPICAP is used to manage chronic obstructive pulmonary disease (inflammatory lung disease that obstructs airflow from lungs) in patients who are on regular bronchodilator (type of medication that makes breathing easy) or who suffer from an evident bronchospasm and require a second bronchodilator for ease of breathing.

COMBIMIST L RESPICAP is not generally recommended for use in patients allergic to ipratropium, levosalbutamol, and/or atropine.

Before using COMBIMIST L RESPICAP, 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 insufficiency/impairment), and/or liver problems (such as hepatic insufficiency/impairment).

COMBIMIST L RESPICAP is generally not recommended for use in pregnant and breastfeeding women unless it is clearly necessary. The medicine is advised to be used with caution in children & adolescents (aged below 18 years) and in elderly patients (aged above 65 years) after consulting the doctor.

The most common side effects of taking COMBIMIST L RESPICAP are dry mouth, sore throat, stuffy nose, throat irritation, dizziness, headache, nausea, and/or vomiting. Consult your doctor if any of these symptoms worsens.

Uses Of COMBIMIST L RESPICAP

• Manage chronic obstructive pulmonary disease (COPD) in affected individuals

How COMBIMIST L RESPICAP Works

COMBIMIST L RESPICAP provides ease in breathing from chronic obstructive pulmonary disease, 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 chronic obstructive pulmonary disease in affected individuals.

How to use COMBIMIST L RESPICAP

Take COMBIMIST L RESPICAP as advised by your physician. It is for inhalation use only. Hold the revolizer at the base and pull back the mouthpiece of revolizer. Remove rotacap/inhalation capsule from its bottle and insert it in the rotacap chamber. Close the mouthpiece firmly and breath out fully through the mouth. Position the mouthpiece between the teeth and close the lips tightly around it. Sit/stand upright and keep your head straight and breath in through the mouth rapidly and deeply. Remove the revolizer from your mouth and hold your breath for 10 seconds/as long as its comfortable. After use, open the mouthpiece and discard the empty rotacap. Repeat this step after every 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 RESPICAP

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 RESPICAP 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 RESPICAP. If it lasts more than a week or severe, inform your doctor.

Nausea and vomiting:

Take COMBIMIST L RESPICAP 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.

Warning & Precautions

Pregnancy

COMBIMIST L RESPICAP is generally not recommended for use during pregnancy unless it is clearly necessary.  Consult your doctor before using COMBIMIST L RESPICAP.

Breastfeeding

COMBIMIST L RESPICAP is generally not recommended for use in breastfeeding women unless clearly necessary since it is unknown whether the medicine passes through breast milk. Consult your doctor before using the medicine.

Kidney

COMBIMIST L RESPICAP should be used with caution in patients with kidney problems such as renal insufficiency/impairment. Consult your doctor before taking COMBIMIST L RESPICAP.

Liver

COMBIMIST L RESPICAP should be used with caution in patients with liver problems such as hepatic insufficiency/impairment. Consult your doctor before taking COMBIMIST L RESPICAP.

Allergy

Do not take COMBIMIST L RESPICAP if you are allergic to ipratropium, levosalbutamol, atropine, and/or any other ingredients of the medicine.

Lungs

COMBIMIST L RESPICAP should be used with caution in patients with lung problems such as asthma. Consult your doctor before using the medicine.  

Heart Disease

COMBIMIST L RESPICAP should be used with caution in patients with heart problems such as coronary insufficiency, cardiac arrhythmias. Consult your doctor before taking COMBIMIST L RESPICAP.

Interactions

A. Drug-Drug interactions:

Before taking COMBIMIST L RESPICAP, inform your doctor if you are taking any of the following medicine:

• medicines used to manage high blood pressure such as beta-adregenic/receptor blocking agents (Ex. propanolol, metoprolol, atenolol)
• anticholinergic agents (medicines used to block acetylcholine) Ex. atropine, benztropine
• diuretics (used to manage high blood pressure) Ex. chlorothiazide, chlorthalidone
• monoamine oxidase inhibitors/tricyclic antidepressants (medicines used to manage depression) Ex. selegiline, phenelzine, amitriptyline, imipramine
• digoxin (medicine used to manage congestive heart failure)

B. Drug–food interactions:

COMBIMIST L RESPICAP is not recommended for use in patients allergic to soyabean, and/or  other related food products such as peanut.

Overdosage:

If you or anyone else accidentally took more of COMBIMIST L RESPICAP, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are seizures, chest pain, high/low blood pressure, fast heartbeat, metabolic acidosis (serious electrolyte disorder), exaggeration of irregular heartbeat, nervousness, headache, tremor, dry mouth, palpitation, nausea, dizziness, fatigue, weakness, sleeplessness, visual accommodation disorder. hypokalaemia (low potassium level in blood), and/or cardiac arrest.

Synopsis

More Information

• Keep COMBIMIST L RESPICAP out of reach of children
• Do not store COMBIMIST L RESPICAP above 30°C

FAQs About COMBIMIST L RESPICAP

What is COMBIMIST L RESPICAP used for?

COMBIMIST L RESPICAP is used to manage chronic obstructive pulmonary disease (inflammatory lung disease that obstructs airflow from lungs) in patients who are on regular bronchodilator (type of medication that makes breathing easy) or who suffer from an evident bronchospasm and require a second bronchodilator for ease of breathing.

What are the side effects of COMBIMIST L RESPICAP?

The most common side effects of taking COMBIMIST L RESPICAP are dry mouth, sore throat, stuffy nose, throat irritation, dizziness, headache, nausea, and/or vomiting. Consult your doctor if any of these symptoms worsens.

How COMBIMIST L RESPICAP works?

COMBIMIST L RESPICAP provides ease in breathing from chronic obstructive pulmonary disease, 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 chronic obstructive pulmonary disease in affected individuals.

How COMBIMIST L RESPICAP should be administered?

Take COMBIMIST L RESPICAP as advised by your physician. It is for inhalation use only. Hold the revolizer at the base and pull back the mouthpiece of revolizer. Remove rotacap from its bottle and insert it in the rotacap chamber. Close the mouthpiece firmly and breath out fully through the mouth. Position the mouthpiece between the teeth and close the lips tightly around it. Sit/stand upright and keep your head straight and breath in through the mouth rapidly and deeply. Remove the revolizer from your mouth and hold your breath for 10 seconds/as long as its comfortable. After use, open the mouthpiece and discard the empty rotacap. Repeat this step after every use. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.

Can COMBIMIST L RESPICAP be used in pregnant and breastfeeding women?

No, COMBIMIST L RESPICAP is generally not recommended for use in pregnant and breastfeeding women unless it is clearly necessary.  Consult your doctor before using COMBIMIST L RESPICAP.

References

1. K.D. Tripathi. Anticholinergic Drugs and Drugs Acting on Autonomic Ganglia. Essentials of medical pharmacology. Seventh edition. 2013. Page- 116.

2. Kabra. Management of Acute Severe Asthma. Allergy and Asthma. Edition. 2009.  Page- 35.

3. Hongzhen Xu, Lin Tong, Peng Gao,  Yan Hu, Huijuan Wang, Zhimin Chen, Luo Fang. Combination of ipratropium bromide and salbutamol in children and adolescents with asthma: A meta-analysis. NIH National Library of Medicine. National Center for Biotechnology Information. PMC PubMed Central. [Revised in February 2021] [Accessed on 27th May 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901745/

4. CiplaMed. DUOLIN Rotacaps. [Revised in August 2018] [Accessed on 27th May 2022] https://www.ciplamed.com/content/duolin-rotacaps

5. CiplaMed. DUOLIN Rotacaps. [Revised in October 2015] [Accessed on 27th May 2022] https://www.ciplamed.com/content/duolin-forte-rotacaps

Useful Diagnostic Tests

• Spirometry
• Chest X-ray
• CT scan

Author Details

Written By Dr. K .AZEEM HUSSAIN - B.D.S

Reviewed By Dr. Sankara Babu Gorle - MBBS, MD(Pharmacology) View profile

Last updated on 26 Nov 2022 | 07:14 PM(IST)