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Pulmodual: Ipratropium bromide + Salbutamol (Pulmodual) should be used with caution in patients with prostatic hypertrophy, bladder neck obstruction, narrow angle glaucoma; risk of paradoxical bronchospasm usually occurs with the first dose of nebulized solution, it should be inhaled under medical supervision; hyperthyroidism, cardiovascular disease, arrhythmias, susceptibility to QT-interval prolongation, hypertension and diabetes mellitus.
Potentially serious hypokalaemia may result from beta2 agonist therapy, possibly through intracellular shunting, which can produce adverse cardiovascular effects. The decrease in serum potassium levels is usually transient, not requiring supplementation.
Pulmodual MDI: The management of asthma should normally follow a stepwise programme and patient response should be monitored clinically and by lung function tests.
Information for Patients: Patients should be cautioned to avoid spraying the aerosol into their eyes and be advised that this may result in precipitation or worsening of narrow-angle glaucoma, mydriasis, increased intraocular pressure, acute eye pain or discomfort, temporary blurring of vision, visual halos or colored images in association with red eyes from conjunctival and corneal congestion. Patients should also be advised that should any combination of these symptoms develop, they should consult their physician immediately.
The action of Salbutamol Sulphate and Ipratropium Bromide Inhalation should last 4 to 5 hours or longer. Salbutamol Sulphate and Ipratropium Bromide Inhalation should not be used more frequently than recommended. Do not increase the dose or frequency of Salbutamol Sulphate and Ipratropium Bromide Inhalation without consulting the physician. If the patient finds that treatment with Salbutamol Sulphate and Ipratropium Bromide Inhalation becomes less effective for symptomatic relief, the symptoms become worse, and/or the patient needs to use the product more frequently than usual, medical attention should be sought immediately. While the patient is taking Salbutamol Sulphate and Ipratropium Bromide Inhalation, other inhaled drugs should be taken only as directed by the physician. If the patient is pregnant or nursing, contact the physician about use of Salbutamol Sulphate and Ipratropium Bromide Inhalation. Appropriate use of Salbutamol Sulphate and Ipratropium Bromide Inhalation includes an understanding of the way it should be administered. Since dizziness, accommodation disorder, mydriasis, and blurred vision may occur with use of Salbutamol Sulphate and Ipratropium Bromide Inhalation, patients should be cautioned about engaging in activities requiring balance and visual acuity such as driving a car or operating appliances or machinery.
Precautions: Before using this product, tell the doctor or the pharmacist if the patient is allergic to salbutamol or Ipratropium or if the patient has any other allergies.
Before using this product, tell the doctor the patient's medical history, especially of: diabetes, heart disease (e.g., irregular heartbeat, coronary insufficiency), high blood pressure, glaucoma, low potassium blood level (hypokalemia), seizure, overactive thyroid (hyperthyroidism), urination problems (e.g., due to enlarged prostate, urinary retention).
This drug may make the patient dizzy. If accidentally sprayed into the eyes, it may also cause temporary blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until the patient is sure the patient can perform such activities safely. Limit alcoholic beverages.
Before having surgery, tell the doctor or dentist that the patient is using this medication.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with the doctor.
It is not known whether this drug passes into breast milk. Consult the doctor before breast-feeding.
