Combimist L Inhaler: Dual-Action Relief for Asthma and COPD Control

Combimist L Inhaler

Price from 51.60 $

Product dosage: 50mcg+20mcg
Package (num)	Per inhaler	Price	Buy
2	$25.80	$51.60 (0%)	🛒 Add to cart
3	$23.22 Best per inhaler	$77.40 $69.66 (10%)	🛒 Add to cart

Combimist L Inhaler is a pressurized metered-dose inhaler (pMDI) containing a fixed-dose combination of Levosalbutamol and Ipratropium Bromide. It is indicated for the treatment of reversible airways obstruction, as in patients with bronchial asthma and chronic obstructive pulmonary disease (COPD), where a combination of bronchodilators is considered appropriate. This inhaler offers the synergistic benefits of a fast-acting beta2-agonist and an anticholinergic agent, providing comprehensive bronchodilation. It is designed for use in patients whose condition is not adequately controlled on a single bronchodilator or who require more convenient administration.

Features

Active Ingredients: Levosalbutamol (Levosalbutamol Sulphate 50 mcg) and Ipratropium Bromide (20 mcg) per puff.
Mechanism of Action: Levosalbutamol is a selective short-acting beta2-adrenergic agonist (SABA) that relaxes bronchial smooth muscle. Ipratropium Bromide is an anticholinergic agent that blocks muscarinic receptors, reducing vagally mediated bronchoconstriction and mucus secretion.
Delivery System: Pressurized Metered-Dose Inhaler (pMDI) with a dose counter for accurate tracking of remaining medication.
Onset of Action: Bronchodilation typically begins within 5-15 minutes of inhalation.
Duration of Action: Relief from bronchospasm can last for up to 4-6 hours.
Presentation: Each canister contains 200 metered doses.

Benefits

Provides rapid and potent relief from acute bronchospasm and breathlessness.
Offers a dual-mechanism approach, targeting different pathways of bronchoconstriction for more comprehensive control than single-agent therapy.
Improves lung function parameters (FEV1, PEFR) effectively, facilitating easier breathing and increased exercise tolerance.
Can reduce the frequency and severity of exacerbations in COPD and asthma patients when used as prescribed.
The integrated dose counter enhances adherence and helps prevent unexpected canister emptiness.
Offers a convenient and portable solution for managing symptoms on the go.

Common use

Combimist L Inhaler is commonly prescribed for the management and prevention of symptoms associated with reversible airways obstruction. Its primary uses include:

Bronchial Asthma: For the relief of acute bronchospasm and as preventative treatment before exercise or exposure to allergens.
Chronic Obstructive Pulmonary Disease (COPD): Including chronic bronchitis and emphysema, for symptomatic relief of dyspnea and wheezing.
It is used on an as-needed basis for symptom relief and should not be considered a substitute for maintenance corticosteroid therapy in persistent asthma.

Dosage and direction

The dosage should be individualized based on the severity of the condition and patient response. It is crucial to instruct patients on the proper inhalation technique.

Adults and children over 12 years: The usual dose is two puffs (inhalations) up to four times a day. The maximum recommended dose is 8 puffs in 24 hours.
Administration Technique:
1. Remove the mouthpiece cover and shake the inhaler well.
2. Breathe out fully, away from the inhaler.
3. Place the mouthpiece between your lips and form a tight seal.
4. Start to breathe in slowly and deeply through your mouth, and simultaneously press down firmly on the canister to release one puff of medication.
5. Continue to breathe in slowly until your lungs are full.
6. Hold your breath for about 10 seconds, or for as long as is comfortable.
7. Breathe out slowly.
8. Wait at least one minute before taking the second puff, if prescribed.
Rinsing the mouth with water after each use is recommended to minimize the risk of oropharyngeal side effects.

Precautions

This inhaler is not indicated for the initial treatment of acute severe episodes of asthma or status asthmaticus, where more intensive therapy is required.
Use with caution in patients with cardiovascular disorders (e.g., coronary artery disease, cardiac arrhythmias, hypertension), hyperthyroidism, diabetes mellitus, phaeochromocytoma, prostatic hyperplasia, or bladder-neck obstruction.
Paradoxical bronchospasm (a sudden worsening of breathing difficulties immediately after inhalation) can occur. If this happens, treatment should be discontinued immediately and alternative therapy instituted.
Be aware of hypokalaemia, which may occur due to beta2-agonist therapy. This effect may be potentiated by xanthine derivatives, steroids, diuretics, and hypoxia. Particular caution is advised in severe asthma.
Immediate hypersensitivity reactions may occur, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, and oropharyngeal edema.

Contraindications

Combimist L Inhaler is contraindicated in patients with:

A history of hypersensitivity to Levosalbutamol, Ipratropium Bromide, Atropine or its derivatives, or any of the excipients (e.g., ethanol, norflurane).
Hypertrophic obstructive cardiomyopathy or tachyarrhythmia.

Possible side effect

Like all medicines, this inhaler can cause side effects, although not everybody gets them.

Common (≥1/100 to <1/10): Headache, tremor, nervousness, dizziness, palpitations, tachycardia, cough, dry mouth, nausea, throat irritation.
Uncommon (≥1/1,000 to <1/100): Hoarseness, dysphonia, vomiting, constipation, blurred vision, difficulty in accommodation, urinary retention.
Rare (≥1/10,000 to <1/1,000): Hypersensitivity reactions (e.g., skin rash, angioedema, laryngospasm), hypokalaemia, hyperglycaemia, muscle cramps, taste perversion, stomatitis, atrial fibrillation, supraventricular tachycardia, chest pain.
Very rare (<1/10,000): Paradoxical bronchospasm, increased intraocular pressure, glaucoma.

Drug interaction

Concomitant use with other medicines can increase the risk of side effects.

Other Beta-adrenergic Drugs: Concomitant use with other sympathomimetic agents may lead to potentiated cardiovascular effects.
Beta-blockers: Non-selective beta-blockers (e.g., propranolol) can antagonize the bronchodilator effect of beta-agonists and may produce severe bronchospasm in asthmatic patients.
Xanthine Derivatives, Steroids, Diuretics: May potentiate the hypokalaemic effect of Levosalbutamol.
Anticholinergic Drugs: Concomitant administration with other anticholinergic-containing drugs (e.g., Tiotropium, Aclidinium) may potentiate anticholinergic adverse effects.
Monoamine Oxidase Inhibitors (MAOIs) and Tricyclic Antidepressants (TCAs): May potentiate the vascular effects of sympathomimetics.

Missed dose

If a dose is missed, it should be taken as soon as remembered.
However, if it is almost time for the next dose, skip the missed dose and go back to the regular dosing schedule.
Do not take a double dose to make up for a forgotten one.

Overdose

Symptoms: Overdosage may manifest as effects primarily attributable to the beta-adrenergic agent (e.g., angina pain, hypertension, hypotension, tachycardia, arrhythmias, nervousness, headache, tremor, dry mouth, palpitation, muscle cramps, nausea, dizziness, fatigue, malaise, hypokalaemia, hyperglycaemia) and/or anticholinergic effects (e.g., blurring of vision, xerostomia, difficulty in accommodation, increased intraocular pressure).
Management: Treatment is symptomatic and supportive. Cardiac monitoring is recommended. Serum potassium levels should be monitored. The use of a cardioselective beta-blocker may be considered, bearing in mind the risk of inducing bronchospasm.

Storage

Store below 30°C. Do not freeze.
Keep the canister away from direct sunlight and heat sources (e.g., radiators, inside a car on a hot day).
Do not puncture or burn the canister, even after it is empty.
Keep out of the sight and reach of children.
The inhaler should be discarded 3 months after removal from the foil pouch or when the dose counter reads “0”, whichever comes first.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or product usage. Never disregard professional medical advice or delay in seeking it because of something you have read here. The product information provided may not be exhaustive or fully updated. Always refer to the latest local prescribing information provided with the medication.

Reviews

“As a respiratory therapist, I find the Combimist L Inhaler to be a highly effective rescue medication for my COPD patients. The dual-action provides quicker and more sustained relief compared to single-agent SABAs. The dose counter is a practical feature that patients appreciate.” – Dr. A. Sharma, Respiratory Specialist
“This inhaler has been a game-changer for managing my exercise-induced asthma. The relief is almost immediate and allows me to continue my activities without fear of an attack. I find it more effective than my previous reliever inhaler.” – Verified Patient
“From a pharmacological standpoint, the combination is rational and well-tolerated in most patients. It’s a valuable tool in our arsenal for managing moderate to severe reversible airway obstruction, particularly in COPD where anticholinergics are a first-line therapy.” – Clinical Pharmacologist
“I’ve been using Combimist L for my chronic bronchitis for over a year. It significantly reduces my wheezing and shortness of breath on bad days. I haven’t experienced any notable side effects aside from a occasional dry mouth, which is manageable.” – Verified Patient