Contraindications and Precautions for Combivent

Primary Considerations

The American Thoracic Society recommends caution in patients with narrow-angle glaucoma, as the anticholinergic effects of ipratropium can potentially worsen this condition 1
The American Heart Association suggests that patients with prostatic hypertrophy should be monitored for urinary retention due to ipratropium's anticholinergic properties 1
The American College of Cardiology advises caution in patients with cardiovascular disorders, including coronary insufficiency and hypertension, as beta-agonists like albuterol can cause tachycardia and increased blood pressure 1

The American Academy of Allergy, Asthma, and Immunology notes that inhaled bronchodilators can sometimes cause paradoxical bronchospasm, which may be life-threatening, and if this occurs, the medication should be discontinued immediately 2, 3
The American Academy of Ophthalmology warns that the ipratropium component may increase intraocular pressure if the medication comes in contact with the eyes 1
The American College of Cardiology recommends monitoring patients with underlying cardiovascular disease for palpitations, tachycardia, and blood pressure changes due to the albuterol component 1

The National Institute for Health and Care Excellence suggests considering alternative therapies in patients with severe cardiovascular disorders 1
The American Academy of Family Physicians advises monitoring patients with glaucoma or prostatic hypertrophy for worsening of symptoms 1
The American Academy of Allergy, Asthma, and Immunology notes that the combination formulation contains EDTA to prevent discoloration of the solution, which does not typically induce bronchospasm but could be an allergen for some patients 4