SAMA + SABA nebule
Ipratropium with salbutamol
Brand names: Combivent, Ipramol Steri-Neb
Adult dose
Dose: Nebulised: 1 vial (500 micrograms ipratropium + 2.5mg salbutamol) TDS-QDS PRN
Route: Nebulised
Frequency: PRN
Clinical pearls
- Acute exacerbation COPD/asthma
- Combination 'back-to-back' nebs in life-threatening asthma
Contraindications
- Hypersensitivity
- Severe cardiovascular disease (caution)
Side effects
- Tachycardia
- Tremor
- Dry mouth
- Hypokalaemia
- Lactic acidosis (high-dose salbutamol)
Interactions
- β-blockers
- QT-prolonging drugs
Monitoring
- K+
- HR
- Lactate
Reference: BNF; BTS/SIGN; https://bnf.nice.org.uk/drugs/ipratropium-with-salbutamol/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024