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The ECG changes and/or hypokalemia which may result from the administration of non-potassium sparing diureticssuch as loop or thiazide diureticscan be acutely worsened by beta-agonistsespecially when the recommended dose of the beta-agonist is exceededAlthough the clinical significance of these effects is not knowncaution is advised in the co-administration of beta-agonist-containing drugssuch as COMBIVENT Inhalation Aerosolwith non-potassium sparing diureticsConsider monitoring potassium levels.

Albuterol is longer acting than isoproterenol in most patients because it is not a substrate for the cellular uptake processes for catecholamines nor for metabolism by catechol-O-methyl transferaseInsteadthe drug is conjugatively metabolized to albuterol 4O-sulfate.

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 glaucomamydriasisincreased intraocular pressureacute eye pain or discomforttemporary blurring of visionvisual halos or colored images in association with red eyes from conjunctival and corneal congestionPatients should also be advised that should any combination of these symptoms developthey should consult their physician immediately.

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combivent respimat will deliver 120 puffs and last 30 days if used at 1 puff four times daily.