Combair Hfa 100 MCG+20 MCG/PUFF


Combair Hfa 100 MCG+20 MCG/PUFF


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Patients with chronic obstructive pulmonary disease (COPD) who are taking a daily aerosol bronchodilator but still develop bronchospasm and need a second bronchodilator should use this inhalation aerosol.


This inhalation spray is a combination of salbutamol (as sulfate) and ipratropium bromide. It is an ecological inhaler based on hydrofluoroalkane (HFA). Because it does not contain chlorofluorocarbon (CFC) as a propellant, this is one of the main causes of ozone layer depletion.

Salbutamol is a short-acting β2 adrenergic bronchodilator and ipratropium bromide is an anticholinergic bronchodilator. When used in combination, ipratropium bromide prevents increased intracellular cyclic guanosine phosphate concentration, which is caused by the interaction of acetylcholine with muscarinic receptors in bronchial smooth muscle. This inhaled aerosol is expected to reduce bronchospasm through two distinct mechanisms of anticholinergic (parasympathetic) and sympathomimetic, thereby maximizing the treatment response of patients with chronic obstructive pulmonary disease (COPD). The simultaneous administration of anticholinergics (ipratropium bromide) and β2 sympathomimetic (salbutamol) is intended to benefit patients by producing a greater bronchiectasis effect than the recommended dose of either drug alone.

Dosage & Administration

Adult dose (Including the elderly): 2 puffs of Salpium 4 times a day (Patients may take additional puffs as required but the total number of puffs should not exceed 12 in 24 hours). Or as directed by the physician.


This inhaled aerosol has been used at the same time as other drugs, including sympathomimetic bronchodilators, methylxanthines, and steroids commonly used to treat COPD. No formal drug interaction studies have been performed with this inhaled spray and these or other medications commonly used to treat COPD. Ipratropium bromide and other anticholinergic and sympathomimetic drugs should be used with caution, which may increase the risk of cardiovascular adverse reactions. In patients using non-potassium-sparing diuretics, monoamine oxidase inhibitors, or tricyclic antidepressants, medications containing β2 agonists, such as this inhaled spray, should be used with extreme caution.


Patients having a history of allergy to Soya-Lecithin or related food products such as soybean and peanut should avoid using this inhalation aerosol. Patients who are hypersensitive to any other components of the therapeutic product, as well as atropine or its derivatives, should avoid using this inhalation aerosol.

Side Effects

Due to the presence of salbutamol, mild tremors, and headaches have been reported. These usually disappear with continued treatment. There are very rare reports of the treatment of muscle spasms, and allergic reactions including angioedema, urticaria, bronchospasm, and hypotension.

There are few reports of headache, flu, chest pain, nausea, dyspnea, cough, pharyngitis, and sinusitis caused by the presence of ipratropium bromide.

Pregnancy & Lactation

Ipratropium Bromide: Pregnancy category B. Studies have demonstrated no teratogenic effects as a result of ipratropium.

Salbutamol: Pregnancy category C. Salbutamol has been shown to be teratogenic in animals.

There are, however, no adequate and well-controlled studies of Salpium Inhalation Aerosol (Salbutamol and Ipratropium Bromide combination) in pregnant women. This inhalation aerosol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether the components of the Salpium InhalationAerosol are excreted in human milk. As many drugs are excreted in human milk, Salpium should be cautiously administered to a nursing mother.

Precautions & Warnings

Do not puncture, break or incinerate the pressurized canister even when apparently empty. Avoid storage in direct sunlight or heat. Store below 30°C. Keep away from eyes. Keep away from children.

Therapeutic Class

Combined bronchodilators.

Storage Conditions

Do not store above 30°C. Protect from light and high humidity. Keep out of the reach of children.


Salbutamol + Ipratropium bromide

Pharmaceuticals name

ACI Limited