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Avoid administration of combiventrespimat with other anticholinergic-containing drugs 7.

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1Product InformationCombiventalbuterol-ipratropiumBoehringer-IngelheimRidgefieldCT.

Activation of beta 2adrenergic receptors on airway smooth muscle leads to the activation of adenylyl cyclase and to an increase in the intracellular concentration of cyclic-35adenosine monophosphatecyclic AMPThis increase of cyclic AMP leads to the activation of protein kinase Awhich inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrationsresulting in relaxationAlbuterol relaxes the smooth muscles of all airwaysfrom the trachea to the terminal bronchiolesAlbuterol acts as a functional antagonist to relax the airway irrespective of the spasmogen involvedthus protecting against all bronchoconstrictor challengesIncreased cyclic AMP concentrations are also associated with the inhibition of release of mediators from mast cells in the airway.

Activation of beta 2adrenergic receptors on airway smooth muscle leads to the activation of adenylyl cyclase and to an increase in the intracellular concentration of cyclic-35adenosine monophosphatecyclic AMPThis increase of cyclic AMP leads to the activation of protein kinase Awhich inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrationsresulting in relaxationAlbuterol relaxes the smooth muscles of all airwaysfrom the trachea to the terminal bronchiolesAlbuterol acts as a functional antagonist to relax the airway irrespective of the spasmogen involvedthus protecting against all bronchoconstrictor challengesIncreased cyclic AMP concentrations are also associated with the inhibition of release of mediators from mast cells in the airway.

Since dizzinessaccommodation disordermydriasisand blurred vision may occur with use of COMBIVENTpatients should be cautioned about engaging in activities requiring balance and visual acuity such as driving a car or operating appliances or machinery.

Caution is advised in the co-administration of COMBIVENT Inhalation Aerosol and other sympathomimetic agents due to the increased risk of adverse cardiovascular effects.

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