Ipratropium-Albuterol

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Drug Information

Common brand names:

Combivent, DuoNeb

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Calcium

    Therapeutic amounts of intravenous salbutamol (albuterol) in four healthy people were associated with decreased plasma levels of calcium, magnesium, phosphate, and potassium.1 Decreased potassium levels have been reported with intramuscular and subcutaneous albuterol administration.2 How frequently this effect occurs is not known; whether these changes are preventable through diet or supplementation is also unknown.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Magnesium

    Therapeutic amounts of intravenous salbutamol (albuterol) in four healthy people were associated with decreased plasma levels of calcium, magnesium, phosphate, and potassium.3 Decreased potassium levels have been reported with oral,4 intramuscular, and subcutaneous albuterol administration.5 How frequently this effect occurs is not known; whether these changes are preventable through diet or supplementation is also unknown.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Phosphate

    Therapeutic amounts of intravenous salbutamol (albuterol) in four healthy people were associated with decreased plasma levels of calcium, magnesium, phosphate, and potassium.6 Decreased potassium levels have been reported with intramuscular and subcutaneous albuterol administration.7 How frequently this effect occurs is not known; whether these changes are preventable through diet or supplementation is also unknown.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Potassium

    Therapeutic amounts of intravenous salbutamol (albuterol) in four healthy people were associated with decreased plasma levels of calcium, magnesium, phosphate, and potassium.8 Decreased potassium levels have been reported with oral,9 intramuscular, and subcutaneous albuterol administration.10 How frequently this effect occurs is not known; whether these changes are preventable through diet or supplementation is also unknown.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • none

Support Medicine

  • Coleus

    A test tube study demonstrated that the bronchodilating effects of salbutamol (albuterol) were significantly increased by the addition of forskolin, the active component of the herb Coleus forskohlii. 11 The results of this preliminary research suggest that the combination of forskolin and beta-agonists such as albuterol might provide an alternative to raising the doses of the beta-agonist drugs as they lose effectiveness. Until more is known, coleus should not be combined with albuterol without the supervision of a doctor.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required 

  • Soy

    Atrovent® and Combivent® for oral inhalation contain soy lecithin. Rarely, people very sensitive to soy have reacted to these drugs,12 and life-threatening anaphylactic reaction is possible, though extremely rare. Ipratropium bromide nasal spray and solution for inhalation contain no soy lecithin.

  • Digitalis

    Digitalis (Digitalis lanata, Digitalis purpurea) refers to a family of plants (commonly called foxglove) that contain digitalis glycosides, chemicals with actions and toxicities similar to the prescription drug digoxin.

    In a small study of salbutamol (albuterol) in people receiving digoxin, albuterol was associated with decreased serum digoxin levels.13 No interactions between albuterol and digitalis have been reported. Until more is known, albuterol and digitalis-containing products should be used only under the direct supervision of a doctor trained in their use.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Phillips PJ, Vedig AE, Jones PL, et al. Metabolic and cardiovascular side effects of the beta 2-adrenoceptor agonists salbutamol and rimiterol. Br J Clin Pharmacol 1980;9:483-91.

2. Spector SL. Adverse reactions associated with parenteral beta agonists: serum potassium changes. N Engl Reg Allergy Proc 1987;8:317-22.

3. Phillips PJ, Vedig AE, Jones PL, et al. Metabolic and cardiovascular side effects of the beta 2-adrenoceptor agonists salbutamol and rimiterol. Br J Clin Pharmacol 1980;9:483-91.

4. Edner M, Jogestrand T. Oral salbutamol decreases serum digoxin concentration. Eur J Clin Pharmacol 1990;38:195-7.

5. Spector SL. Adverse reactions associated with parenteral beta agonists: serum potassium changes. N Engl Reg Allergy Proc 1987;8:317-22.

6. Phillips PJ, Vedig AE, Jones PL, et al. Metabolic and cardiovascular side effects of the beta 2-adrenoceptor agonists salbutamol and rimiterol. Br J Clin Pharmacol 1980;9:483-91.

7. Spector SL. Adverse reactions associated with parenteral beta agonists: serum potassium changes. N Engl Reg Allergy Proc 1987;8:317-22.

8. Phillips PJ, Vedig AE, Jones PL, et al. Metabolic and cardiovascular side effects of the beta 2-adrenoceptor agonists salbutamol and rimiterol. Br J Clin Pharmacol 1980;9:483-91.

9. Edner M, Jogestrand T. Oral salbutamol decreases serum digoxin concentration. Eur J Clin Pharmacol 1990;38:195-7.

10. Spector SL. Adverse reactions associated with parenteral beta agonists: serum potassium changes. N Engl Reg Allergy Proc 1987;8:317-22.

11. Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51:181-6.

12. Threlkeld DS, ed. Respiratory Drugs, Respiratory Inhalant Products, Anticholinergics, Ipratropium Bromide. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1996, 182f-2g.

13. Edner M, Jogestrand T. Oral salbutamol decreases serum digoxin concentration. Eur J Clin Pharmacol 1990;38:195-7.