Aerosol Characteristics and Physico-Chemical Compatibility of Combivent® (Containing Salbutamol and Ipratropium Bromide) Mixed with Three Other Inhalants: Budesonide, Beclomethasone or N-Acetylcysteine

Zhang, Rui; Hu, Junhua; Deng, Liangjun; Li, Sha; Chen, Xi; Liu, Fei; Wang, Shanping; Abdul, Khaja Shameem Mohammed; Beng, Huimin; Tan, Wen

doi:10.3390/pharmaceutics12010078

Cited by 8 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The administration of combined inhalation solutions is frequently used in the treatment of pulmonary diseases. At present, only a few publications have focused on the impact generated by simultaneous inhalation [10,12,14,29]. To our knowledge, this study is the first systematic one addressing the physicochemical compatibility and aerosol characteristics of Atrovent ® mixed with Ventolin ® , Bricanyl ® , Pulmicort ® , and Fluimucil ® .…”

Section: Discussionmentioning

confidence: 97%

“…Although most of the previous studies have proven the advantages of combination therapies in terms of addictive/synergistic pharmacological activities [ 6 , 7 , 8 , 9 ], the potential incompatibility between excipients and/or drugs in different commercial products may lead to adverse effects and toxicity, which should not be ignored. Nevertheless, little research has been carried out on the physicochemical compatibility of mixtures [ 10 , 11 ], especially on aerosol characteristics [ 12 , 13 , 14 ], which may significantly impact drug absorption and subsequently inhalation efficacy. A study has shown that Pulmozymel ® (brand of dornase alfa) should not be used along with Atrovent ® (brand of ipratropium) or Sultanol ® (brand of albuterol) because benzalkonium chloride (BAC) and disodium edetate used as excipients in Atrovent ® or Sultanol ® may destroy the integrity of dornase alfa, thereby causing microbiological instability [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Compatible Stability and Aerosol Characteristics of Atrovent® (Ipratropium Bromide) Mixed with Salbutamol Sulfate, Terbutaline Sulfate, Budesonide, and Acetylcysteine

Chen

Zhang

et al. 2020

Pharmaceutics

View full text Add to dashboard Cite

(1) Background: It is common practice in the treatment of respiratory diseases to mix different inhalation solutions for simultaneous inhalation. At present, a small number of studies have been published that evaluate the physicochemical compatibility and aerosol characteristics of different inhalation medications. However, none of them studied Atrovent®. Our work aims to address the lack of studies on Atrovent®. (2) Methods: Portions of admixtures were withdrawn at certain time intervals after mixing and were tested by pH determination, osmolarity measurement, and high-performance liquid chromatography (HPLC) assay of each active ingredient as measures of physicochemical compatibility. The geometrical and aerosol particle size distribution, active drug delivery rate, and total active drug delivered were measured to characterize aerosol behaviors. (3) Results: During the testing time, no significant variation was found in the pH value, the osmotic pressure, or the active components of admixtures. With the increase in nebulization volume after mixing, fine particle dose (FPD) and total active drug delivered showed statistically significant improvements, while the active drug delivery rate decreased compared to the single-drug preparations. (4) Conclusions: These results endorse the physicochemical compatibility of Atrovent® over 1 h when mixed with other inhalation medications. Considering aerosol characteristics, simultaneous inhalation is more efficient.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Compatible Stability and Aerosol Characteristics of Atrovent® (Ipratropium Bromide) Mixed with Salbutamol Sulfate, Terbutaline Sulfate, Budesonide, and Acetylcysteine

Chen

Zhang

et al. 2020

Pharmaceutics

View full text Add to dashboard Cite

show abstract

“…These types of drugs are used in combination to achieve the combined effects of resolving phlegm, relieving asthma, antispasmodic, antibacterial and anti-inflammatory [12,13]. In order to simplify the operating procedures, clinical medical staff often mixes the above three inhalants and atomize them at the same time [14]. After mixing, the investigation of content change and atomization performance requires the use of high-performance liquid chromatography (HPLC).…”

Section: Introductionmentioning

confidence: 99%

HPLC-UV/VIS for Determination of Ipratropium Bromide Mixed with Salbuterol, Beclomethasone Propionate and Budesonide using Dual Wavelength-Detection Method

et al. 2023

View full text Add to dashboard Cite

Background Inhalation preparation involves liquid or solid raw materials for delivering to lungs as aerosol or vapor. The liquid preparation for nebulizer is effective for convenient use and patient compliance and it has been extensively used in the treatment of clinical lung diseases. Clinical staff often mixes the compound ipratropium bromide with beclomethasone propionate and budesonide inhaler but reference values of inhalants for clinical use need to be established for simplifying the operation procedure. The high-performance liquid chromatography (HPLC) method of compound ipratropium bromide solution, beclomethasone propionate suspension and budesonide suspension after mixed atomization was studied. Methods The specificity, linearity, recovery (accuracy), precision and stability of compound ipratropium bromide, beclomethasone propionate and budesonide were tested to verify the developed liquid phase method. Results The developed liquid phase method had high specificity, linear R2≥0,999, recovery (accuracy) RSD (relative standard deviation) less than 2%, precision RSD less than 2,0%, and stability RSD less than 2,0%. Conclusion The liquid phase methodology developed in this study can be used for the determination of compound ipratropium bromide mixed with beclomethasone propionate and budesonide. The current methodology can also be used to provide a reference for the determination of its content after mixing, and further data support for its clinical medication.

show abstract

“…Ipratropium and salbutamol are two agents recommended by the current Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease (GOLD) guidelines for the treatment of chronic obstructive pulmonary disease (COPD) (1). These active substances are usually given to the patient by inhalation (2). For this treatment to be effective, the mask through which the inhaler is applied must fit the face snugly.…”

Section: Introductionmentioning

confidence: 99%

Relationship of inhaled ipratropium and inhaled salbutamol with pupil dilation: A prospective observational study

Akça¹,

İslam²,

Akgün³

et al. 2021

J Exp Clin Med

View full text Add to dashboard Cite

This prospective randomized study aimed to compare the effects of nebulizer drugs on unilateral or bilateral dilation of the pupil that may develop due to mask incompatibility or patient incompatibility in patients receiving inhaled therapy. Following the approval of the local ethics committee, this study was carried out prospectively and observationally in the period from October 1, 2018 to April 1, 2019 in an emergency clinic with an annual capacity of 600,000 patients in a tertiary education and research hospital. The patients were divided into three groups: those given salbutamol alone (200 mcg), those given ipratropium alone (250 mcg/2ml), and those receiving both salbutamol and ipratropium. The pupil diameters of the patients included in the study were measured twice using a pupilometer device at hours 0 and 2 of treatment. Ninety- one patients that received inhaler treatment in the emergency department were included in the study. The process of treatments given to patients with indications was not interrupted. Ipratropium and salbutamol (49.5%) were used together in 45 patients, ipratropium alone in 38 (41.7%), and salbutamol alone in eight (8.8%). When the absolute delta ratios were compared, a statistically significant difference was observed between the patients given salbutamol and those given ipratropium, and between the patients that received salbutamol and those given salbutamol and ipratropium (p=0.001, 95% CI: 1.36-6.11 and p<0.001, 95% CI: 1.51- 6.19, respectively). Salbutamol caused statistically significantly greater pupil diameter changes than the other drugs. Although neurological diagnoses are considered in patients with anisocoria, it should be kept in mind that anisocoria may also be due to the current or the treatment being given.

show abstract

Aerosol Characteristics and Physico-Chemical Compatibility of Combivent® (Containing Salbutamol and Ipratropium Bromide) Mixed with Three Other Inhalants: Budesonide, Beclomethasone or N-Acetylcysteine

Cited by 8 publications

References 20 publications

Compatible Stability and Aerosol Characteristics of Atrovent® (Ipratropium Bromide) Mixed with Salbutamol Sulfate, Terbutaline Sulfate, Budesonide, and Acetylcysteine

Compatible Stability and Aerosol Characteristics of Atrovent® (Ipratropium Bromide) Mixed with Salbutamol Sulfate, Terbutaline Sulfate, Budesonide, and Acetylcysteine

HPLC-UV/VIS for Determination of Ipratropium Bromide Mixed with Salbuterol, Beclomethasone Propionate and Budesonide using Dual Wavelength-Detection Method

Relationship of inhaled ipratropium and inhaled salbutamol with pupil dilation: A prospective observational study

Contact Info

Product

Resources

About