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COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION

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How to use COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Leaflet:information for theuser

COMBIPRASAL 0.5 mg/2.5 mg

nebulizer inhalation solution

Read the entire leaflet carefully before startingto usethis medication, as it contains important information for you.

  • Keep this leaflet, as you may need to read it again. If you have any questions, consult your doctor or pharmacist.
  • This medication has been prescribed to you only, and you should not give it to others, even if they have the same symptoms as you, as it may harm them.
  • If you experience side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. See section 4.

Contents of the leaflet

  1. What is COMBIPRASAL and what is it used for
  2. What you need to know before starting to use COMBIPRASAL
  3. How to use COMBIPRASAL
  4. Possible side effects
  5. Storage of COMBIPRASAL
  6. Package contents and additional information

1. What is COMBIPRASAL and what is it used for

This medication comes in single-dose vials containing a clear, colorless solution for nebulizer inhalation. Combiprasal contains 0.5 mg of ipratropium bromide (as monohydrate) and 2.5 mg of salbutamol (as sulfate).

COMBIPRASAL belongs to a group of medications called bronchodilators that help open the airways in the lungs, making it easier for you to breathe.

It is indicated for the treatment of reversible bronchospasm associated with chronic obstructive pulmonary disease (COPD) in patients who require more than one bronchodilator.

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2. BEFORE USING COMBIPRASAL

Do not use COMBIPRASAL

  • If you are allergic (hypersensitive) to ipratropium bromide, salbutamol sulfate, atropine, or any other component of Combiprasal.
  • If you have a heart condition called hypertrophic obstructive cardiomyopathy (when the heart does not work properly due to inflammation of the heart muscle).
  • If you have a rapid and irregular heartbeat (known as tachyarrhythmia).

Warnings and precautions

Lactic acidosis has been observed with high therapeutic doses of salbutamol, mainly in patients treated for acute bronchospasm (see sections 3 and 4). The increase in lactate levels can lead to respiratory failure and hyperventilation.

Tell your doctor immediately if you feel that the medication is not working as usual and you need to use the nebulizer more often than your doctor has recommended.

Be careful with COMBIPRASAL

Tell your doctor before starting treatment with this medication:

  • If you have a history of heart disease, irregular heartbeat, or angina pectoris.
  • If you are pregnant, planning to become pregnant, or breastfeeding.
  • Immediate allergic reactions, such as hives, angioedema, skin rash, cough, wheezing, and difficulty breathing (bronchospasm) and swelling of the mouth and throat (oropharyngeal edema), may occur.
  • If you experience acute difficulty breathing that worsens rapidly, you should consult your doctor immediately.
  • If you have diabetes.
  • If you have an overactive thyroid gland.
  • If you have a condition called pheochromocytoma, a tumor that produces chemicals that can cause fatigue, high blood pressure, and rapid heartbeat.
  • If you have cystic fibrosis, as you may be more prone to gastrointestinal motility disorders.
  • If you are prone to increased eye pressure (narrow-angle glaucoma). You should avoid getting the solution in your eyes. This can cause eye pain or discomfort, blurred vision, halos, or colored images, along with eye redness. If you experience any of these symptoms, you should stop treatment and consult your doctor immediately.
  • If you have prostate enlargement (hyperplasia).
  • If you have a disorder that makes it difficult to pass urine.

Using other medications

Tell your doctor or pharmacist if you are taking or have recently taken other medications, including those purchased without a prescription.

Some medications may interact with Combiprasal. It is essential to inform your doctor if you are taking any of the following medications:

  • Xanthine derivatives, such as theophylline.
  • Medications containing beta-blockers, such as propranolol or timolol, as they may reduce the effectiveness of this medication.
  • Diuretics, such as furosemide or indapamide.
  • Digoxin, used to treat heart failure.
  • Other medications that help you breathe more easily, such as terbutaline.
  • Medications containing anticholinergics (used to treat asthma, irritable bowel syndrome, Parkinson's disease, and incontinence).
  • Certain medications for treating depression (known as monoamine oxidase inhibitors and tricyclic antidepressants).
  • Anesthetic medications, such as halothane.

Pregnancy and breastfeeding

Consult your doctor or pharmacist before taking any medication.

The use of Combiprasal is not recommended during pregnancy or breastfeeding. If necessary, your doctor will assess the convenience of using it.

Driving and using machines

No studies have been conducted on the effects on the ability to drive and use machines. However, do not drive or use machines until you know how the medication affects you.

Use in athletes

Athletes are informed that this medication contains salbutamol, which may result in a positive doping test.

3. How to use COMBIPRASAL

Follow your doctor's instructions for administering Combiprasal exactly. Consult your doctor or pharmacist if you have any questions.

Combiprasal should be used as needed and not on a regular basis.

If your asthma is active (for example, you have symptoms or frequent crises, such as difficulty breathing that makes it hard to speak, eat, or sleep, cough, wheezing, chest tightness, or limited physical capacity), you should inform your doctor immediately, who may start you on a medication or increase the treatment dose, such as an inhaled corticosteroid, to control your asthma.

Tell your doctor as soon as possible if your medication seems to be not working as well as usual (for example, if you need higher doses to relieve your respiratory problems or if your inhaler does not provide relief for at least 3 hours), as your asthma may be worsening, and you may need a different medication.

If you use Combiprasal more than twice a week to treat your asthma symptoms, excluding preventive use before exercise, this indicates poorly controlled asthma and may increase the risk of severe asthma attacks (asthma worsening) that can have serious complications and can be life-threatening. You should contact your doctor as soon as possible to review your asthma treatment.

If you use a daily medication to reduce inflammation in your lungs, such as an "inhaled corticosteroid," it is essential to continue using it regularly, even if you feel better.

Your doctor may instruct you to use your nebulizer regularly, either daily or only when you have difficulty breathing.

Adults, including the elderly, and children over 12 years:The recommended dose is 1 single-dose vial, 3 or 4 times a day. In severe cases, your doctor may increase the dose to 1 single-dose vial, 4 times a day.

There is no experience with the use of this medication in children under 12 years.

If you do not achieve significant improvement or your condition worsens, you should consult your doctor.

Instructions for correct administration of the preparation:

Your medication is for inhalation via a nebulizer or ventilator and should not be injected or swallowed.

Hands holding and separating white tablet blisters and hands opening a blister with a fingernail

  1. Prepare your nebulizer according to the manufacturer's instructions and your doctor's instructions. Ensure the nebulizer device is clean.
  1. Take a plastic strip with vials from the box, open it, and remove one of the vials (Fig. 1). Leave the remaining vials on the strip and return it to the box.
  1. Take the vial and open it by twisting the top (Fig.2).
  1. Unless your doctor gives you other instructions, add all the liquid from the plastic vial to the nebulizer solution container.
  1. Use the nebulizer according to your doctor's instructions. Discard the empty plastic vial.
  1. After using the nebulizer, clean it according to the manufacturer's instructions.

If you think the effect of Combiprasal is too strong or too weak, tell your doctor or pharmacist.

If you use more COMBIPRASAL than you should:

If you use more than you should, you may experience changes in heart rhythm, palpitations, tremors, increased or decreased blood pressure, changes in pulse, angina pectoris, hot flashes, dry mouth, and visual accommodation disorders.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone 91 562 04 20, indicating the medication and the amount administered. Contact your doctor or the nearest Hospital Emergency Service. Bring this leaflet or a vial of this medication with you, so the treating doctor knows what you are taking.

If you forget to use COMBIPRASAL

If you forget to use Combiprasal, use the next dose when it is due or sooner if you start to have difficulty breathing.

Do not take a double dose to make up for forgotten doses.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medications, Combiprasal can cause side effects, although not everyone will experience them.

The following side effects have been reported:

Common (affect 1 in 10 people)

  • Nervousness
  • Headache (cephalalgia)
  • Cough
  • Dry mouth

Uncommon (affect less than 1 in 100 people)

  • Dizziness
  • Tremors
  • Hoarseness
  • Changes in heart rhythm (tachycardia, palpitations, arrhythmia)
  • Throat irritation
  • Nausea
  • Urinary retention

Rare (affect less than 1 in 1000 people)

  • Allergic reactions (hypersensitivity)
  • Decreased potassium levels in the blood (hypokalemia)
  • Psychiatric disorders
  • Increased intraocular pressure
  • Narrow-angle glaucoma
  • Eye pain
  • Pupil dilation (mydriasis)
  • Paradoxical bronchospasm
  • Vomiting
  • Gastrointestinal motility disorders
  • Skin rash and increased sweating
  • Muscle pain and weakness
  • Muscle cramps
  • Increased or decreased blood pressure

The following side effects may also occur, but their frequency is unknown:

  • Some people may occasionally experience chest pain (due to heart problems such as angina pectoris). Tell your doctor if you develop these symptoms while being treated with COMBIPRASAL, but do not stop taking this medication unless your doctor tells you to.
  • A condition known as lactic acidosis, which can cause stomach pain, hyperventilation, difficulty breathing, despite possible improvement in wheezing, cold hands and feet, irregular heartbeat, or thirst.

Reporting side effects:

If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. You can also report them directly through the Spanish Medication Surveillance System for Human Use: http://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medication.

5. Storage of COMBIPRASAL

Keep out of the reach and sight of children.

Do not store above 25°C.

Keep in the outer packaging to protect from light.

The vials should be opened immediately before use, and any remaining solution should be discarded.

Expiry date:

Do not use Combiprasal after the expiry date stated on the packaging after "Cad.:" The expiry date is the last day of the month indicated.

Medications should not be disposed of through wastewater or household waste. Deposit the packaging and any unused medications in the pharmacy's SIGRE collection point. If you have any questions, ask your pharmacist how to dispose of the packaging and medications you no longer need. This will help protect the environment.

6. ADDITIONAL INFORMATION

Combiprasal composition:

  • The active ingredients are ipratropium bromide and salbutamol.
  • The other ingredients (excipients) are: sodium chloride, hydrochloric acid, and water for injection.

Each 2.5 ml vial of Combiprasal contains 0.5 mg of ipratropium bromide (equivalent to 0.52 mg of ipratropium bromide monohydrate) and 2.5 mg of salbutamol (equivalent to 3 mg of salbutamol sulfate).

Appearance of the product and package contents:

Combiprasal is presented in strips of 10 vials containing a clear, colorless solution inside an aluminum pouch.

Each box contains 20 vials.

Marketing authorization holder:

Laboratorio ALDO-UNIÓN, S.L.

Baronessa de Maldà, 73

08950 Esplugues de Llobregat

Barcelona (Spain)

Manufacturer:

Laboratoire Unither

Espace Industriel Nord

151 rue André Durouchez-CS 28028

80084 AMIENS Cedex 2

France

This leaflet was approved in February 2018.

Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

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Lina Travkina

Family medicine 13 years exp.

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

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  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
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Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
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  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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Yevgen Yakovenko

General surgery 12 years exp.

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

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Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
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Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

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Anna Biriukova

General medicine 6 years exp.

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

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General internal medicine and preventive care:
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Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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Frequently Asked Questions

Is a prescription required for COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION?
COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION?
The active ingredient in COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION is salbutamol and ipratropium bromide. This information helps identify medicines with the same composition but different brand names.
How much does COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION cost in pharmacies?
The average pharmacy price for COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION is around 13.88 EUR. Prices may vary depending on the manufacturer and dosage form.
Who manufactures COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION?
COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION is manufactured by Laboratorio Aldo Union S.L.. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to COMBIPRASAL 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION?
Other medicines with the same active substance (salbutamol and ipratropium bromide) include IPRATROPIUM BROMIDE/SALBUTAMOL GENETIC 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION, IPRATROPIUM BROMIDE/SALBUTAMOL NEUTEC 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION, IPRATROPIUM BROMIDE/SALBUTAMOL CIPLA 0.5 mg/2.5 mg SOLUTION FOR NEBULIZER INHALATION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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