Campbell's recent article1 in the ARCHIVES demonstrated that the use of scheduled dosing with the combination product ipratropium bromide and albuterol sulfate (Combivent) is more effective in patients with chronic obstructive pulmonary disease (COPD) than scheduled albuterol base alone. This finding is not surprising, nor should it change the way one manages patients with COPD. The American Thoracic Society and the National Lung Health Education Program advocate scheduled dosing with ipratropium as initial therapy for patients with COPD who have mild to moderate continuing symptoms.2,3 Albuterol is recommended concomitantly with ipratropium on an as-needed basis for symptomatic relief, or as scheduled dosing when a patient requires continuous treatment.
Crouch MA, Raney CRK, Davis K. Use of the Combination Product Ipratropium and Albuterol in Chronic Obstructive Pulmonary Disease. Arch Intern Med. 1999;159(13):1499. doi:
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.