What Are Combination Agents?

You might be prescribed combination agents to treat your COPD; a combination of various drugs that each work to relieve different aspects of the disease. Here’s a quick tutorial on the combination agents that are widely used today: Combivent®, Advair®, Symbicort®,, Duoneb®, Stiolto, Breo and Anoro.

Combivent is the brand name for albuterol sulfate and ipratropium bromide (Atrovent®). It’s delivered in a slow-moving mist inhaler; it contains two different kinds of bronchodilators that work additively to open up airways, which helps alleviate shortness of breath. It’s relatively fast-acting, but is classified as a short-acting bronchodilator combination.  Its actions last only a few hours.

Advair is the brand name for a combination of fluticasone propionate (Flovent®) and salmeterol (Serevent®), and comes as a dry powder inhaler. Its effect is to open up the airways (bronchodilate) and to reduce airway swelling (inflammation).  It is classified as a long acting agent and is taken twice a day.

Symbicort also is a metered dose inhaler and, like Advair, opens up the airways and reduces swelling. Symbicort is the brand name for a combination of formoterol (Foradil®) and budesonide (Pulmicort®) and is taken twice a day.

Duoneb is available as a nebulizer solution and, like Combivent, it opens up airways and helps alleviate shortness of breath. Duoneb is the brand name for a combination of ipratropium bromide and albuterol sulfate.

Stiolto contains both tiotropium and olodaterol and is delivered in a slow-moving mist inhaler.  These two bronchodilators act additively to open up airways.  Stiolto is taken once a day.

Breo is a dry powder inhaler that, like Advair and Symbicort opens up the airways and reduces swelling, but Breo is taken only once a day.  It is a combination of vilanterol and fluticasone.

Anoro contains both umeclidinium and vilanterol; both are bronchodilators that act additively to open up airways.  Anoro is taken once a day.

Side effects to watch out for include dizziness, headache, muscle cramps, dry mouth, urinary retention, nausea, vomiting, nervousness, tremor, palpitations, rapid heart beat, cough, and increased wheezing. As when taking any medications, consult your doctor if you are experiencing any side effects while taking combination agents for your COPD.

 

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2 Comments
  • Art Cottrell
    Posted at 20:45h, 08 June Reply

    Along with Advair I take Spiriva (once a day). I didn’t see Spiriva on your list is it a good
    Combination agent for treating COPD.?

    • PERF2ndWind
      Posted at 18:07h, 15 June Reply

      Thanks for your message. Spiriva is a good drug for COPD; in fact, it is the most commonly used COPD drug. But it is a single drug and our article focused on combinations… two drugs in the same inhaler.
      ~ Richard Casaburi, Ph.D., M.D.

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