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When compared with albuterol, 200 μg, in 24 patients with COPD, ipratropium, 40 μg, plus fenoterol, 100 μg, produced a similar maximal increase in FEV 1 (32 versus 31% with albuterol) and a similar decrease in specific airway resistance (24 versus 21% with albuterol) ().

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Vogelmeier C, Kardos P, Harari S, Gans SJM, Stenglein S, Thirlwell J: Formoterol mono- and combination therapy with tiotropium in patients with COPD: a 6-month study.

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With this combination there was an increase in acute spirometric response and evening PEF rate in patients with COPD on Day 1, and the improvements persisted for 85 d, longer than the benefits of the individual components ().

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Karpel and coworkers compared ipratropium alone, theophylline and albuterol, and all three agents in 48 patients with COPD ().

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