In addition, beta-adrenergic agents have been reported to produce ECG changes, such as flattening of the wave, prolongation of the QTc interval, and ST segment depression. If these effects occur, use caution engaging in activities requiring alertness and clear vision such as driving or using machinery. Keep your inhaler clean and dry, and store it with the cap on the mouthpiece. With the exception of albuterol, there are no formal studies fully evaluating the interaction effects ne receptu ipratropium fedex pristatymo of COMBIVENT Inhalation Aerosol and these drugs with respect to effectiveness. Tell your doctor immediately if any of these unlikely but serious side effects occur: fast pounding irregular heartbeat, vision changes, eye pain, increased wheezing trouble breathing, trouble urinating. Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm and oropharyngeal edema.