Ibires I 200mg/40mcg Nexcap: Complete Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Breathing becomes worse right after using this medicine.
- Severe chest pain or a racing, irregular heartbeat.
- Swelling of the face, lips, tongue, or throat, or a severe rash.
- Fainting or severe dizziness.
- Eye pain, blurred vision, or seeing halos around lights.
- Inability to pass urine or severe lower abdominal pain.
- Severe muscle weakness or cramps that do not go away.
- High fever with worsening breathlessness and chest pain.
If experiencing severe symptoms, call emergency services immediately.
What is ibires i 200mg/40mcg nexcap used for?
This medicine is an inhaled combination of salbutamol and ipratropium used to open the airways in people with asthma or chronic obstructive pulmonary disease. Salbutamol works quickly to relax airway muscles, while ipratropium blocks nerve signals that tighten the airways. It must be used only with the recommended inhalation device and exactly as prescribed by a clinician.
- Generic Name: Salbutamol (200mg) + Ipratropium (40mcg)
- Manufacturer: Indiabulls pharmaceutical ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 ibires i 200mg/40mcg nexcap के बारे में (Hindi Summary)
उपयोग: यह दवा सल्ब्यूटामोल और आइप्रेट्रोपियम का संयोजन है, जिसका उपयोग इनहेलेशन (साँस के ज़रिए) के लिए किया जाता है। यह अस्थमा और क्रॉनिक ऑब्सट्रक्टिव पल्मोनरी डिज़ीज़ जैसी स्थितियों में साँस की नलियों को खोलने में मदद करती है। सल्ब्यूटामोल तेज़ी से काम करता है और साँस की मांसपेशियों को आराम देता है, जबकि आइप्रेट्रोपियम नसों के उन संकेतों को रोकता है जो नलियों को सिकोड़ते हैं। इससे घरघराहट, साँस फूलना और छाती में जकड़न कम होती है। यह दवा केवल डॉक्टर द्वारा बताए गए तरीके और डिवाइस से ही लेनी चाहिए। इसे निगलना नहीं है और बिना सलाह बंद या शुरू नहीं करना चाहिए।
साइड इफेक्ट्स: इस दवा के आम दुष्प्रभावों में हाथ काँपना, घबराहट, सिरदर्द, चक्कर आना, गले में जलन, खाँसी, मुँह सूखना और आवाज़ में बदलाव शामिल हैं। कुछ लोगों को धड़कन तेज़ होना, मांसपेशियों में ऐंठन या हल्की मतली हो सकती है। ये आमतौर पर हल्के होते हैं और समय के साथ कम हो जाते हैं। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन इनमें साँस लेने में अचानक कठिनाई, चेहरे या गले में सूजन, तेज़ या अनियमित धड़कन, बेहोशी, आँखों में दर्द या धुंधला दिखना, और पेशाब रुकना शामिल हो सकते हैं। ऐसे लक्षण दिखने पर तुरंत डॉक्टर से मिलें।
सुरक्षा सलाह: इस दवा का इस्तेमाल डॉक्टर के बताए अनुसार ही करें और खुराक या बार-बार उपयोग अपने मन से न बढ़ाएँ। यह दवा केवल साँस के ज़रिए लेने के लिए है और डॉक्टर द्वारा बताए गए डिवाइस से ही लेनी चाहिए। सही तरीका सीखें, क्योंकि गलत तरीके से दवा गले में जलन और खाँसी बढ़ा सकती है। उपयोग के बाद मुँह धोएँ। अपनी सभी दवाओं, खासकर दिल की दवाओं, पानी की गोलियों और अवसाद की दवाओं के बारे में डॉक्टर को बताएँ। धूम्रपान और धूल-धुएँ से बचें। अचानक साँस फूलने पर घबराएँ नहीं, डॉक्टर की सलाह लें। दवा को बच्चों से दूर, ठंडी और सूखी जगह पर रखें।
💊 ibires i 200mg/40mcg nexcap Uses & Benefits
[{"condition":"Asthma","description":"Used to relieve reversible airflow obstruction and bronchospasm in people with asthma when a combination bronchodilator is considered appropriate by the treating clinician.","evidence":"Well-established for short-acting bronchodilator combinations in acute and maintenance settings, though long-acting controller therapy is often needed."},{"condition":"Chronic obstructive pulmonary disease","description":"Helps relax airways and improve symptoms in people with chronic obstructive pulmonary disease who have reversible or partially reversible obstruction.","evidence":"Well-established for symptom relief in selected patients."},{"condition":"Exercise-induced bronchoconstriction","description":"May be used to prevent or reduce narrowing of the airways triggered by physical activity in some patients.","evidence":"Moderate, based on the known effects of the individual ingredients."},{"condition":"Acute exacerbation of obstructive airway disease","description":"May be used in a supervised setting as part of a treatment plan for worsening breathlessness and wheezing.","evidence":"Well-established in acute care when used under medical supervision."}]
Off-label uses: [{"condition":"Bronchospasm during mechanical ventilation","description":"Sometimes used in intensive care settings for patients with bronchospasm who are on breathing support.","evidence":"Limited, based on clinical experience and the known effects of the ingredients."},{"condition":"Preoperative bronchodilation in selected patients","description":"May be considered before surgery in patients with reactive airway disease, as advised by the anesthesia team.","evidence":"Limited."}]
Primary treatment for: Asthma and chronic obstructive pulmonary disease with reversible airway obstruction
Also treats: Exercise-induced bronchoconstriction, Acute exacerbation of obstructive airway disease, Chronic bronchitis with bronchospasm
📋 Drug Information
| Generic Name(s) | Salbutamol (200mg) + Ipratropium (40mcg) |
| Brand Name | ibires i 200mg/40mcg nexcap |
| Manufacturer | Indiabulls pharmaceutical ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | RESPIRATORY |
| Action Class | |
| Route of Administration | Inhalation. This medicine is supplied as a nexcap and must be used only with the inhalation device recommended by your clinician. It is not for oral, injectable, or topical use |
| Storage | Store this medicine at room temperature, between 15 and 30 degrees Celsius, away from direct sunlight and moisture. Keep it in its original packaging. Do not freeze it unless the manufacturer's instructions say otherwise. Keep it out of reach of children and pets. |
| Shelf Life | The shelf life is usually 24 months from the date of manufacture, but you should always check the expiry date printed on the pack. Do not use the medicine after the expiry date. |
| WHO Guideline | Not established from the available information for this specific fixed-dose combination product. International guidelines generally support the use of short-acting bronchodilator combinations in selected patients with asthma or chronic obstructive pulmonary disease, but treatment must be individualized. |
| ICMR Guideline | Not established from the available information for this specific fixed-dose combination product. Follow the advice of your treating clinician and local guidelines. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two bronchodilators with different mechanisms. Salbutamol selectively stimulates beta-2 adrenergic receptors on airway smooth muscle, which increases cyclic adenosine monophosphate and leads to relaxation of the bronchial muscles. Ipratropium blocks muscarinic acetylcholine receptors in the airways, which reduces cholinergic bronchoconstriction and decreases mucus secretion. The two actions complement each other, producing broader bronchodilation than either ingredient alone.
Mechanism Steps
💡 How to Take ibires i 200mg/40mcg nexcap
Strength: Nexcap containing salbutamol 200 mg and ipratropium 40 mcg, for inhalation using a compatible device.
Dosage Information
| Adult Dosage | The dose of this medicine must be individualized by a qualified clinician based on the indication, severity of symptoms, age, weight, kidney and liver function, and response to treatment. In general, inhaled salbutamol and ipratropium combinations are used at a dose and frequency set by the clinician, often one or two inhalations at scheduled times or as needed for symptoms. Do not change the dose or frequency on your own. Follow the exact instructions given by your clinician and the device manufacturer. |
| Pediatric Dosage | Pediatric dosing is not established from available information for this specific product. Consult a pediatrician or a qualified clinician for appropriate dosing in children. |
| Elderly Dosage | Older adults may be more sensitive to the effects of this medicine, especially a faster heart rate, tremor, urinary retention, and confusion. The dose must be individualized by a qualified clinician, and monitoring for side effects is important. Use with caution in people with heart disease, glaucoma, or prostate enlargement. |
| Renal Impairment | Salbutamol and its metabolites are excreted in the urine. People with severe kidney disease should be monitored closely, and the dose should be individualized by a qualified clinician. Specific dose adjustments for this combination product are not established from the available information. |
| Hepatic Impairment | Salbutamol is metabolized in the liver. People with severe liver disease should be monitored closely, and the dose should be individualized by a qualified clinician. Specific dose adjustments for this combination product are not established from the available information. |
| Maximum Daily Dose | The maximum daily dose must be determined by a qualified clinician based on the patient's condition and response. Do not exceed the prescribed dose. Using more than the recommended amount can increase the risk of serious heart and potassium problems. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of ibires i 200mg/40mcg nexcap
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Propranolol | Major | |
| Tiotropium | Major | |
| Furosemide | Major | |
| Digoxin | Moderate | |
| Prednisolone | Moderate | |
| Amitriptyline | Major | |
| Oxybutynin | Major | |
| Levodopa | Moderate | |
| Formoterol | Moderate | |
| Chlorpheniramine | Minor |
🚨 Major Interactions
- Non-selective beta-blockers such as propranolol
- Other anticholinergic medicines such as tiotropium or oxybutynin
- Potassium-wasting diuretics such as furosemide or hydrochlorothiazide
- Monoamine oxidase inhibitors and tricyclic antidepressants
⚡ Moderate Interactions
- Corticosteroids
- Digoxin
- Other beta-2 agonists such as formoterol or salmeterol
- Levodopa
🍷 Alcohol Interaction
Alcohol is not known to interact directly with this medicine, but it can cause dizziness, drowsiness, and a faster heart rate, which may add to the side effects of salbutamol. It is best to limit or avoid alcohol while using this medicine, especially if you have heart or lung disease.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known allergy to salbutamol, ipratropium, or any component of this medicine","Known allergy to atropine or related anticholinergic medicines","Acute severe asthma attack requiring immediate emergency care, unless directed by a clinician","Use in children under the age recommended by the clinician for this specific product","Use with a device that is not compatible with this nexcap"]
⚠️ Warnings & Precautions
["This medicine can cause paradoxical bronchospasm, which is worsening of breathing right after use. Stop using it and seek medical help if this happens.","Use with caution in people with heart disease, irregular heart rhythms, or high blood pressure.","Use with caution in people with diabetes, because salbutamol can raise blood sugar levels.","Use with caution in people with an overactive thyroid, because salbutamol can increase heart rate and tremor.","Use with caution in people with glaucoma, because ipratropium can increase eye pressure if it gets into the eyes.","Use with caution in men with prostate enlargement or urinary retention, because ipratropium can worsen these problems.","Do not exceed the prescribed dose or frequency, because too much salbutamol can cause serious heart and potassium problems.","Keep a rescue inhaler available if prescribed, and do not rely on this medicine for sudden severe attacks unless your clinician has told you to do so.","Tell your clinician about all other medicines, supplements, and herbal products you use.","Do not use this medicine after the expiry date, and do not use it if the packaging is damaged."]
🤱 Lactation Safety
Salbutamol is present in breast milk in small amounts, and ipratropium is unlikely to be present in significant amounts after inhalation. This medicine is generally considered acceptable during breastfeeding when clinically needed, but you should discuss it with your clinician. Watch for any unusual symptoms in the baby, such as fast heartbeat or irritability.
💊 Overdose Management
Overdose with this inhaled combination is unlikely to be serious because only a small amount is absorbed, but using too much can cause a fast or irregular heartbeat, tremor, nervousness, headache, low potassium, and high blood sugar. If you or someone else has used too much of this medicine and has severe symptoms such as chest pain, fainting, or a racing heartbeat, seek emergency medical help immediately. Treatment is supportive and may include monitoring of heart rhythm, blood pressure, potassium, and blood sugar. Do not try to treat an overdose at home.
⏰ Missed Dose
If you miss a dose of this medicine, take it as soon as you remember, unless it is almost time for your next dose. If it is almost time for the next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time to make up for a missed dose. If you are unsure what to do, contact your clinician or pharmacist.
Additional Safety Advice
Use this medicine exactly as prescribed by your clinician and never increase the dose or frequency on your own. This product is for inhalation only and must be used with the device recommended by your healthcare professional. Learn and practice the correct inhalation technique, because poor technique can reduce the benefit and increase local side effects such as throat irritation. Rinse your mouth after each use if your clinician advises it. Do not use this medicine to treat sudden severe breathing difficulty unless your clinician has specifically told you it is appropriate for that purpose. Keep a rescue inhaler available if prescribed. Tell your doctor about all other medicines you take, especially heart medicines, water pills, antidepressants, and other inhaled medicines. Avoid smoking and secondhand smoke, and keep away from known triggers such as dust, pollen, and cold air. Do not stop or change this medicine without talking to your clinician, even if you feel better. Store it as directed and keep it out of reach of children.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Older adults may be more sensitive to the side effects of this medicine, especially a faster heart rate, tremor, urinary retention, confusion, and eye problems. Use with caution in people with heart disease, glaucoma, or prostate enlargement. Regular monitoring of heart rate, blood pressure, potassium, urinary symptoms, and eye health is recommended. The dose must be individualized by a qualified clinician.
🤰 Pregnancy Planning (TTC)
If you are planning pregnancy, talk to your clinician before starting or continuing this medicine. There are no well-controlled studies of this exact combination in pregnancy. Your clinician will weigh the benefits of controlling your airway disease against any potential risks to you and the baby. Do not stop or change your medicine without medical advice, because uncontrolled asthma or COPD can be dangerous during pregnancy.
🏥 Post-Surgery Considerations
Tell your surgeon and anesthesia team that you use this medicine. It may be continued or adjusted around surgery depending on your breathing status and the type of procedure. In some cases, it may be used to prevent bronchospasm during or after surgery. Follow the instructions given by your surgical and anesthesia team.
🦷 Dental Procedures
Tell your dentist that you use this medicine, especially if you have asthma or COPD. Keep your rescue inhaler with you during dental visits. Some dental procedures can trigger breathing problems in people with airway disease, so your dentist may take extra precautions. Rinse your mouth after using this medicine before dental work to reduce throat irritation.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Exercise can trigger breathlessness in some people. If your clinician has prescribed this medicine for exercise-induced symptoms, use it as directed before activity. Warm up slowly and avoid exercising in very cold, dry, or polluted air. Stop and rest if you feel chest tightness, severe breathlessness, or dizziness, and seek help if symptoms do not improve.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause tremor, dizziness, or a faster heart rate in some people. If you feel dizzy or shaky, avoid driving or operating heavy machinery until you know how the medicine affects you. Most people can continue their usual work and daily activities, but you should follow your clinician's advice and your asthma or COPD action plan. Tell your employer or school about your condition if you need to keep rescue medicine nearby.
🛑 When to Stop This Medicine
Do not stop this medicine suddenly without talking to your clinician. If you have severe side effects such as a severe allergic reaction, paradoxical bronchospasm, chest pain, or an irregular heartbeat, stop using it and seek emergency medical help. Your clinician will decide whether to adjust the dose, change the medicine, or stop it based on your condition and response.
📅 Long-Term Use Effects
Long-term use of this medicine should be reviewed regularly by your clinician. Salbutamol can cause tremor, a faster heart rate, and low potassium, especially at higher doses. Ipratropium can cause dry mouth, urinary retention, and eye problems in some people. Regular monitoring of symptoms, heart rate, potassium, and eye and urinary health is important. Do not use this medicine as a substitute for controller medicines when they are needed. Your clinician may adjust or change treatment based on your response and side effects.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Controller medicines that reduce airway inflammation and are often used alongside bronchodilators in asthma.
Evidence: Well-established.Medicines such as tiotropium or long-acting beta-2 agonists may be used for maintenance therapy in COPD or asthma.
Evidence: Well-established for selected patients.A structured program of exercise, education, and breathing training that can improve symptoms and quality of life in COPD.
Evidence: Well-established.Reducing exposure to smoke, dust, and allergens can decrease the frequency of attacks.
Evidence: Well-established.💉 Vaccination Considerations
💉 If You're Getting Vaccinated
People with asthma or chronic obstructive pulmonary disease should discuss influenza and pneumococcal vaccination with their clinician. Vaccination can reduce the risk of respiratory infections that may worsen airway symptoms. This medicine does not interact with vaccines, but you should tell your clinician about your condition and medicines before any vaccination.
📦 Storage Guide
✅ DO
Store at room temperature between 15 and 30 degrees Celsius.
❌ DON'T
Do not freeze or refrigerate unless the manufacturer says to do so.
✅ DO
Keep the medicine in its original packaging.
❌ DON'T
Do not transfer it to unmarked containers.
✅ DO
Keep it away from direct sunlight and moisture.
❌ DON'T
Do not store it in a bathroom cabinet.
✅ DO
Keep it out of reach of children and pets.
❌ DON'T
Do not use it after the expiry date.
✈️ Traveling with This Medicine
Carry this medicine in its original packaging with the prescription copy and a letter from your clinician if you are traveling internationally. Keep it in your hand luggage so it stays at room temperature and is not exposed to extreme heat or cold. If you use it at scheduled times, adjust the timing gradually to the new time zone with advice from your clinician. Carry enough supply for the whole trip plus extra in case of delays. Check local customs rules for carrying prescription inhalation medicines, and keep the device clean and ready to use during travel.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: Salbutamol usually starts to relieve breathlessness within about 5 minutes. Ipratropium takes about 15 to 30 minutes to add its effect. The combined effect usually lasts up to about 6 hours.
A: Only if your clinician has prescribed it for regular use. Do not use it more often than prescribed. If you need it more frequently, contact your clinician.
A: Take the missed dose as soon as you remember if it is not almost time for the next dose. If it is almost time, skip the missed dose and continue your regular schedule. Do not double dose.
A: It is best to limit or avoid alcohol because it can add to dizziness and a faster heart rate. Ask your clinician for advice based on your health.
A: There are no well-controlled studies of this exact combination in pregnancy. It should be used only if clearly needed and under medical supervision. Discuss the risks and benefits with your clinician.
A: Stop using it and seek emergency medical help. This could be paradoxical bronchospasm, which is a serious reaction.
🤔 Common Patient Concerns
🔄 Substitutes for ibires i 200mg/40mcg nexcap
View AllAlternative brands with exact same active ingredient:
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine can be swallowed like a tablet.
Fact: This medicine is for inhalation only and must be used with the recommended device. Swallowing it will not give the same effect and may cause unnecessary side effects. - Myth: Using this medicine more often will make it work better.
Fact: Using more than prescribed can cause serious heart and potassium problems. Always follow the dose and frequency set by your clinician. - Myth: This medicine can replace all other asthma or COPD medicines.
Fact: This medicine is a bronchodilator. Many people also need controller medicines such as inhaled corticosteroids. Do not stop or change other medicines without medical advice. - Myth: Once you feel better, you can stop this medicine.
Fact: Do not stop or change this medicine without talking to your clinician. Stopping suddenly can lead to worsening symptoms.
🔄 Alternative Options
Generic Alternatives
- Salbutamol and ipratropium inhalation combination products from other manufacturers
- Separate salbutamol inhaler and ipratropium inhaler used together as prescribed
Brand Alternatives
- Not established from the available information.