Limited Coverage Drugs - Ipratropium and Salbutamol Combination Nebules

Generic Name ipratropium and salbutamol combination nebules
Strength Ipratropium 0.5 mg in combination with salbutamol 2.5 mg per 2.5 mL unit dose vial
Form nebule for inhalation

Special Authority Criteria

Approval Period

1. Person has cognitive impairment
has had an unsuccessful trial in the use of an inhaler attached to an aerochamber with a mouthpiece.


2. Person who is living independently
either suffers from severe upper extremity disability or lacks fine motor co-ordination to a degree that precludes effective inhaler techniques, even when aided by inhaler-assistance devices.


3. Resident of a long-term care facility
regularly requires the administration of three or more inhaled medications at least three times daily.


4. Person has difficulty generating adequate inspiratory effort to achieve therapeutic benefit from an inhaler with an aerochamber.


​Practitioner Exemptions

  • No practitioner exemptions

Special Notes

  • Special Authority is not required for individuals 18 years and younger.

Special Authority Request Form(s)