Ipratropium, Albuterol & Nutrient Depletion
Also searched as Combivent, Combivent Respimat. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Ipratropium, Albuterol has been associated with depletion of MAGNESIUM and POTASSIUM. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Ipratropium, Albuterol long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Ipratropium, Albuterol pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Ipratropium, Albuterol
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
MAGNESIUM
Insignificant DepletionBETA-2 AGONISTS
Beta-2 agonists promote movement of magnesium from the extracellular to the intracellular space, and increase magnesium excretion in the urine. Reduced serum magnesium levels occur after a single dose of albuterol or terbutaline orally, by IV infusion, SC injection, or by inhalation. The reductions are generally small, about 4.5-9%, or 0.04 to 0.06 mmol/L compared with the normal serum magnesium range of 0.65 to 1.1 mmol/L. However, these acute changes could contribute to ECG changes, including prolonged QT intervals. With chronic use of beta-2 agonists, serum magnesium levels generally return to normal, but muscle magnesium levels may remain low. For information on foods that are rich in magnesium, see our chart.
Magnesium helps your muscles contract, keeps your heart rhythm steady, and supports hundreds of chemical reactions in the body. The albuterol component of this inhaler works on beta-2 receptors and, in doing so, can shift magnesium from the bloodstream into cells and nudge the kidneys to excrete a little more of it in urine. That said, the dip in blood magnesium levels is typically small and tends to reverse on its own with regular use, which is why this is rated insignificant. Most people using this inhaler do not need a magnesium supplement, but if you have questions about your levels, a quick conversation with your pharmacist or doctor is always a good idea.
What Magnesium does & food sources
Magnesium is involved in muscle and nerve function, heart rhythm, blood sugar control, and bone health.
Common food sources:
- Nuts and seeds (almonds, pumpkin seeds)
- Whole grains
- Leafy green vegetables
- Beans and legumes
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask whether a magnesium level is worth checking if you take an associated medication long-term — particularly with symptoms like muscle cramps, twitching, or palpitations. Blood levels do not always reflect total body stores, which is worth discussing too.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Magnesium supplements come in many forms and can cause loose stools at higher doses. They can also bind some medications in the gut (certain antibiotics, thyroid medication), so timing matters — check with your pharmacist.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Magnesium supplementation can be risky in kidney disease, where magnesium can accumulate — always check with a clinician first if your kidney function is reduced.
Learn more about this nutrient: Magnesium — uses, safety & interactions
References (10)
- Tveskov C, Djurhuus MS, Klitgaard NAH, Egstrup K. Potassium and magnesium distribution, ECG changes, and ventricular ectopic beats during beta-2-adrenergic stimulation with terbutaline in healthy subjects. Chest 1994;106:1654-9..
- Whyte KF, Addis GJ, Whitesmith R, Reid JL. Adrenergic control of plasma magnesium in man. Clin Sci 1987;72:135-8.. PubMed
- Rolla G, Bucca C. Magnesium, beta-agonists, and asthma. Lancet 1988;1:989. PubMed
- Bremme K, Eneroth P, Nordstrom L, Nilsson B. Effects of infusion of the beta-adrenoceptor agonist terbutaline on serum magnesium in pregnant women. Magnesium 1986;5:85-94.
- Khilnani G, Parchani H, Toshniwal G. Hypomagnesemia due to beta 2-agonist use in bronchial asthma. J Assoc Physicians India 1992;40:346..
- Bos WJ, Postma DS, van Doormaal JJ. Magnesiuric and calciuric effects of terbutaline in man. Clin Sci 1988;74:595-7.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Gustafson T, Boman K, Rosenhall L, et al. Skeletal muscle magnesium and potassium in asthmatics treated with oral beta-2-agonists. Eur Resp J 1996;9:237-40.. PubMed
- Rolla G, Bucca C, Bugiani M, et al. Hypomagnesemia in chronic obstructive lung disease: effect of therapy. Magnes Trace Elem 1990;9:132-6..
POTASSIUM
Moderate DepletionBETA-2 AGONISTS
Binding of agonists to beta-2 receptors stimulates adenylate cyclase, increasing intracellular cyclic-AMP and activating membrane Na/K-ATPase pumps. This increases cellular potassium uptake which may cause hypokalemia. This can occur with oral, parenteral, or inhaled beta-2 agonists, especially during acute use of high doses. In high-risk patients, such as those with heart disease or taking other potassium-lowering medications, beta-2 agonist-induced hypokalemia might also lead to ventricular ectopy, prolonged QT intervals, and arrhythmias. Continued use of the beta-2 agonist results in a reduction of the hypokalemic effect over time. Monitor serum potassium levels in people receiving acute high dose beta-2 agonists and in those with other risk factors for hypokalemia; potassium supplements may be necessary if symptomatic hypokalemia develops. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to fire correctly. The albuterol in this combination works by activating certain receptors that essentially push potassium out of the bloodstream and into your cells, temporarily lowering the level circulating in your blood. This is rated a moderate concern, meaning it is real enough to take seriously, especially at higher doses or if you have heart disease or take other medications that also lower potassium. If you use this inhaler regularly, it is worth asking your pharmacist or doctor whether your potassium level should be checked.
What Potassium does & food sources
Potassium keeps nerve signals, muscle contractions, and heart rhythm working normally.
Common food sources:
- Bananas and citrus fruits
- Potatoes and sweet potatoes
- Beans and lentils
- Tomatoes and leafy greens
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Potassium is routinely checked with basic blood work. If you take a medication associated with potassium loss (like some diuretics), ask your provider how often your electrolytes should be monitored.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Do not start potassium supplements on your own. Both low and high potassium can affect heart rhythm, and several common medications (ACE inhibitors, ARBs, potassium-sparing diuretics) raise potassium.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Potassium supplementation can be dangerous in kidney disease or alongside potassium-raising medications — this is a decision for your prescriber, guided by lab results.
Learn more about this nutrient: Potassium — uses, safety & interactions
References (14)
- Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. PubMed
- Gelmont DM, Balmes JR, Yee A. Hypokalemia induced by inhaled bronchodilators. Chest 1988;94:763-6.. PubMed
- Lipworth BJ, McDevitt DG. Beta-adrenoceptor responses to inhaled salbutamol in normal subjects. Eur J Clin Pharmacol 1989;36:239-45.. PubMed
- Deenstra M, Haalboom JRE, Struyvenberg A. Decrease of plasma potassium due to inhalation of beta-2-agonists: absence of an additional effect of intravenous theophylline. Eur J Clin Invest 1988;18:162-5.. PubMed
- Shrestha M, Bidadi K, Gourlay S, Hayes J. Continuous vs intermittent albuterol, as high and low doses, in the treatment of severe acute asthma in adults. Chest 1996;110:42-7..
- Rahman ARA, McDevitt DG, Struthers AD, Lipworth BJ. The effects of enalapril and spironolactone on terbutaline-induced hypokalemia. Chest 1992;102:91-5..
- Clifton GD, Hunt BA, Patel RC, Burki NK. Effects of sequential doses of parenteral terbutaline on plasma levels of potassium and related cardiopulmonary responses. Am Rev Respir Dis 1990;141:575-9.. PubMed
- Haalboom JRE, Deenstra M, Struyvenberg A. Effect of fenoterol on plasma potassium and cardiac ectopic activity (letter). Lancet 1989;2:45. PubMed
- Raimondi GA, Rodriguez-Moncalvo JJ. Effects of beta-adrenergic agents on hypokalemia (letter). Chest 1987;91:288-9. PubMed
- Kung M, White JR, Burki NK. The effect of subcutaneously administered terbutaline on serum potassium in asymptomatic adult asthmatics. Am Rev Respir Dis 1984;129:329-32..
- Rohr AS, Spector SL, Rachelefsky GS, et al. Efficacy of parenteral albuterol in the treatment of asthma: Comparison of its metabolic side effects with subcutaneous epinephrine. Chest 1986;89:348-51.. PubMed
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Smith SR, Kendall MJ. Metabolic responses to beta-2 stimulants. J R Coll Phys Lond 1984;18:190-4.
- Lipworth BJ, Clark RA, Dhillon DP, McDevitt DG. Comparison of the effects of prolonged treatment with low and high doses of inhaled terbutaline on beta-adrenoceptor responsiveness in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis PubMed
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Ipratropium, Albuterol
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Ipratropium, Albuterol & nutrients: FAQs
Does Ipratropium, Albuterol deplete MAGNESIUM?
Should I take a supplement because I take Ipratropium, Albuterol?
Should I stop taking Ipratropium, Albuterol?
Where does this information come from?
Questions about Ipratropium, Albuterol and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Ipratropium, Albuterol are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.