Combination Therapy

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Combination Therapy

The AEROECLIPSE® Nebulizer can easily be used with the AEROBIKA® OPEP device for Combination Therapy. This can save time for both the patient and caregivers, and may improve patient compliance to therapy, all while achieving similar results to individual therapy.

Radio labeled imaging confirmed therapeutically equivalent delivery to the lungs, whether the nebulizer was used alone or in combination with the AEROBIKA® OPEP device.  This means you can confidently combine nebulizer treatments while maintaining therapeutic benefits.1,2

How To Use

  1. Start by carefully adding your prescribed medication into the nebulizer cup, then reattach the top of the nebulizer.
  2. Next, remove the mouthpiece from the nebulizer and connect it to the back of the AEROBIKA® OPEP device.
  3. Place the mouthpiece of the AEROBIKA® OPEP device in your mouth – creating a good seal with your lips.
  4. Continue taking deep breaths in and strong exhalations until the nebulizer begins to sputter.

These are abbreviated instructions for use, please remember to read the complete instructions that are packaged with your device.  Between treatments, we recommend you clean both devices according to the product instructions.

How It Works

The AEROBIKA® device has a one-way valve which opens when the patient inhales, so the aerosol has a direct pathway through the device. The benefit of using combination therapy with the BAN™ Nebulizer is that aerosol is not produced, or more importantly, lost during the long, slow exhalation.  This ensures that the patient will receive a similar amount of medication with combined therapy to that of using the nebulizer alone.

This is a huge timesaver for staff and patients requiring both treatments and allows for therapeutically similar results.

AEROBIKA® OPEP Device Instructions for Use/Indications for Use

(English and Spanish)


Medications which open your airways (eg. albuterol) or help to thin mucus (eg. hypertonic saline) would be good choices to use for combined therapy because they would help remove or thin the mucus in your lungs. Medications you want to stay in your lungs, like antibiotics, should be taken after you have completed your treatment.

Some medications are sticky which can leave a residue on the devices that may impair performance.  It’s good practice to wash the devices in between uses to prevent this.

If you aren’t getting oscillations on exhalation, you may be using the wrong mouthpiece.  Ensure you are using the solid white AEROBIKA® OPEP device mouthpiece, and not the one with the green valve that came with the nebulizer. Using the valved mouthpiece will allow exhaled breath to bypass the AEROBIKA® OPEP device.

If you have a question that was not answered here, please contact us.

Clinical Evidence

Combination therapy offers the potential to reduce treatment times for patients who may currently be taking separate nebulizer and OPEP treatments. An evaluation of the use of the AEROECLIPSE® II Nebulizer alone and in Combination with the AEROBIKA® OPEP Device on drug deposition in the lungs using gamma scintigraphy identified that whole lung deposition was, on average, 31 ± 13% vs 32 ± 13% of loaded dose for BAN alone and BAN + OPEP device respectively – meaning delivery of medication was not significantly affected by combining the two devices. Read the full study here.


  1. Nagel M, et al. Eur Respir J 2019;54:PA4529.
  2. Nagel M, et al. Combining Drug Delivery via Breath Actuated Nebulizer with Exhalation Through An Oscillating Positive Expiratory Pressure Device — The Potential For Optimal Combined Therapy. Presented at North American Cystic Fibrosis Conference 2019.