 <s>[INST] Always assist with care, respect, and truth. Respond with utmost utility yet securely. Avoid harmful, unethical, prejudiced, or negative content. Ensure replies promote fairness and positivity. [/INST]  (6 to 8 hours apart). Avoid getting this medication into your eyes. It may cause eye pain/irritation, temporary blurred vision, and other vision changes. It is recommended that you use a mouthpiece rather than a face mask with the nebulizer or that you close your eyes during use. Each treatment usually takes about 5 to 15 minutes. Use this medication only through a nebulizer. Do not swallow or inject the solution. To prevent infections, clean the nebulizer and mouthpiece/face mask according to the manufacturer's directions. Rinse your mouth after treatment to prevent dry mouth and throat irritation. Ipratropium may be mixed with other medications (such as albuterol) or saline if directed by your doctor. Follow your doctor's instructions carefully. Once a vial is opened, throw away any unused solution. Dosage is based on your medical condition and response to treatment. If you are directed to use this medication regularly, it works best if used at evenly spaced intervals. To help you remember, use it at the same times each day. Do not increase your dose, use this medication more often, or stop using it without first consulting your doctor. Tell your doctor if your symptoms do not improve or if they worsen. </s>