Duoneb

(Ipratropium Bromide/Albuterol (Salbutamol) Sulfate)

The active ingredients of Duoneb are ipratropium bromide and albuterol sulfate. Ipratropium bromide is an anticholinergic that reduces smooth muscle contractions, helping to relax the muscles in your lungs. Albuterol sulfate is a short-acting beta agonist (SABA) that also acts on the smooth muscles in your lungs to help them relax and open up your airways (bronchodilation) more quickly during flare-ups.

It is indicated for the maintenance of chronic obstructive pulmonary disease (COPD) when one medication is insufficient. It is a scheduled medication and is not intended for rescue use.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide, before using Duoneb. However, the following is a synopsis of the general guidelines for the use of Duoneb:

1. Remove a vial from the foil pouch, leaving the remaining vials in the foil.

2. Twist off the vial cap and squeeze the contents into the nebulizer reservoir.

3. Connect the nebulizer to the mouthpiece or face mask, then to the compressor.

4. Sit upright and place the mouthpiece in your mouth (or facemask over your nose and mouth) and turn on the compressor.

5. Breathe calmly and deeply through your mouth until no more mist is formed in the chamber, about 5-15 minutes.

6. Clean the nebulizer following the manufacturer’s instructions.

The most common side effects of Duoneb include:

• Lung disease.
• Sore throat.
• Chest pain.
• Bronchitis.
• Headache.
• Dry mouth.
• Constipation.
• Diarrhea.
• Urinary tract infection.

Some individuals may experience serious side effects while using Duoneb. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Worsening bronchospasm, wheezing, chest pain, and shortness of breath.
• Heart problems, including dizziness, fatigue, irregular heart rhythm, and irregular heartbeat.
• Vision changes, including eye pain, blurred vision, and seeing halos around lights
• Serious allergic reactions include skin rash, hives, or anaphylaxis.
• Low potassium levels with symptoms such as fatigue, weakness, irregular heartbeat, and muscle cramps.
• Trouble urinating.

These are not all of the possible side effects of Duoneb. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088

Before starting Duoneb, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including whether you have:

• High blood pressure.
• Diabetes.
• Seizures/ seizure disorder.
• Hyperthyroidism.
• Narrow-angle glaucoma - may be worsened by the use of ipratropium bromide.
• Benign prostatic hyperplasia (BPH) or bladder-neck obstruction - urinary retention may be worsened by the use of ipratropium bromide.

Hypersensitivity to any of the ingredients in Duoneb, atropine, or any of its derivatives.

You should feel the immediate effects of albuterol within a few minutes, but the ipratropium may take a few weeks to have an effect on relaxing the smooth muscle in the airways.

When Duoneb is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Anticholinergic medications, such as atropine, diphenhydramine, scopolamine, amitriptyline, and doxepin, may have additive anticholinergic effects when combined with ipratropium.
• Beta-adrenergic agonists, including salmeterol and formoterol, may have additive beta-agonist effects when combined with albuterol.
• Beta-blockers, such as propranolol, atenolol, and metoprolol, would inhibit the effect of albuterol.
• Diuretics, such as furosemide or spironolactone, may worsen the low potassium (hypokalemia) when used with albuterol.
• Antidepressants such as monoamine oxidase inhibitors or tricyclic antidepressants may increase the cardiovascular effects of Duoneb.

Duoneb is provided as 3mL vials of inhalation solution to be used in a nebulizer, each containing Ipratropium Bromide 0.5 mg and Albuterol Sulfate 3.0 mg (equivalent to 2.5mg albuterol base).

Duoneb should be stored at room temperature, kept protected from light, and away from the reach of children or pets.

It is manufactured by DEY.

Yes, there are generic versions of Duoneb available from many manufacturers of generic drugs.

You should not stop this medication without consulting your doctor first. Stopping this medication suddenly can increase your risk of sudden breathing problems.

Neither albuterol nor ipratropium has been tested in pregnant people, though, as it is not absorbed systemically, it is expected to be safe in pregnancy.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Neither albuterol nor ipratropium has been tested in nursing people, though, as it is not absorbed systemically, it is expected to be safe for a nursing infant.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.