Duovent

(Ipratropium Bromide/Fenoterol Hydrobromide)

The active ingredients in Duovent UDV are ipratropium bromide, an anticholinergic solution, and fenoterol hydrobromide, a short-acting beta-agonist (SABA). Both are bronchodilators that work on the cholinergic and adrenergic systems, respectively, working to open up your lungs by relaxing the muscles and making it easier to breathe.

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 Duovent. However, the following is a synopsis of the general guidelines for the use of Duovent:

1. These nebules are intended to be taken by inhalation from a nebuliser, and not injected or swallowed.

2. Detach one plastic unit-dose vial from the strip, and open it by twisting off the top.

3. The liquid should be put into the nebulizer chamber, with the aerosol inhaled through a face mask or mouthpiece.

4. When using a face mask, use a barrier cream on your face, and wash your face thoroughly after treatment.

5. Do not dilute the nebule content unless advised by a doctor. Use only sterile sodium chloride injection BP for dilution.

6. Ensure the liquid or mist from the machine does not get into your eyes.

7. Always use the nebulizer in a well-ventilated room.

8. Discard any remaining solution in the nebulizer after use.

9. Keep the nebules in the pack until you are ready to use them. Once removed from the foil wrap, use within 3 months. Do not use past the expiry date.

The most common side effects of Duovent include:

• Dry mouth.
• Cough.
• Tremor/nervousness.
• Headache.
• Sore throat.
• Hoarseness.
• Constipation.
• Increased sweating.

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

• Eye problems, including blurred vision, eye pain, visual halos, dilated pupils (mydriasis), or increased pressure in the eye.
• Heart problems, including heart palpitations (tachycardia) or increased blood pressure.
• Muscle spasms, weakness, or pain.
• Difficulty passing urine.
• Difficulty breathing, increased coughing, or wheezing.
• Serious allergic reactions - rash, hives, swelling of the face, mouth, or tongue, anaphylaxis, and trouble breathing.

This medication also has the potential to cause an initial worsening of your asthma symptoms (shortness of breath or bronchospasm), requiring you to use your rescue nebules more often, experience nighttime awakenings due to your symptoms, or have acute asthma attacks. Contact your physician if this occurs at any time.

These are not all of the possible side effects of Duovent. 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 Duovent, 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:

• Eye problems, including glaucoma or eye pain.
• Urinary incontinence or an enlarged prostate.
• Heart problems involving the blood vessels, blood pressure, or heart rate.
• Diabetes.

Allergy or hypersensitivity to ipratropium bromide, fenoterol hydrobromide, atropine, or any other sympathomimetic amines.

Tachyarrhythmias (abnormal heart rhythms where the heart beats too fast) or hypertrophic obstructive cardiomyopathy (a condition where the heart muscle thickens and can block blood flow out of the heart).

Fenoterol works quickly, within 5-15 minutes. Ipratropium takes longer, about 30 minutes.

When Duovent 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:

• Other beta-adrenergic agents, anticholinergics, xanthine derivatives (theophylline), and corticosteroids may increase the effect of Duovent and its adverse reactions when used together.
• Beta blockers such as propanolol, atenolol, or metoprolol may reduce the effect of fenoterol.
• Monoamine oxidase inhibitors (phenelzine, selegiline, tranylcypromine), tricyclic antidepressants (amitriptyline, desipramine, doxepin), or inhaled anesthetics (halothane, trichloroethylene, enflurane) agents may increase the cardiovascular side effects of Duovent.

Duovent is available as 4mL vials containing 0.5 mg of ipratropium bromide and 1.25 mg of fenoterol hydrobromide. Each carton contains 2 strips of 10 vials each.

It should be stored at room temperature, protected from heat and light. It should be kept out of reach of children or pets.

It is manufactured by Boehringer Ingelheim.

No, but there are similar products combining ipratropium bromide and salbutamol (albuterol) solution available from generic drug manufacturers.

This medication should be used as needed for sudden breathing problems. If you find you are using it more often than usual, contact your doctor to see what the next steps might be best for you.

While inhaled ipratropium is considered safe in pregnancy, fenoterol is known to inhibit uterine contractions during childbirth. For this reason, Duovent should be used with caution 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.

Ipratropium is not found in breast milk, but fenoterol is. The effect of fenoterol on a nursing infant is not known, and therefore caution is advised when using this medication during breastfeeding.

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.