Duoneb (Ipratropium Bromide and Albuterol Sulfate) Drug Information: Description, User Reviews, Drug Side Effects, Interactions

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February 9, 2012

Duoneb

Chronic Obstructive Pulmonary Disease »

What is COPD?

Chronic obstructive pulmonary disease (COPD) is comprised primarily of three related conditions - chronic bronchitis, chronic asthma, and emphysema. In each condition there is chronic obstruction of the flow of air through the airways and out of the lungs, and the obstruction generally is permanent and may be progressive over time.

While asthma features obstruction to the flow of air out of the lungs, usually, the obstruction is reversible. Between "attacks" of asthma the flow of air through the airways typically is normal. These patients do not have COPD. However, if asthma is left untreated, the chronic inflammation associated with this disease can cause the airway obstruction to become fixed. That is, between attacks, the asthmatic patient may then have abnormal air flow. This process is referred to as lung remodeling. These asthma patients with a fixed component of airway obstruction are also considered to have COPD.

Often patien...

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DuoNeb®
(ipratropium bromide 0.5 mg/albuterol sulfate 3.0 mg*) Inhalation Solution

What are the precautions when taking ipratropium bromide and albuterol sulfate (Duoneb)?

Before using this product, tell your doctor or pharmacist if you are allergic to ipratropium or albuterol (salbutamol); or to atropine or other belladonna-type drugs; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood pressure, heart disease (such as chest pain, heart attack, irregular heartbeat), glaucoma (narrow-angle), difficulty urinating (for example, due to enlarged prostate), seizure, overactive thyroid (hyperthyroidism), diabetes.

This drug may make you dizzy or cause blurred vision or other vision changes. Do not drive, use...

Read All Potential Precautions of Duoneb »

*Equivalent to 2.5 mg albuterol base

DRUG DESCRIPTION

The active components in DuoNeb® (ipratropium bromide and albuterol sulfate) Inhalation Solution are albuterol sulfate and ipratropium bromide.

Albuterol sulfate, is a salt of racemic albuterol and a relatively selective β2-adrenergic bronchodilator chemically described as α1-[(tert-butylamino)methyl]-4-hydroxy-mxylene-α, α'-diol sulfate (2:1) (salt). It has a molecular weight of 576.7 and the empirical formula is (C₁₃H₂₁NO₃)2•H₂SO₄. It is a white crystalline powder, soluble in water and slightly soluble in ethanol. The World Health Organization recommended name for albuterol base is salbutamol.

Figure 3 1-1: Chemical structure of albuterol sulfate

Albuterol Sulfate Structural Formula Illustration

Ipratropium bromide is an anticholinergic bronchodilator chemically described as 8azoniabicyclo [3.2.1]-octane, 3-(3-hydroxy-1-oxo-2-phenylpropoxy)-8methyl-8-(1methylethyl)-, bromide, monohydrate (endo, syn)-, (±)-; a synthetic quaternary ammonium compound, chemically related to atropine. It has a molecular weight of 430.4 and the empirical formula is C₂₀H₃₀BrNO₃•H₂O. It is a white crystalline substance, freely soluble in water and lower alcohols, and insoluble in lipophilic solvents such as ether, chloroform, and fluorocarbons.

Figure 3. 1-2: Chemical structure of ipratropium bromide.

Ipratropium Bromide Structural Formula Illustration

Each 3 mL vial of DuoNeb (ipratropium bromide and albuterol sulfate) contains 3.0 mg (0.1%) of albuterol sulfate (equivalent to 2.5 mg (0.083%) of albuterol base) and 0.5 mg (0.017%) of ipratropium bromide in an isotonic, sterile, aqueous solution containing sodium chloride, hydrochloric acid to adjust to pH 4, and edetate disodium, USP (a chelating agent).

DuoNeb (ipratropium bromide and albuterol sulfate) is a clear, colorless solution. It does not require dilution prior to administration by nebulization. For DuoNeb (ipratropium bromide and albuterol sulfate) Inhalation Solution, like all other nebulized treatments, the amount delivered to the lungs will depend on patient factors, the jet nebulizer utilized, and compressor performance. Using the Pari-LC-Plus™ nebulizer (with face mask or mouthpiece) connected to a PRONEB™ compressor system, under in vitro conditions, the mean delivered dose from the mouth piece (% nominal dose) was approximately 46% of albuterol and 42% of ipratropium bromide at a mean flow rate of 3.6 L/min. The mean nebulization time was 15 minutes or less. DuoNeb (ipratropium bromide and albuterol sulfate) should be administered from jet nebulizers at adequate flow rates, via face masks or mouthpieces (see DOSAGE AND ADMINISTRATION).