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DuoNeb®
(Ipratropium Bromide 0.5 mg/Albuterol Sulfate 3.0 mg*) Inhalation Solution

*Equivalent to 2.5 mg albuterol base

Patient's Instructions for Use

Read this patient information completely every time your prescription is filled as information may have changed. Keep these instructions with your medication as you may want to read them again.

DuoNeb (ipratropium bromide and albuterol sulfate) should only be used under the direction of a physician. Your physician and pharmacist have more information about DuoNeb (ipratropium bromide and albuterol sulfate) and the condition for which it has been prescribed. Contact them if you have additional questions.

Storing your Medicine

Store DuoNeb (ipratropium bromide and albuterol sulfate) between 2°C and 25°C (36°F and 77°F). Vials should be protected from light before use, therefore, keep unused vials in the foil pouch or carton. Do not use after the expiration (EXP) date printed on the carton.

Dose

DuoNeb (ipratropium bromide and albuterol sulfate) is supplied as a single-dose, ready-to-use vial containing 3 mL of solution. No mixing or dilution is needed. Use one new vial for each nebulizer treatment.

FOLLOW THESE DIRECTIONS FOR USE OF YOUR NEBULIZER/COMPRESSOR OR THE DIRECTIONS GIVEN BY YOUR HEALTHCARE PROVIDER. A TYPICAL EXAMPLE IS SHOWN BELOW.

Instructions for Use

1. Remove one vial from the foil pouch. Place remaining vials back into pouch for storage.

2. Twist the cap completely off the vial and squeeze the contents into the nebulizer reservoir (Figure 1).

Figure 1

3. Connect the nebulizer to the mouthpiece or face mask (Figure 2).

Figure 2

4. Connect the nebulizer to the compressor.

5. Sit in a comfortable, upright position; place the mouthpiece in your mouth (Figure 3) or put on the face mask (Figure 4); and turn on the compressor.

Figure 3

Figure 4

6. Breathe as calmly, deeply and evenly as possible through your mouth until no more mist is formed in the nebulizer chamber (about 5-15 minutes). At this point, the treatment is finished.

7. Clean the nebulizer (see manufacturer's instructions).

DuoNeb®
(DOO-o-neb) (Ipratropium Bromide 0.5 mg/Albuterol Sulfate 3.0 mg*) Inhalation Solution

*Equivalent to 2.5 mg albuterol base

Read the patient information that comes with DuoNeb® (ipratropium bromide and albuterol sulfate) before you start using it and each time you get a refill. There may be new information. This leaflet does not take the place of talking with your doctor about your medical condition or your treatment.

What is DuoNeb® (ipratropium bromide and albuterol sulfate) ?

DuoNeb® (ipratropium bromide and albuterol sulfate) is a combination of two medicines called bronchodilators. DuoNeb® (ipratropium bromide and albuterol sulfate) contains albuterol sulfate, which is a beta-adrenergic agonist, and ipratropium bromide, which is an anticholinergic. These two medicines work together to help open the airways in your lungs. DuoNeb® (ipratropium bromide and albuterol sulfate) is used to help treat airway narrowing (bronchospasm) that happens with chronic obstructive pulmonary disease (COPD) in adult patients who need to use more than one bronchodilator medicine.

Who should not use DuoNeb® (ipratropium bromide and albuterol sulfate) ?

Do not use DuoNeb® (ipratropium bromide and albuterol sulfate) if you: Are allergic to any of the ingredients in DuoNeb (ipratropium bromide and albuterol sulfate) or to atropine. The active ingredients are albuterol sulfate and ipratropium bromide. See the end of this leaflet for a complete list of ingredients in DuoNeb® (ipratropium bromide and albuterol sulfate) .

DuoNeb® (ipratropium bromide and albuterol sulfate) has not been studied in patients younger than 18 years of age.

What should I tell my doctor before I start using DuoNeb® (ipratropium bromide and albuterol sulfate) ?

Tell your doctor about all of your conditions, including if you:

• Have heart problems. This includes coronary artery disease and heart rhythm problems.
• Have high blood pressure
• Have diabetes
• Have or had seizures
• Have a thyroid problem called hyperthyroidism
• Have an eye problem called narrow-angle glaucoma
• Have liver or kidney problems
• Have problems urinating due to bladder-neck blockage or an enlarged prostate (men)
• Are pregnant or planning to become pregnant. It is not known if DuoNeb® (ipratropium bromide and albuterol sulfate) can harm your unborn baby. You and your doctor will have to decide if DuoNeb® (ipratropium bromide and albuterol sulfate) is right for you during a pregnancy.
• Are breastfeeding. It is not known if DuoNeb® (ipratropium bromide and albuterol sulfate) passes into your milk or if it can harm your baby. You and your doctor should decide whether you should take DuoNeb® (ipratropium bromide and albuterol sulfate) or breastfeed, but not both.

Tell your doctor about all the medicines you take including prescription and nonprescription medicines, vitamins and herbal supplements. DuoNeb® (ipratropium bromide and albuterol sulfate) and other medicines can interact. This may cause serious side effects. Especially tell your doctor if you take:

• Other medicines that contain anticholinergics such as ipratropium bromide. This also includes medicines used for Parkinson's disease.
• Other medicines that contain beta-agonists such as albuterol sulfate. These are usually used to treat airway narrowing (bronchospasm).
• Medicines called beta-blockers. These are usually used for high blood pressure or heart problems.
• Medicines called “water pills” (diuretics)
• Medicines for depression called monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants.

Ask your doctor or pharmacist if you are not sure if you take any of these types of medicines. Know the medicines you take. Keep a list of them and show it to your doctor and pharmacists when you get a new medicine.

How should I use DuoNeb® (ipratropium bromide and albuterol sulfate) ?

• Read the Patient's Instructions for Use that you get with your prescription. Talk to your doctor or pharmacist if you have any questions.
• Take DuoNeb® (ipratropium bromide and albuterol sulfate) exactly as prescribed by your doctor. Do not change your dose or how often you use DuoNeb® (ipratropium bromide and albuterol sulfate) without talking to your doctor. Inhale DuoNeb® (ipratropium bromide and albuterol sulfate) through your mouth and into your lungs using a machine called a nebulizer.
• DuoNeb® (ipratropium bromide and albuterol sulfate) may help to open your airways for up to 5 hours after taking this medicine. If DuoNeb® (ipratropium bromide and albuterol sulfate) does not help your airway narrowing (bronchospasm) or your bronchospasm gets worse, call your doctor right away or get emergency help if needed.

What should I avoid while using DuoNeb® (ipratropium bromide and albuterol sulfate) ?

Do not get DuoNeb® (ipratropium bromide and albuterol sulfate) in your eyes. Be careful not to spray DuoNeb® (ipratropium bromide and albuterol sulfate) in your eyes while you are using your nebulizer. DuoNeb® (ipratropium bromide and albuterol sulfate) can cause the following short-term eye problems:

• Enlarged pupils
• Blurry vision
• Eye pain

DuoNeb® (ipratropium bromide and albuterol sulfate) can cause a serious eye problem called narrow-angle glaucoma or worsen the narrow-angle glaucoma you already have.

What are the possible side effects with DuoNeb® (ipratropium bromide and albuterol sulfate) ?

DuoNeb® (ipratropium bromide and albuterol sulfate) may cause the following serious side effects:

• Worsening of the narrowing in your airways (bronchospasm). This side effect can be life-threatening and has happened with both of the medicines that are in DuoNeb® (ipratropium bromide and albuterol sulfate) . Stop DuoNeb® (ipratropium bromide and albuterol sulfate) and call your doctor right away or get emergency help if your breathing problems get worse while or after using DuoNeb® (ipratropium bromide and albuterol sulfate) .
• Serious and life-threatening allergic reactions. Symptoms of a serious allergic reaction include:
  • Hives, rash
  • Swelling of your face, eyelids, lips, tongue, or throat, and trouble swallowing
  • Worsening of your breathing problems such as wheezing, chest tightness or shortness of breath
  • Shock (loss of blood pressure and consciousness)

The most common side effects with DuoNeb® (ipratropium bromide and albuterol sulfate) include lung disease, sore throat, chest pain, constipation, diarrhea, bronchitis, urinary tract infection, leg cramps, nausea, upset stomach, voice changes, and pain.

These are not all the side effects with DuoNeb® (ipratropium bromide and albuterol sulfate) . For a complete list, ask your doctor or pharmacist.

How should I store DuoNeb® (ipratropium bromide and albuterol sulfate) ?

• Store DuoNeb® (ipratropium bromide and albuterol sulfate) between 36° and 77°F (2° and 25°C). Protect from light. Keep the unused vials in the foil pouch or carton.
• Safely discard DuoNeb® (ipratropium bromide and albuterol sulfate) that is out-of-date or no longer needed.
• Keep DuoNeb® (ipratropium bromide and albuterol sulfate) and all medicines out of the reach of children.

General advice about DuoNeb® (ipratropium bromide and albuterol sulfate)

Medicines are sometimes prescribed for conditions that are not mentioned in the patient information leaflets. Do not use DuoNeb® (ipratropium bromide and albuterol sulfate) for a condition for which it was not prescribed. Do not give DuoNeb® (ipratropium bromide and albuterol sulfate) to other people, even if they have the same symptoms you have. It may harm them.

This leaflet summarizes the most important information about DuoNeb® (ipratropium bromide and albuterol sulfate) . If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about DuoNeb® (ipratropium bromide and albuterol sulfate) that is written for healthcare professionals. You can also call the company that makes DuoNeb® (ipratropium bromide and albuterol sulfate) toll free at 1-800-755-5560 or visit their website at www.dey.com.

What are the ingredients in DuoNeb®?

Active Ingredients: ipratropium bromide and albuterol sulfate

Inactive Ingredients: sodium chloride, hydrochloric acid, and edetate sodium, USP.

Last reviewed on RxList: 4/22/2011
This monograph has been modified to include the generic and brand name in many instances.