DuoNeb (albuterol/ipratropium) Disease Interactions
There are 6 disease interactions with DuoNeb (albuterol/ipratropium):
Albuterol Er (Includes DuoNeb) ↔ Gi Narrowing
Moderate Potential Hazard, Moderate plausibility
Applies to: Gastrointestinal Obstruction
The extended-release formulation of albuterol (Proventil Repetabs, Volmax) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of albuterol should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.
Beta-2 Adrenergic Bronchodilators (Includes DuoNeb) ↔ Cardiovascular
Moderate Potential Hazard, High plausibility
Applies to: Heart Disease, Hypertension, Hyperthyroidism
Adrenergic bronchodilators can stimulate cardiovascular beta-1 and beta-2 receptors, occasionally producing adverse effects such as tachycardia, palpitation, ECG changes, peripheral vasodilation, and blood pressure changes. Direct stimulation of cardiac tissues is mediated by beta-1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism or underlying cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded. Systemic adverse effects are minimized but not abolished by administration of these agents via oral inhalation.
Beta-2 Adrenergic Bronchodilators (Includes DuoNeb) ↔ Diabetes
Moderate Potential Hazard, Low plausibility
Applies to: Diabetes Mellitus
Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to exacerbate preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.
Beta-2 Adrenergic Bronchodilators (Includes DuoNeb) ↔ Hypokalemia
Moderate Potential Hazard, Moderate plausibility
Applies to: Hypokalemia
Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.
Beta-2 Adrenergic Bronchodilators (Includes DuoNeb) ↔ Seizures
Moderate Potential Hazard, Low plausibility
Applies to: Seizures
Adrenergic bronchodilators may cause CNS stimulation. Seizures have been reported rarely in patients treated with terbutaline. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized but not abolished by administration of these agents via oral inhalation.
Ipratropium/Tiotropium (Includes DuoNeb) ↔ Anticholinergic Effects
Moderate Potential Hazard, Low plausibility
Applies to: Urinary Retention, Glaucoma (Narrow Angle)
Ipratropium and tiotropium are anticholinergic agents. Although systemic effects are rarely seen due to the poor absorption of quaternary ammonium compounds from gastrointestinal and nasal mucosa, there have been reports of increased intraocular pressure and precipitation or exacerbation of angle-closure glaucoma following inadvertent contact of the eye with aerosolized or nebulized drug. Accordingly, therapy with ipratropium and tiotropium should be administered cautiously in patients with urinary retention/obstruction or angle-closure glaucoma. Measures should be taken to minimize ocular exposure to these drugs (e.g., keeping eyes closed during administration by oral inhalation; use of a mouthpiece rather than face mask during nebulization). Urinary retention has been reported occasionally in patients receiving larger doses of ipratropium by nebulizer.
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DuoNeb (albuterol/ipratropium) drug Interactions
There are 614 drug interactions with DuoNeb (albuterol/ipratropium)
DuoNeb (albuterol/ipratropium) alcohol/food Interactions
There is 1 alcohol/food interaction with DuoNeb (albuterol/ipratropium)
See also...
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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