Consumer Information

DuoNeb

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Treatment & Uses
Side Effects
Treating Overdose
Safety Information
Before Using

Generic Name: albuterol and ipratropium (inhalation) (al BYOO ter ol and ip ra TRO pee um)
Brand Names: Combivent, DuoNeb

What is DuoNeb?

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DuoNeb contains a combination of albuterol and ipratropium. Albuterol and ipratropium are bronchodilators that relax muscles in the airways and increase air flow to the lungs.

DuoNeb is used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD) who are also using other medicines to control their condition.

DuoNeb may also be used for other purposes not listed in this medication guide.

Important information about DuoNeb

Do not use the DuoNeb if you are allergic to albuterol or ipratropium, or to atropine (Atreza, Sal-Tropine).

Call your doctor right away if you feel that DuoNeb is not working as well as usual, or if it makes your condition worse. If it seems like you need to use more of any of your medications in a 24-hour period, talk with your doctor.

Before using DuoNeb

Do not use the DuoNeb if you are allergic to albuterol or ipratropium, or to atropine (Atreza, Sal-Tropine).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use DuoNeb:

heart disease, high blood pressure, or congestive heart failure;
a seizure disorder such as epilepsy;
diabetes;
overactive thyroid;
glaucoma;
enlarged prostate, problems with urination; or
liver or kidney disease.

FDA pregnancy category C. It is not known whether DuoNeb is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether albuterol and ipratropium passes into breast milk or if it could harm a nursing baby. Do not use DuoNeb without telling your doctor if you are breast-feeding a baby.

How should I use DuoNeb?

Use DuoNeb exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

DuoNeb may increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Take DuoNeb exactly as prescribed by your doctor. Do not change your dose or how often you use this medicine without talking to your doctor. Inhale DuoNeb through your mouth and into your lungs using a machine called a nebulizer.

To use the DuoNeb solution with a nebulizer:

Measure the correct amount of medicine using the dropper provided, or use the proper number of ampules. Place the liquid into the medication chamber of the nebulizer. If using a medicine dropper, do not allow the dropper to touch any surface including your hands or the nebulizer.
Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright in a comfortable position. Place the mouthpiece into your mouth or put the face mask on, covering your nose and mouth. Breathe in slowly and evenly until you have inhaled all of the medicine (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.
Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

To be sure DuoNeb is helping your condition, your lung function will need to be tested on a regular basis. It is important that you not miss any scheduled visits to your doctor.

It is important to use this medication regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Keep using all of your other medications as prescribed by your doctor.

Store DuoNeb at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of DuoNeb can be fatal. Overdose symptoms may include chest pain or heavy feeling, rapid or uneven heart rate, pain spreading to the arm or shoulder, nausea, sweating, weakness, or general ill feeling.

What should I avoid while using DuoNeb?

Avoid getting this medication in your eyes. If this does happen, rinse the eyes with water and seek medical attention.

DuoNeb side effects

Stop using this medication and get emergency medical help if you have any of these signs of an allergic reaction to DuoNeb: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using DuoNeb and call your doctor at once if you have any of these serious side effects:

bronchospasm (wheezing, chest tightness, trouble breathing), especially after starting a new canister of this medicine;
chest pain and fast, pounding, or uneven heart beats;
swelling of your ankles or feet;
pain or burning with urination; or
increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure).

Less serious DuoNeb side effects may include:

headache, dizziness, nervousness;
drowsiness or sleep problems (insomnia);
cough, hoarseness, sore throat, runny or stuffy nose;
dry mouth, unusual taste in your mouth;
tremors, numbness or tingly feeling;
nausea, vomiting, upset stomach, diarrhea, constipation; or
blurred vision.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect DuoNeb?

Tell your doctor about all other medications you use, especially:

atropine (Donnatal, and others);
belladonna;
clidinium (Quarzan);
dicyclomine (Bentyl);
glycopyrrolate (Robinul);
hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);
mepenzolate (Cantil);
methantheline (Provocholine);
methscopolamine (Pamine), scopolamine (Transderm-Scop);
propantheline (Pro-Banthine);
a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), metoprolol (Lopressor), propranolol (Inderal), and others;
a diuretic (water pill);
a stimulant, ADHD medication, diet pills, or over-the-counter cold or allergy medicines; or
an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

This list is not complete and there may be other drugs that can interact with DuoNeb. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about DuoNeb.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.