DuoNeb

Duoneb is a prescription medication used to prevent symptoms associated with chronic obstructive pulmonary disease (COPD). Symptoms of COPD include wheezing, difficulty breathing, chest tightness, and coughing.

It is a single product containing 2 medications: ipratropium and albuterol. Both ipratropium and albuterol belong to a group of drugs called bronchodilators. Ipratropium is also known as an anticholinergic or antimuscarinic agent, and albuterol is also known as a beta-agonist. Both ingredients work by relaxing and opening the air passages to the lungs, which makes breathing easier.

Duoneb is supplied as a solution for inhalation using a nebulizer to inhale by mouth. It is usually inhaled 4 times a day.

Common side effects of Duoneb include respiratory tract infection, headache, cough, and nervousness.

Duonebcan also cause blurred vision, drowsiness, and dizziness. Do not drive or operate heavy machinery until you know how Duoneb affects you.

Duoneb is a prescription medication used to prevent symptoms associated with chronic obstructive pulmonary disease (COPD). Symptoms of COPD include wheezing, difficulty breathing, chest tightness, and coughing.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Mylan Specialty

Serious side effects have been reported with Duoneb. See the “Drug Precautions” section.

Common side effects of Duoneb include the following:

• headache
• respiratory tract infection
• cough
• shortness of breath

This is not a complete list of Duoneb side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take or have recently stopped taking:

• antidepressants such as amitriptyline amoxapine; clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
• beta blockers such as atenolol (Tenormin), labetalol, metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
• diuretics ('water pills')
• epinephrine (Epipen, Primatene Mist)
• medications for colds, irritable bowel disease, Parkinson's disease, ulcers, or urinary problems
• monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar)
• other inhaled medications, especially other medications for asthma such as arformoterol (Brovana), formoterol (Foradil, Perforomist), metaproterenol, levalbuterol (Xopenex), and salmeterol (Serevent, in Advair)
• terbutaline (Brethine)

This is not a complete list of Duoneb drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with Duoneb including the following:

• Brochospasm. Duoneb can cause life-threatening bronchospasm, which is a sudden constriction of the muscles in the walls of the airways leading to the lungs. Bronchospasm is more likely to occur with the first use of a new canister.
• Cardiovascular effects. Duoneb can cause changes in blood pressure and heart rate and symptoms including chest pain or past or pounding heartbeat. This medication should be used with caution in patients with cardiovascular disorders.
• Hypersensitivity reactions. Tell your healthcare provider right away if you have any of the following symptoms of a hypersensitivity reaction to Duoneb:
  • itching
  • hives
  • rash
  • swelling of the eyes, face, lips, tongue, or throat
  • swelling of the hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing or breathing

Duoneb can cause drowsiness, dizziness, and blurred vision. Do not drive or operate heavy machinery until you know how Duoneb affects you.

Do not take Duoneb if you:

• are allergic to Duoneb or to any of its ingredients
• are allergic to peanuts or soybeans
• are allergic to atropine or related medications

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Duoneb, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking Duoneb, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to Duoneb or to any of its ingredients
• are allergic to peanuts or soybeans
• are allergic to atropine or related medications
• have or have had urinary difficulties or prostate problems
• have or have had seizures
• have hyperthyroidism
• have high blood pressure
• have an irregular heartbeat
• have diabetes
• have liver problems
• have heart problems
• have kidney problems
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Duoneb falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Duoneb crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Duoneb.

Use Duoneb exactly as prescribed.

Duoneb is supplied as a solution for inhalation using a nebulizer to inhale by mouth. It is usually inhaled 4 times a day.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Duoneb at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• how you respond to this medication

The recommended dose of Duoneb (ipratropium/albuterol) solution is 1 vial via nebulizer 3 to 4 times daily. Up to 2 additional doses may be taken each day as needed.

If you take too much Duoneb, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If Duoneb is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store Duoneb 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 that is out-of-date or no longer needed.
• Keep DuoNeb and all medicines out of the reach of children.