DuoNeb?
(ipratropium bromide 0.5 mg/albuterol sulfate 3.0 mg*)
Inhalation Solution *Equivalent to 2.5 mg albuterol base
DRUG DESCRIPTION
The active components in DuoNeb? Inhalation Solution are albuterol sulfate and ipratropium bromide.
Albuterol sulfate, is a salt of racemic albuterol and a relatively selective ⓶-adrenergic bronchodilator chemically described as ⓫-[(tert-butylamino)methyl]-4-hydroxy-m-xylene-α, α'-diol sulfate (2:1) (salt). It has a molecular weight of 576.7 and the empirical formula is (C13H21NO3)2?H2SO4.
Each 3 mL vial of DuoNeb contains 3.0mg (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 is a clear, colorless solution. It does not require dilution prior to administration by nebulization. For DuoNeb 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 should be administered from jet nebulizers at adequate flow rates, via face masks or mouthpieces
INDICATIONS
DuoNeb is indicated for the treatment of bronchospasm associated with COPD in patients requiring more than one bronchodilator.
DRUG INTERACTIONS
Anticholinergic agents: Although ipratropium bromide is minimally absorbed into the systemic circulation, there is some potential for an additive interaction with concomitantly used anticholinergic medications. Caution is, therefore, advised in the co-administration of DuoNeb with other drugs having anticholinergic properties.
β-adrenergic agents: Caution is advised in the co-administration of DuoNeb and other sympathomimetic agents due to the increased risk of adverse cardiovascular effects.
β-receptor blocking agents: These agents and albuterol sulfate inhibit the effect of each other. β-receptor blocking agents should be used with caution in patients with hyperreactive airways, and if used, relatively selective ⓵ selective agents are recommended.
