Duavent

Per 2.5 mL pulmoneb Ipratropium Br 500 mcg, salbutamol sulfate 2.5 mg. Per actuation Ipratropium Br 21 mcg, salbutamol sulfate 120 mcg

Management of reversible bronchospasm associated w/ obstructive airway diseases (eg, bronchial asthma). Patients w/ COPD on a regular inhaled bronchodilator who continue to have evidence of bronchospasm & require a 2nd bronchodilator.

Pulmoneb Adult, adolescent >12 yr & elderly Acute attacks 1-2 pulmoneb. Maintenance: 1 pulmoneb every 6-8 hr daily. Childn 2-12 yr 3 drops/kg/dose. Max: 2.5 mg of salbutamol every 6-8 hr. MDI Adult & childn > 12 yr 2 actuations 6 hrly. Max: 12 actuations in 24 hr.

Hypersensitivity to salbutamol, ipratropium Br or to atropine & its derivatives. Hypertrophic obstructive cardiomyopathy or tachyarrhythmia.

Cardiac arrest following severe, acute asthmatic crisis & hypoxia. Discontinue immediately if paradoxical bronchospasm occurs. Increased IOP & precipitate angle-closure glaucoma. Patients w/ cystic fibrosis may be more prone to GI motility disturbances. Narrow-angle glaucoma; CV disorders including coronary insufficiency, cardiac arrhythmias or HTN; convulsive disorders; hyperthyroidism; DM; patients who are unusually responsive to sympathomimetic amines; prostatic hypertrophy or bladder-neck obstruction. Hepatic or renal disease. Severe airway obstruction where concomitant therapy w/ steroid, xanthine derivatives or diuretics may result in hypokalemia. Monitor plasma K conc. Pregnancy & lactation. Salbutamol: Decreased plasma K conc through intracellular shunting resulting in CV adverse reactions. Ipratropium Br: Increased risk of mortality &/or CV events (eg, MI, stroke, transient ischemic attacks). Pulmoneb: Do not expose the eyes to the nebulized soln as this may result in temporary pupillary dilation, precipitation or worsening of narrow-angle glaucoma, eye pain or discomfort, blurred vision, visual halos or colored images in association w/ red eyes from conjunctival & corneal congestion.

Bronchitis, dyspnea, cough, lower/upper resp tract disorders, pneumonia, bronchospasm, URTI, sinusitis, pharyngitis/sore throat, rhinitis, flu-like symptoms, nasal congestion, wheezing, lung disease, dysphonia/voice alterations, increased sputum, exacerbation of resp symptoms, hemoptysis, oropharyngeal edema, laryngospasm, bronchospasm, anaphylactic reactions, paradoxical bronchospasm; tachycardia, palpitation, angina, chest pain, hypotension, HTN, arrhythmias, vasodilation, heartburn; tremor, nervousness, dizziness, headache, drowsiness, coordination difficulty, paresthesia, hypertonia, flushing, reduced appetite, insomnia, migraine, anxiety, vertigo, CNS stimulation; dry mouth, throat & tongue; mucosal ulcers, thirst, diarrhea, dyspepsia, GI distress, constipation, paralytic ileus, nausea, vomiting; slight elevation of serum ALT, increased sweating, hypokalemia; arthralgia, pain, back pain, leg cramps, asthenia/muscle weakness, myalgia, muscle cramps; skin rash; angioedema of the tongue, lips & face; urticaria, pruritus, contact dermatitis; precipitation or worsening of narrow-angle glaucoma, temporary pupillary dilation, blurred vision, acute eye pain; UTI/dysuria, urinary retention/difficulty; otitis media, tinnitus; viral infection, local irritation, unusual taste/taste perversion, fatigue.

May increase risk of adverse CV events w/ other sympathomimetic agents. ECG changes &/or hypokalemia w/ non-K sparing diuretics (eg, loop or thiazide diuretics). Salbutamol: Inhibit effect w/ β-receptor blocking agent. May potentiate effect on CV system w/ MAOIs & TCAs. Ipratropium Br: Potential for additive interaction w/ anticholinergic medications.

Antiasthmatic & COPD Preparations

R03AL02 - salbutamol and ipratropium bromide ; Belongs to the class of combination of adrenergics with anticholinergics, that may also include a corticosteroid. Used in the treatment of obstructive airway diseases.

Rx