Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)

Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler) is used for the treatment or prevention of bronchospasm in adults, adolescents, and children (4 years of age and older) with reversible obstructive airway diseases like asthma and COPD, including chronic bronchitis and emphysema.
Duolin Inhaler is a combination of an anticholinergic and beta-adrenergic used for patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continue to have evidence of bronchospasm and who require a second bronchodilator.

1. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy

2. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Duolin Inhaler (Generic Ipratropium Bromide and
Levalbuterol Tartrate Inhaler) is used for the treatment or
prevention of bronchospasm in adults, adolescents, and
children (4 years of age and older) with reversible
obstructive airway diseases like asthma and COPD,
including chronic bronchitis and emphysema.
Duolin Inhaler is a combination of an anticholinergic and
beta-adrenergic used for patients with chronic obstructive
pulmonary disease (COPD) on a regular aerosol
bronchodilator who continue to have evidence of
bronchospasm and who require a second bronchodilator.

3. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Duolin Inhaler is manufactured by
Cipla Limited, India.
Each puff contains Levalbuterol /
Levosalbutamol Sulfate 50 mcg and
Ipratropium Bromide 20 mcg.

4. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Chemical Structure - Ipratropium Bromide

5. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Chemical Structure - Levalbuterol Tartrate

6. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
The active ingredients contained in Duolin Inhaler
are Ipratropium Bromide and Levalbuterol
Tartrate (Levosalbutamol Tartrate).
Each puff contains 50 mcg of Levalbuterol
Tartrate (Levosalbutamol Tartrate) and 20 mcg of
Ipratropium Bromide.

7. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Uses of Duolin Inhaler:
Ipratropium Bromide and Levalbuterol Tartrate inhalation solution is a
combination of two medicines called bronchodilators.
Ipratropium and Levalbuterol combination is used to help control the
symptoms of lung diseases, such as asthma, chronic bronchitis, and
emphysema. It is also used to treat air flow blockage and prevent the
worsening of chronic obstructive pulmonary disease (COPD) in patients who
need another medicine.
Duolin Inhaler contains Levalbuterol Tartrate, which is a beta-adrenergic
agonist, and Ipratropium Bromide, which is an anticholinergic. These two
medicines work together to help open the airways in your lungs. Ipratropium
Bromide and Levalbuterol Tartrate inhalation solution is used to help treat
airway narrowing (bronchospasm) that happens with chronic obstructive
pulmonary disease (COPD) in adult patients who need to use more than one
bronchodilator medicine.
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8. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Recommended Adult Dosage
The dosage of Duolin Inhaler (Generic Ipratropium and
Levalbuterol Inhaler) is is 2 inhalations, four times a day.
Patients may take additional inhalations as required; however,
the total number of inhalations should not exceed 12 in 24
hours.
It is recommended to “test-spray” three times before using for
the first time and in cases where the aerosol has not been
used for more than 24 hours. Avoid spraying into eyes.
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9. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Contraindications
➔
Duolin Inhaler is contraindicated in patients with a known
hypersensitivity to Ipratropium Bromide, Levosalbutamol
Tartarate, Racemic Albuterol or any component of the tablet.
Reactions have included urticaria, angioedema, rash,
bronchospasm, anaphylaxis, and oropharyngeal edema
➔
Administration of Ipratropium Bromide is contraindicated in
patients who are hypersensitive to atropine or its derivatives.
➔
Duolin Inhaler is contraindicated in patients with a history of
hypersensitivity to soya lecithin or related food products such as
soybean and peanut.
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10. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Storage Instructions
Duolin Inhaler (Generic Ipratropium Bromide and
Levalbuterol Tartrate Inhaler) has to be stored at
controlled room temperature i.e. from 20°C to 25°C
(68°F to 77°F) with excursions permitted between 15°
to 30°C (59° to 86°F).
Keep this as well as all other medicines away from
children and pets.
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11. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Warnings
Paradoxical Bronchospasm: Discontinue Duolin Inhaler immediately and treat
with alternative therapy if paradoxical bronchospasm occurs.
Deterioration of Asthma: Asthma may deteriorate acutely over a period of
hours or chronically over several days or longer. If the patient needs more
doses of Levosalbutamol (Levalbuterol) than usual, this may be a marker of
destabilization of asthma and requires re-evaluation of the patient and
treatment regimen.
Use of Anti-Inflammatory Agents: The use of a beta-adrenergic agonist alone
may not be adequate to control asthma in many patients. Early consideration
should be given to adding anti-
­inflammatory agents, e.g., corticosteroids, to
the therapeutic regimen.
Patients with cardiovascular system disorders: Use with caution because of
beta-adrenergic stimulation.
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12. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Warnings
Ocular effects: Advise patients to avoid spraying into eyes and to contact a
physician if blurred vision, halos, or other visual disturbances occur. Monitor
patients with narrow-angle glaucoma.
Do Not Exceed Recommended Dose: Fatalities have been reported in
association with excessive use of inhaled sympathomimetic drugs in patients
with asthma. The exact cause of death is unknown, but cardiac arrest
following an unexpected development of a severe acute asthmatic crisis and
subsequent hypoxia is suspected.
Immediate Hypersensitivity Reactions: Immediate hypersensitivity reactions
may occur after administration of ipratropium bromide or racemic salbutamol
(Albuterol), as demonstrated by rare cases of urticaria, angioedema, rash,
bronchospasm, anaphylaxis, and oropharyngeal edema. In case such a
reaction occurs, Duolin Inhaler must be stopped at once and alternative
treatment should be considered.
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13. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Warnings
Urinary retention: Use with caution in patients with prostatic hyperplasia or
bladder-neck obstruction
Coexisting conditions: Levalbuterol (Levosalbutamol), like all
sympathomimetic amines, should be used with caution in patients with
cardiovascular disorders, especially coronary insufficiency, hypertension, and
cardiac arrhythmias; in patients with convulsive disorders, hyperthyroidism, or
diabetes mellitus; and in patients who are unusually responsive to
sympathomimetic amines.
Ipratropium Bromide: Ipratropium bromide is a bronchodilator for the
maintenance treatment of bronchospasm associated with COPD and is not
indicated for the initial treatment of acute episodes of bronchospasm, where
rescue therapy is required for rapid response.
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14. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Possible Side Effects
Use of Levalbuterol (Levosalbutamol) may be associated with the
following serious side effects: Paradoxical bronchospasm,
Cardiovascular effects, Immediate hypersensitivity reactions and
Hypokalemia.
Following side effects were observed in 2% or more of the patients
receiving Levalbuterol inhalation or racemic Albuterol and more
frequently than in patients receiving placebo during placebo-controlled
trial in patients with asthma 12 years of age and older: Allergic reaction,
Flu syndrome, Accidental injury, Pain, Back pain, Tachycardia, Migraine,
Dyspepsia, Leg cramps, Dizziness, Hypertonia, Nervousness, Tremor,
Anxiety, Cough increased, Infection viral, Rhinitis, Sinusitis and Turbinate
edema
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15. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Possible Side Effects
Ipratropium Bromide inhalation side effects reported by three percent
or more patients in the 12-week controlled clinical trials from 12-week
active-controlled clinical trials are Headache, Pain, Influenza-like
symptoms, Back Pain, Chest Pain, Hypertension/Hypertension
Aggravated, Dizziness, Insomnia, Tremor, Nervousness, Mouth
Dryness, Nausea, Constipation, Arthritis, Coughing, Dyspnea, Bronchitis,
Bronchospasm, Sputum Increased, Respiratory Disorder, Upper
Respiratory Tract Infection, Pharyngitis, Rhinitis and Sinusitus.
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16. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Overdosage
Levalbuterol Tartarate: The expected symptoms with overdosage are those
of excessive beta-adrenergic receptor stimulation and/or occurrence or
exaggeration of any of the symptoms listed under adverse reactions, e.g.,
seizures, angina, hypertension or hypotension, tachycardia with rates up to
200 beats/minute, arrhythmias, nervousness, headache, tremor, dry mouth,
palpitation, nausea, dizziness, fatigue, malaise, and sleeplessness.
Hypokalemia may also occur. As with all sympathomimetic medications,
cardiac arrest and, even, death may be associated with the abuse of
Levalbuterol (Levosalbutamol).
Ipratropium Bromide: Dose of Ipratropium Bromide up to 1.2 mg (60 puffs)
have been administered by inhalation without the appearance of serious
systemic anticholinergic effects. Minor systemic manifestations of
anticholinergic action, including dry mouth, visual accommodation disorder
and increase of heart rate may occur.
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17. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Treatment of Duolin Inhaler Overdosage
Levalbuterol Tartarate: Treatment consists of discontinuation of
Levalbuterol Tartarate (Levosalbutamol) together with appropriate
symptomatic therapy. The judicious use of a cardioselective beta-
receptor blocker may be considered, bearing in mind that such
medication can produce bronchospasm. There is insufficient evidence
to determine if dialysis is beneficial in treating overdosage of
Levalbuterol.
Ipratropium Bromide: Should signs of serious anticholinergic toxicity
appear, cholinesterase inhibitors may be considered.
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18. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Duolin Inhaler During Pregnancy
Ipratropium Bromide and Levalbuterol Tartarate Inhaler (Duolin Inhaler)
has been classified by the US FDA as Pregnancy Category C.
There are no adequate and well-controlled studies of Ipratropium
Bromide and Levalbuterol Tartarate combination inhaler (Duolin
Inhaler) in pregnant women.
Published literature, including cohort studies, case control studies and
case series, over several decades have not identified a drug associated
risk of major birth defects, miscarriage or adverse maternal or fetal
outcomes with Ipratropium Bromide.
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19. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Duolin Inhaler During Pregnancy
Available data from published epidemiological studies and
postmarketing case reports of pregnancy outcomes following inhaled
Albuterol use do not consistently demonstrate a risk of major birth
defects or, miscarriage.
Because animal reproduction studies are not always predictive of
human response, Duolin Inhaler should be used during pregnancy only
if the potential benefit justifies the potential risk to the fetus.
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20. Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol Tartrate Inhaler)
© The Swiss Pharmacy
Duolin Inhaler (Generic Ipratropium Bromide and Levalbuterol
Tartrate Inhaler) is manufactured by Cipla Limited, India.
URL: https://www.theswisspharmacy.com/product_info.php?info=p9535_Levosalbutamol-and-Ipratropium-Inhaler.html