Duolin Inhaler

Duolin Inhaler (Levosalbutamol and Ipratropium Bromide Inhaler) - Product Information

Duolin Inhaler (Levosalbutamol Sulphate and Ipratropium Bromide Inhaler) is indicated 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.
Levalbuterol (Levosalbutamol) is used to prevent or treat bronchospasm in patients with asthma and other lung diseases.
Ipratropium 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).
We also have in stock Asthalin Inhaler (Albuterol Inhaler) which is used by patients diagnosed with various bronchospasm conditions such as bronchitis, emphysema, or COPD (chronic obstructive pulmonary disease).

Name of the Drug

Duolin Inhaler. Duolin Inhaler is also known as Ipratropium Bromide and Levalbuterol Sulphate Inhaler.

Manufacturer of Duolin Inhaler

Cipla Limited, India.  
Website: www.cipla.com

Active Pharmaceutical Ingredient

The active ingredient present in are Levosalbutamol Tartrate (Levalbuterol Tartrate) and Ipratropium Bromide. Each puff contains Levosalbutamol Tartrate equivalent to Levosalbutamol 50 mcg and Ipratropium Bromide 20 mcg.

Uses of Duolin Inhaler

Duolin Inhaler is a combination of Ipratropium Bromide (an anticholinergic agent) and Levalbuterol Tartrate (a beta2-adrenergic agonist) indicated for use in 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.

Duolin Inhaler - Dosage

Generic Levosalbutamol Tartrate and Ipratropium Bromide inhaler should be administered exactly as suggested by your doctor. Your doctor may recommend a dosage of Duolin inhaler depending on your age, medical requirement, body weight, other medical conditions, and current medications.
The dosage of Duolin Inhaler 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.

Duolin Inhaler works effectively if the amount of Levosalbutamol Tartrate and Ipratropium is maintained at a constant level in the body. You should be systematic about the daily schedule for the medication such that you take tablets at about the same time every day, to get the maximum benefit of the medication. Continue administering Duolin Inhaler without missing any doses for the recommended treatment period and do not stop the treatment suddenly even if you feel better.

Please consult your doctor for exact dosing instructions. Duolin inhaler (Generic Levosalbutamol Tartrate and Ipratropium Bromide inhaler) should be administered in the dose prescribed by the doctor and for the duration recommended by the doctor.

Missed Dose

If you forget to take your regular Duolin Inhaler dose on time, take it whenever you remember.
If you remember the next day, skip the missed dose and take your scheduled dose. Do not take a double dose to compensate the missed dose.

Duolin Inhaler Mechanism of Action

Duolin Inhaler contains a combination of two bronchodilators, Ipratropium Bromide and Levosalbutamol, which work synergistically to treat the characteristic symptoms of asthma and chronic obstructive pulmonary disease (COPD).
Levosalbutamol belongs to a class of medications known as selective short-acting beta2-agonist. Levosalbutamol exerts its mechanism of action on all the airways of the lungs, beginning from the trachea (windpipe) to the terminal bronchioles (small airways) and acts as a bronchodilator by relaxing the smooth muscle in the airway walls to expand the airways and to improve the airflow to the lungs.
Ipratropium bromide is an anticholinergic (parasympatholytic) agent, which appears to inhibit vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter agent released at neuromuscular junctions in the lungs. Anticholinergics prevent increases in intracellular concentration of cyclic guanosine monophosphate (cGMP), which are caused by interaction of acetylcholine with the muscarinic receptor on bronchial smooth muscle.
The bronchodilation following inhalation of ipratropium bromide is primarily local and site specific to the lung and not systemic in nature.

Storage Instructions for Duolin Inhaler

Store Duolin Inhaler at controlled room temperature (20°C to 25°C),protected from heat, moisture, and sunlight. Excursions are permitted from 15°C to 30°C.
Retain the original packing of the medication and do not consume past its expiration date printed on the blister pack. Keep the pack of Duolin Inhaler away from the reach of children and pets. Do not dispose Duolin Inhaler along with domestic waste or sewage. Consult your doctor or pharmacist about the correct method of disposal.

Contraindications

Duolin Inhaler is contraindicated in patients with a hypersensitivity to Ipratropium Bromide or Levosalbutamol or any inactive ingredient present in Duolin Inhaler. 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.

Overdose

Levosalbutamol:
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 levosalbutamol.
Treatment consists of discontinuation of 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 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.
Should signs of serious anticholinergic toxicity appear, cholinesterase inhibitors may be considered.

Warnings and Precautions

Paradoxical Bronchospasm
Like other inhaled beta-adrenergic agonists, levosalbutamol can produce paradoxical bronchospasm, which may be life-threatening. If paradoxical bronchospasm occurs, DUOLIN Inhaler should be discontinued immediately and alternative therapy instituted. It should be recognized that paradoxical bronchospasm, when associated with inhaled formulations, frequently occurs with the first use of a new canister.
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 than usual, this may be a marker of destabilization of asthma and requires re-evaluation of the patient and treatment regimen, with special consideration to the possible need for anti-inflammatory treatment, e.g., corticosteroids.
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.
Cardiovascular Effects
Levosalbutamol contained in DUOLIN Inhaler, like other beta-adrenergic agonists, can produce clinically significant cardiovascular effects in some patients, as measured by heart rate, blood pressure, and/or symptoms. Although such effects are uncommon after administration of levosalbutamol at recommended doses, if they occur, the drug may need to be discontinued. In addition, beta-agonists have been reported to produce electrocardiogram (ECG) changes
Do Not Exceed Recommended Dose
Fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs in patients with asthma
Immediate Hypersensitivity Reactions
Immediate hypersensitivity reactions may occur after administration of ipratropium bromide or racemic salbutamol, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis, and oropharyngeal edema.
If such a reaction occurs, DUOLIN Inhaler must be stopped at once and alternative treatment should be considered.
Co-existing Conditions
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. Clinically significant changes in systolic and diastolic blood pressures have been seen in individual patients and could be expected to occur in some patients after the use of any beta-adrenergic bronchodilator.
Excessive Use and Use with other Muscarinic Antagonists
Ipratropium bromide should not be used more frequently or at higher doses than recommended (maximum recommended daily dose is 12 actuations = 240 mcg; minimum dosing interval is 4 hours).
Worsening of Narrow-Angle Glaucoma
Ipratropium bromide should be used with caution in patients with narrow-angle glaucoma. Care should be taken to avoid spraying the mist into the eyes. Since the pressurized inhalation solution is applied via mouth piece and manually controlled, the risk for the mist entering the eyes is limited. There have been isolated cases of ocular complications (i.e., mydriasis, increased intraocular pressure, narrow angle closure glaucoma, eye pain) when aerosolised ipratropium bromide either alone or in combination with an adrenergic beta2-agonist solution has come in contact with the eyes.
Worsening of Urinary Retention
Ipratropium bromide should be used with caution in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of prostatic hyperplasia or bladder-neck obstruction (e.g., difficulty passing urine, painful urination). Instruct patients to consult a physician immediately should any of these signs or symptoms develop.

Side Effects of Duolin Inhaler (Levosalbutamol and Ipratropium Bromide Inhaler )

The most frequent side effects reported in clinical trials for Levosalbutamol and Ipratropium Bromide Inhaler were headache, throat irritation, cough, dry mouth, gastrointestinal motility disorders (including constipation, diarrhoea and vomiting), nausea and dizziness. Other side effects include

• Central Nervous System- headache, tremor (shaky or tense feeling), blurred vision
• Cardiovascular System - tachycardia (rapid heartbeat)
• Gastrointestinal System- dryness of mouth and palpitations, nausea
• Respiratory System- pharyngitis, upper respiratory tract infection, dysphonia, pneumonia, throat irritation, viral respiratory infections, cough
• Musculoskeletal System- back pain, pain in joints, muscle pain, muscle cramps
• Hypersensitivity- rash, hives, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, tightness in the chest, skin redness

Inform your doctor immediately if you experience any of these side effects. This is not an exhaustive list of all the potential side effects of Ipratropium Bromide and Levosalbutamol Inhaler. If you develop any other medical conditions during the course of treatment with Duolin Inhaler, please contact your doctor immediately.

Levosalbutamol and Ipratropium Bromide Inhaler (Duolin Inhaler) During Pregnancy

Levosalbutamol and Ipratropium Bromide Inhaler (Duolin Inhaler) has been classified by the US FDA as Pregnancy Category C.
There are no adequate and well-controlled studies of levosalbutamol and ipratropium combination inhaler in pregnant women. 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.
Do not use this medicine without your doctor's consent in case you are pregnant. Stop using this medication and inform your doctor immediately if you become pregnant during treatment.
Plasma concentrations of levosalbutamol after inhalation of therapeutic doses are very low in humans. It is not known whether Levosalbutamol and Ipratropium bromide are excreted in human milk.
Because of the potential for tumorigenicity shown for racemic salbutamol in animal studies, decision should be made whether to discontinue nursing or to discontinue Levosalbutamol, taking into account the importance of the drug to the mother.
Do not use this medication without telling your doctor if you are breast-feeding a baby.

Buy Duolin Inhaler (Levosalbutamol and Ipratropium Bromide Inhaler ) Online at Only $15 per Inhaler

You can buy Levosalbutamol and Ipratropium Bromide Inhaler online from Everest Online Pharmacy at a cheap price. Duolin Inhaler (50 mcg of Levosalbutamol and 20 mcg Ipratropium Bromide) , manufactured by Cipla limited, India is supplied in a cannister. The inhaler costs only $15 per unit when you place an order for 16 cannisters (Inhalers).

Disclaimer

The above information is provided to the best of our knowledge and in good faith. It is without a warrant of any kind, expressed or implied.

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