(Ipratropium Bromide/Albuterol (Salbutamol) Sulfate)
Brand Name Choices
What Duoneb is and what it is used for
The name of your medicine is COMBIVENT
UDVs. You use it with a device called a
‘nebuliser’. This changes your medicine into a
mist for you to breathe in. COMBIVENT contains
two different medicines called:
• Ipratropium bromide and
• Salbutamol sulfate Both belong to a group of medicines called bronchodilators. They are used to make breathing easier in an illness called ‘chronic obstructive pulmonary disease’ or COPD. They work by opening up your airways.
How to take Duoneb
Always use COMBIVENT exactly as your
doctor has told you. You should check with your
doctor or pharmacist if you are not sure. Follow
these instructions to get the best results. If
anything is unclear after reading this leaflet, ask
your doctor, pharmacist or practice nurse.
How many dose units
The usual dose is the contents of 1 single dose
unit, three or four times a day for:
Adults (including the elderly) and children over
COMBIVENT is not recommended for
children under 12 years.
Do not swallow or give this medicine by
Do not use more than your doctor has told you
See your doctor straight away if:
• You feel that your medicine is not working as well as usual
• You need to use the nebuliser more than your doctor has recommended Your doctor may need to check how well your medicine is working. In some cases your doctor may need to change your medicin How to use your nebuliser Read through numbers 1 to 6 first, before starting to use your nebuliser. 1. Get your nebuliser ready by following the manufacturer’s instructions. Ask your doctor if you are not sure how to use it. 2.
• Open the pouch and remove the strip of unit dose vials
• Carefully separate a new dose unit from the strip
• Do not use if it is already open or if the liquid inside is discoloured 3.
• Twist off the top
• Always hold it upright while you do this 4.
• Squeeze all the contents of the dose unit into the nebuliser chamber
• Your doctor will tell you if you need to use a different amount
• If your doctor has told you that your medicine needs to be diluted, you will be given ‘sterile sodium chloride 0.9%’ solution. Your doctor will tell you how to do this 5. Use your nebuliser as directed by your doctor. 6.
• After you have finished, dispose of any leftover medicine carefully
• Follow the manufacturer’s instructions on how to clean your nebuliser
• It is important to keep your nebuliser clean If any of the liquid or mist accidentally gets into your eyes you may get painful, stinging or red eyes, dilated pupils, blurred vision, see colours or lights. If this happens, talk to your doctor for advice. If you get problems with your eyes at any other time, talk to your doctor for advice. If you use more COMBIVENT than you should If you use more of this medicine than you should, talk to a doctor or go to a hospital straight away. If you forget to take COMBIVENT
• If you forget a dose, take it as soon as you remember it
• However, if it is time for the next dose, skip the missed dose
• Do not take a double dose to make up for a forgotten dose If you have any further questions, ask your doctor or pharmacist
Possible side effects
Like all medicines, COMBIVENT can cause side
effects, although not everybody gets them.
Tell your doctor straight away if you notice any
of the following serious side effects
•you may need urgent medical treatment:
• If after taking COMBIVENT you are wheezy or have other difficulties in breathing, do not take any more (unless you have been told to by your doctor)
• Allergic reactions
•the signs may include skin rash, itching and nettle rash. In severe cases the signs include swelling of your tongue, lips and face, sudden difficulties in breathing and a fall in your blood pressure that may cause dizziness. See your doctor straight away if you have any of these side effects. The following side effect can also happen but the frequency of this is not known:
• A condition known as lactic acidosis which may cause stomach pain, hyperventilation, shortness of breath even though there may be improvement in your wheezing, cold feet and hands, irregular heartbeat or thirst. The side effects described below have been experienced by people taking COMBIVENT.
Uncommon (affects less than 1 in 100 people)
• Feeling nervous, shaky or dizzy
• Dry mouth
• Cough, headache
• Feeling sick (nausea)
• Throat irritation
• Increase in blood pressure
• Increased heart rate or uneven heart beats (palpitations)
• Voice problems (‘dysphonia’)
• Skin reactions
Rare (affects less than 1 in 1,000 people)
• Irregular heart beat
• Regular but abnormally fast heart rate (supraventricular tachycardia)
• Chest pain (due to heart problems such as angina). Tell your doctor or pharmacist if this occurs but do not stop taking this medicine unless told to do so
• Blurred vision, dilated pupils, glaucoma, painful, stinging, or red eyes, swelling of the eyes, see colours or lights
• Increased sweating
• Unexpected tightening of the chest immediately after inhaling the medicine
• Dry throat, swelling of the throat
• Difficulty in breathing or speaking due to a brief spasm of your vocal muscles
• Diarrhoea, constipation, being sick (vomiting) or other problems with your digestive system
• Inflammation of the mouth
• Muscle cramps, muscle weakness and pain
• Difficulty in passing water (urine)
• Feeling weak
• Fall in blood pressure
• Mood changes You may also get unusually low levels of potassium in your blood (called ‘hypokalemia’). If this happens, your doctor will keep checking your potassium levels. If any of the liquid or mist accidentally gets into your eyes you may get painful, stinging or red eyes, dilated pupils, blurred vision, see colours or lights. If this happens, talk to your doctor for advice. If you get problems with your eyes at any other time, talk to your doctor for advice.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
How to Store Duoneb
Do not use this medicine after the expiry date which is stated on the carton and the vial label. The expiry date refers to the last day of the month. Store below 25°C. Do not freeze. Do not use if the liquid is discoloured. Keep vials in the outer carton in order to protect from light. Keep out of the sight and reach of children
2 to 3 weeks on average
The average shipping time is 2 weeks in North America and 4 weeks internationally. We offer free shipping on all orders shipped to North America. Shipping is a flat rate of $20.00 for all other countries.
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About Medix Pharmacy
Medix Pharmacy is a fully licensed pharmacy in the United Kingdom who provides competitive pricing on brand and generic medications with international shipping.
We are regulated by a number of executive government agencies in the United Kingdom including the Medicines and Healthcare products Regulatory Agency and the GPhC to ensure we offer our customers the highest level of service and peace of mind knowing that the medicines that you receive are safe, effective and authentic.
Drug prices for Duoneb vary throughout the world with the highest prices generally in the United States. Patients can save significantly on their prescriptions drugs when purchasing them from a licensed pharmacy in the United Kingdom and other countries such as Canada, Australia, and New Zealand.