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|DuoNeb Solution

DuoNeb Solution

DuoNeb Solution is used for:

Treating chronic obstructive pulmonary disease (COPD) in patients who require more than one bronchodilator.

DuoNeb Solution is a combination of a beta-adrenergic (sympathomimetic) bronchodilator and an anticholinergic bronchodilator. It works by relaxing and widening the air passages, which helps you to breathe more easily.

Do NOT use DuoNeb Solution if:

• you are allergic to any ingredient in DuoNeb Solution, to atropine, or to similar medicines

Contact your doctor or health care provider right away if any of these apply to you.

Before using DuoNeb Solution:

Some medical conditions may interact with DuoNeb Solution. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of heart problems (eg, irregular heartbeat), blood vessel problems, or high blood pressure
• if you have a history of other lung or breathing problems (eg asthma, hyperactive airway)
• if you have a history of overactive thyroid, diabetes, seizures, liver or kidney problems, or an adrenal gland tumor (pheochromocytoma)
• if you have a history of enlarged prostate, blockage or narrowing of the bladder, or glaucoma, or if you are at risk for glaucoma
• if you have low blood potassium levels
• if you have had an unusual reaction to other sympathomimetic medicines

Some MEDICINES MAY INTERACT with DuoNeb Solution. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood potassium levels may be increased
• Anticholinergics (eg, methscopolamine, bromocriptine), catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), sympathomimetics (eg, pseudoephedrine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of DuoNeb Solution"s side effects
• Beta-blockers (eg, propranolol) because they may decrease DuoNeb Solution"s effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if DuoNeb Solution may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use DuoNeb Solution:

Use DuoNeb Solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with DuoNeb Solution. Talk to your pharmacist if you have questions about this information.
• A health care provider will teach you how to use DuoNeb Solution at home. Be sure you understand how to use DuoNeb Solution. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• To use DuoNeb Solution, twist open the top of the vial and pour the entire contents into the nebulizer unless otherwise directed by your doctor. Use DuoNeb Solution as soon as you open the vial. Throw away any unused medicine. Do not save medicine in an open vial for use at a later time.
• Connect the nebulizer reservoir to the mouthpiece or face mask. Connect the nebulizer to the compressor.
• Sit in a comfortable, upright position. Place the mouthpiece in your mouth (or put on the face mask) and turn on the compressor.
• Breathe as calmly, deeply, and evenly as possible until no more mist is formed in the nebulizer chamber (about 5 to 15 minutes).
• Clean the nebulizer according to the instructions. If you do not keep the nebulizer clean, bacteria may get into the medicine and you may get an infection.
• Contact your health care provider at once if you feel you have taken too much of DuoNeb Solution.
• Continue to use DuoNeb Solution even if you feel well. Do not miss any doses.
• If you miss a dose of DuoNeb Solution, take it as soon as possible. If it is almost time for the next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use DuoNeb Solution.

Important safety information:

• DuoNeb Solution is for inhalation only. Do not get DuoNeb Solution in your eyes. Getting it in your eyes may cause eye pain or discomfort, blurred vision or other vision changes, or worsening of narrow-angle glaucoma. If you get DuoNeb Solution in your eyes, rinse immediately with cool tap water.
• DuoNeb Solution may cause dizziness, blurred vision, or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use DuoNeb Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do NOT take more than the recommended dose without checking with your doctor. The risk of severe heart problems and sometime death may be increased with overuse of DuoNeb Solution.
• If DuoNeb Solution stops working well, if you symptoms become worse, or if you need to use DuoNeb Solution more often than usual, contact your doctor right away.
• DuoNeb Solution may cause dry mouth or unpleasant taste in your mouth. To prevent dry mouth, rinse your mouth and gargle after using DuoNeb Solution. If you experience dry mouth, use sugarless gum or candy, or melt bits of ice in your mouth.
• DuoNeb Solution may sometimes cause severe breathing problems right after you use a dose. If this happens, seek medical care at once.
• Carry an ID card at all times that says you take DuoNeb Solution.
• DuoNeb Solution should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using DuoNeb Solution while you are pregnant. DuoNeb Solution should be used with extreme caution if you are in labor. It is not known if DuoNeb Solution is found in breast milk. Do not breast-feed while taking DuoNeb Solution.

Possible side effects of DuoNeb Solution:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Coughing; dizziness; dry mouth; headache; nervousness; sinus inflammation; sore throat.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fast or irregular heartbeat; new or worsening breathing problems; pounding in the chest; shortness of breath; swelling of the arms or legs; tremors; unexplained hoarseness; wheezing.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include chest pain; fast or irregular heartbeat; seizures; severe headache, dizziness, or nervousness; tremor; weakness.

Store DuoNeb Solution between 36 and 77 degrees F (2 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep DuoNeb Solution out of the reach of children and away from pets.

General information:

• If you have any questions about DuoNeb Solution, please talk with your doctor, pharmacist, or other health care provider.
• DuoNeb Solution is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.
• If using DuoNeb Solution for an extended period of time, obtain refills before your supply runs out.

This information is a summary only. It does not contain all information about DuoNeb Solution. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.