The combination of albuterol and ipratropium is used to prevent wheezing, difficulty breathing, chest tightness, and coughing in people with chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways) such as chronic bronchitis (swelling of the air passages that lead to the lungs) and emphysema (damage to the air sacs in the lungs). Albuterol and ipratropium combination is used by people whose symptoms have not been controlled by a single inhaled medication. Albuterol and ipratropium are in a class of medications called bronchodilators. Albuterol and ipratropium combination works by relaxing and opening the air passages to the lungs to make breathing easier.

The combination of albuterol and ipratropium comes as a solution (liquid) to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled) and as a spray to inhale by mouth using an inhaler. It is usually inhaled four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use albuterol and ipratropium exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

It is very important that your doctor check your progress closely while you are using this medicine to see if it is working properly and to help reduce any unwanted effects. This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Paradoxical bronchospasm may be life-threatening. Stop using this medicine and check with your doctor right away if you have coughing, difficulty breathing, shortness of breath, or wheezing after using this medicine. DuoNeb is not approved for use by anyone younger than 18 years old. You should not use DuoNeb if you are allergic to albuterol (Proventil, Ventolin), ipratropium (Atrovent), or atropine. It is not known whether DuoNeb will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

DuoNeb (ipratropium bromide and albuterol sulfate) is a combination of bronchodilators used to treat and prevent symptoms (wheezing and shortness of breath) caused by ongoing lung disease (chronic obstructive pulmonary disease-COPD which includes bronchitis and emphysema). Common side effects of DuoNeb include: •

- A Common Cold 

- A Stuffy And Runny Nose 

- Fast Heartbeat 

- Flu-Like Symptoms 

- Muscle Tremors 

- Nausea 

- Nervousness 

- Throat Dryness 

- Trouble Breathing 

- Vomiting

Tell your doctor if you have serious side effects of DuoNeb including: 

- Difficult or painful urination, or 

- Muscle cramps.

How long does the effect of Duoneb last?

The action of DuoNeb (ipratropium bromide and albuterol sulfate) should last up to 5 hours. DuoNeb (ipratropium bromide and albuterol sulfate) should not be used more frequently than recommended.

How long does it take for DuoNeb to work?

Each treatment usually takes about 5 to 15 minutes. Use this medication only through a nebulizer. Do not swallow or inject the solution.

Does DuoNeb increase heart rate?

DuoNeb (ipratropium bromide and albuterol sulfate), like other beta-adrenergic agonists, can produce a clinically significant cardiovascular effect in some patients as measured by pulse rate, blood pressure, and/or symptoms.

How often can you give DuoNeb?

The recommended dose of DuoNeb (ipratropium bromide and albuterol sulfate) is one 3 mL vial administered 4 times per day via nebulization with up to 2 additional 3 mL doses allowed per day if needed.