Duolin HFA CFC Free Inhaler (Rex brand)

Duolin Inhaler general information

What is Duolin Inhaler used for?

Duolin Inhaler is used to treat bronchospasm (contraction of the airways) associated with obstructive airways disease such as asthma, chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema for people who are already taking one bronchodilator (airway-opening medication) and need another to relieve their symptoms, including tightness of the chest, wheezing and shortness of breath.

How does Duolin Inhaler work?

Levosalbutamol is a selective short-acting beta2-agonist that acts on all the airways of the lungs from the trachea (windpipe) to the terminal bronchioles (small airways) and works as bronchodilator by relaxing the smooth muscle in the airway walls to widen the airways. Ipratropium is an anticholinergic that acts on specific receptors (muscarinic receptors) in the bronchioles of the lung and inhibits the interaction of acetylcholine (a neurotransmitter or chemical messenger of the nervous system) with muscarinic receptors, which prevents spasm of the airway wall caused by acetylcholine. The synergistic action (interacting to enhance the action of each other) of the two drugs working together by different mechanisms, reduces bronchospasm (contraction of the airways) to a greater extent than would be provided by each drug alone and increases air flow into the lungs, relieving symptoms of COPD such as tightness of the chest, wheezing and shortness of breath.

What does Duolin Inhaler contain?

Duolin Inhaler is a metered dose inhaler that contains two active ingredients; levosalbutamol sulphate 100 mcg, which is the active isomer of (R-enantiomer) of the racemate, racemic salbutamol (also known as albuterol) without the inactive S-enantiomer and is a short-acting beta2 agonist; ipratropium bromide 20mcg, which is an anticholinergic. Both active ingredients work together to reduce bronchospasm (contraction of the airways). Duolin Inhaler also contains a CFC-free propellant HFC 227, which delivers levosalbutamol and ipratropium together as an aerosol into your lungs each time your actuate (press down) your inhaler. Each inhaler contains at least 200 actuations.

Propellant guide

Duolin Inhaler contains propellant HFA 227, which is a non-ozone depleting propellant that has been approved by the FDA for use in metered dose aerosol inhalers.

What is the difference between CFC, HFC and HFA propellants?

CFCs or Chlorofluorocarbons are the original propellants used in metered dose aerosol inhalers. When released into the earth’s atmosphere, these propellants cause ozone-depletion when they reach the stratosphere, which contributes towards the destruction of the ozone layer. Ozone-depleting CFCs are being phased out for use as propellants in inhalers and are being replaced with a non-CFC and non-ozone depleting propellant called HFA or hydrofluoroalkane, also known as or HFC or hydrofluorocarbon. There are currently two forms of HFA: HFA 227 (also known as 1,1,1,2,3,3,3- heptafluoropropane) and HFA 334 (also known as 1,1,1,2- tetrafluoroethane). These HFCs have been approved by the FDA for use as propellants.

Treating chronic obstructive pulmonary disease (COPD) with Duolin Inhaler

Duolin Inhaler contains two bronchodilators: levosalbutamol and ipratropium, which work together to relax the muscles of the airways, reducing bronchospasm (contraction of the airways) and increasing air flow into the lungs. Chronic obstructive pulmonary disease (COPD) is an obstructive airways disease, with symptoms similar to asthma, including tightness of the chest, wheezing and shortness of breath; and is a progressive disease that usually gets worse and needs more than a single medication to relieve symptoms. The synergistic action (interacting to enhance the action of each other) of levosalbutamol and ipratropium in Duolin Inhaler reduces bronchospasm to a greater extent than would be provided by each drug alone, helping to prevent and relieve symptoms of COPD.

Duolin Inhaler for brochospasm

Duolin Inhaler contains two bronchodilators: levosalbutamol and ipratropium, which work together to relax the muscles of the airways, reducing bronchospasm (contraction of the airways) and increasing air flow into the lungs. Bronchospasm is a condition of several obstructive airways diseases including asthma and chronic obstructive pulmonary disease (COPD), which causes symptoms like tightness of the chest, wheezing and shortness of breath. The synergistic action (interacting to enhance the action of each other) of levosalbutamol and ipratropium in Duolin Inhaler reduces bronchospasm to a greater extent than would be provided by each drug alone, helping to prevent and relieve symptoms of asthma and COPD.

What are the side effects of Duolin Inhaler?

The most commonly reported side effects when taking Duolin Inhaler include: headache, tachycardia (rapid heart beat), tremor (shaky or tense feeling), dryness of mouth and palpitations. Less common side effects include, cough, mouth or throat irritation, muscle cramps, nausea, blurred vision. Paradoxical bronchospasm is uncommon but can occur in which your inhaler worsens your breathing. Also hypokalaemia (low blood potassium) is an uncommon but serious side effect.

When should Duolin Inhaler not be used?

You should not use Duolin Inhaler if you:

• allergic to levosalbutamol, ipratropium or any of the other ingredients in your Duolin Inhaler inhaler
• pregnant or breast feeding, without discussion with your doctor
• have any of the following condition without discussion with your doctor: heart disease, high blood pressure, or congestive heart failure, epilepsy, diabetes, overactive thyroid, liver or kidney disease, glaucoma, enlarged prostate or problems with urination
• taking any medicines that may interact with Duolin Inhaler, including: other beta-agonists like pseudoephidrine in cold medications, anticholinergics like atropine; diuretics like furosemide or hydrochlorothiazide; MAOIs like phenelzine; tricyclic antidepressants (TCAs) like amitriptyline; beta-blockers like atenolol

What medications interact with Duolin Inhaler inhaler?

Several medications interact with Duolin Inhaler and should either not be taken while you are taking Duolin Inhaler or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Duolin Inhaler: anticholinergics like atropine, other beta-agonists like pseudoephidrine in cold medications,diuretics like furosemide, hydrochlorothiazide, MAOIs like phenelzine tricyclic antidepressants (TCAs) like amitriptyline
• Drugs that affect Duolin Inhaler: beta-blockers like atenolol
• Drugs that are affected by Duolin Inhaler: beta-blockers like atenolol

How should Duolin Inhaler be taken?

You should use your Duolin Inhaler as recommended by your doctor, usually two puffs 4 times a day or more as needed, with a maximum or 12 puffs in 24 hours. One puff should last for at least 4 or 5 hours. You should use your Duolin Inhaler continually for as long as your doctor recommends and you should not stop taking your Duolin inhaler, even if you feel better.

How to use your Duolin inhaler

Follow the instruction provided with your Duolin inhaler.

1. Shake the inhaler vigorously for at least 10 seconds before use.
2. Remove the mouthpiece cover.
3. Breathe out as far as is comfortable and then place the mouthpiece in your mouth
4. Start to inhale and press down on the top of the inhaler to release a dose of levosalbutamol and ipratropium while still breathing in through your mouth until your lungs are full and hold your breath for a few seconds.
5. Remove the inhaler and breathe normally.
6. Replace the mouthpiece cover.

Note: You can use a spacer device to help you inhale correctly.

How long should you take Duolin Inhaler?

For the best effect you should use your Duolin Inhaler continually for as long as your doctor recommends. You should not stop taking your Duolin inhaler, even if you feel better.

Missed dose of Duolin Inhaler

If you miss a dose of Duolin Inhaler take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Duolin Inhaler be stored?

Your Duolin Inhaler should be stored in a cool dry place below 30°C. Protect your inhaler from frost, it will not work properly if it gets cold and keep away from direct sunlight. Always replace the mouthpiece cover when you are not using your inhaler.