Duolin LD Respules 5x2.5ml

• If you are allergic to Ipratropium or Levosalbutamol or any other ingredients of Duolin Ld 2.5ml Packet Of 5 Respules
• If you are allergic to atropine or its derivatives
• If you have any problems with your heart
• If you are below 12 years of age (as there is no information on safety)

• Headache, dizziness
• Cough, runny nose
• Nausea, vomiting
• Stomach pain, indigestion, constipation
• Dry mouth, sore throat
• Shakiness, nervousness
• Muscle pain or cramps
• Breathing problem
• Palpitations, chest pain
• Blurred vision
• Skin rash, itching, swelling

Other General Warnings

• You are suffering from any heart problems.
• You have problems with your liver or kidney.
• You have diabetes.
• You have glaucoma.
• You have high blood pressure.
• You had or have fits.
• You have an overactive thyroid gland.
• You have difficulty passing urine due to bladder problems or an enlarged prostate (mostly in men).
• You are suffering from a condition called cystic fibrosis. It increases the chances of getting stomach disturbances if you use Duolin with it.
• The chances of side effects increase significantly in the elderly population, so elderly patients should be cautious while using this medicine.
• Duolin Ld 2.5ml Packet Of 5 Respules is not recommended for use in children less than 12 years old.

• Take Duolin Ld 2.5ml Packet Of 5 Respules exactly as directed by your doctor. Check with your doctor or pharmacist if you are not sure.
• Read the instructions on the label or leaflet before use.
• Shake the inhaler.
• You should not take more puffs than that told by your doctor.

• Store Duolin Ld 2.5ml Packet Of 5 Respules below 25°C in a clean and dry place, protected from moisture, sunlight and heat.
• Keep the medicine away from children and pets.

• Duolin LD Respules contains two bronchodilators that open the airways in different ways, giving fuller and longer-lasting relief than either alone.
• Use a mouthpiece rather than a mask wherever possible, and always keep the mist out of your eyes.
• If the mist does reach your eyes, rinse them with water at once and seek advice if vision blurs or the eye becomes painful.
• Rinse your mouth with water and spit it out after every nebulisation to reduce dry mouth, bad taste and throat irritation.
• Open one respule at a time and discard any solution left over; never save it for the next dose.
• Clean and thoroughly dry the nebuliser chamber, mouthpiece and tubing after each use to prevent infection.
• Continue your preventer inhaler regularly, as this nebulisation treats symptoms but not the underlying inflammation.
• Tell your doctor if you need nebulisation more often than prescribed, which signals worsening disease.
• Men with an enlarged prostate should report any new difficulty passing urine.
• Cut back on coffee, tea and energy drinks if you notice tremor, restlessness or palpitations.
• Stop smoking completely and stay away from dust, smoke and strong fumes.

Overdose

Missed a Dose

• Duolin LD Respules works through two separate mechanisms that both end in relaxation of the muscle encircling the airways. Levosalbutamol, the active form of salbutamol, stimulates beta-2 adrenergic receptors on airway smooth muscle, raising cyclic AMP inside the cell and causing rapid relaxation.
• Ipratropium bromide blocks muscarinic receptors, interrupting signals carried by the vagus nerve that would otherwise keep the airway muscle contracted and stimulate mucus glands. Blocking this pathway relaxes the airways further and reduces secretions.
• Because one medicine switches on relaxation while the other switches off constriction, the airways open more completely and stay open longer than with either component alone. Delivered as a fine mist, the medicine reaches the lungs directly, which allows a rapid effect with relatively little absorbed into the rest of the body.

Interactions with other medicines

• Concomitant use of Duolin Ld 2.5ml Packet Of 5 Respules along with medicines used to treat psychiatric illness (Amitriptyline, selegiline, etc.) or medicines used to treat asthma (Albuterol, Epinephrine) should be avoided as it may alter the effects of this medicine.
• Concomitant use of this medicine with beta-blockers like Propranolol, Labetalol, etc. (used to treat high blood pressure and heart problems), may decrease the effectiveness of Duolin Ld 2.5ml Packet Of 5 Respules.
• Concomitant use of this medicine with water pills like Furosemide, Hydrochlorothiazide may decrease the potassium level in the body which leads to heart rhythm abnormalities. Your doctor may advise the monitoring of blood potassium levels.
• Other medicines like Digoxin (used to treat heart problems), Xanthine preparations like Theophylline (used in asthma) and should be used cautiously.

Interactions with food items

• Because Duolin LD Respules is breathed in rather than swallowed, food does not affect how well it works, and no meal timing is required.
• Caffeine is still worth watching. Coffee, tea, cola, chocolate and energy drinks stimulate the body in the same direction as the levosalbutamol component and can add to tremor, restlessness, disturbed sleep and palpitations.
• Sipping water through the day, chewing sugar-free gum and rinsing the mouth after each nebulisation help considerably with the dry mouth and altered taste this medicine commonly causes.
• A diet with adequate fibre and fluid helps offset the constipating tendency of the anticholinergic component, particularly in older people.
• If you have diabetes, monitor blood glucose a little more closely when treatment is started or the frequency is increased.