Duolin Rotacaps (Generic Levalbuterol Sulphate and Ipratropium Bromide Rotacaps) – Product Information
Duolin Rotacaps (Generic Levalbuterol and Ipratropium Rotacaps) is a combination of an anticholinergic and beta-adrenergic are used for the treatment of patients with chronic obstructive pulmonary disease (COPD), who are on a regular bronchodilator, or who continue to have evidence of bronchospasm and who require a second bronchodilator.
We also stock Asthalin Rotacaps (Albuterol Sulphate Rotacaps)
which are used in the treatment of bronchospasm in bronchial asthma, chronic bronchitis and emphysema, prevention of exercise–induced asthma and chronic obstructive pulmonary disease.
Name of Drug
Manufacturer of Duolin Rotacaps (Generic Levalbuterol Sulphate and Ipratropium Bromide Rotacaps)
Cipla limited, India
Active Pharmaceutical Ingredient
The active pharmaceutical ingredients contained in Duolin Rotacaps are Levalbuterol Sulphate (Levosalbutamol Sulphate) and Ipratropium Bromide. Each rotacap contains 100mcg of Levosalbutamol Sulphate and 40 mcg of Ipratropium Bromide.
Duolin Rotacaps - Mechanism of Action
Duolin Rotacaps is a combination of the anticholinergic Ipratropium Bromide and the beta2-adrenergic agonist Levalbuterol Sulfate. The mechanisms of action described below for the individual components apply to Duolin Rotacaps. The two classes of medications (an anticholinergic and a beta2-adrenergic agonist) are both bronchodilators. Simultaneous administration of both an anticholinergic (Ipratropium Bromide) and a beta2-sympathomimetic (Levalbuterol Sulfate) is designed to produce a greater bronchodilator effect than when either medicine is utilized alone at its recommended dosage. The efficacy of Duolin Rotacaps is likely to be due to a local effect on the muscarinic and beta2-adrenergic receptors in the lung.
Ipratropium Bromide: Ipratropium bromide is an anticholinergic (parasympatholytic) agent which, based on animal studies, appears to inhibit vagally mediated reflexes by antagonizing the action of acetylcholine, the transmitter agent released at the neuromuscular junctions in the lung. Anticholinergics prevent the increases in intracellular concentration of Ca++ which is caused by interaction of acetylcholine with the muscarinic receptors on bronchial smooth muscle.
Levalbuterol Sulfate: In vitro studies and in vivo pharmacology studies have demonstrated that albuterol has a preferential effect on beta2-adrenergic receptors compared with Isoproterenol. While it is recognized that beta2-a drenergic receptors are the predominant receptors on bronchial smooth muscle, recent data indicate that there is a population of beta2-receptors in the human heart which comprise between 10% and 50% of cardiac beta-adrenergic receptors. The precise function of these receptors, however, is not yet established.
Uses of Duolin Rotacaps (Generic Levalbuterol Sulphate and Ipratropium Bromide Rotacaps)
Duolin Rotacaps (Generic Levalbuterol Sulphate and Ipratropium Bromide Rotacaps) are used for treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Duolin Rotacaps is used in Dry Powder Inhaler (DPI) device. A DPI is a breath-actuated device that delivers medication contained in a capsule or blister that is punctured before use. The medicine is delivered to the lungs in the form of a dry powder. It doesn't contain propellants or other ingredients, only your medication.
Levalbuterol and Albuterol are two options that can help treat symptoms as needed.Because they both contain the active R-isomer of albuterol, they are both effective options. Levalbuterol only contains the active R-isomer of Albuterol, which may produce less side effects than the R/S mixture.
Duolin Rotacaps (Generic Levalbuterol Sulphate and Ipratropium Bromide Rotacaps) – Dosage
The dosage of Duolin Rotacaps is 1 rotacap, four times a day. Patients may take additional inhalations as required; however, the total number of rotacaps should not exceed 6 in 24 hours. Duolin Rotacaps should be used only with the Cipla Rotahaler/ Revolizer. Duolin Rotacaps must not be swallowed.
How To Use Duolin Rotacaps?
- Hold the Rotahaler vertically and position the two halves of the Rotahaler such that the fin is not directly below the rotacap hole.
- Remove the rotacap from its bottle and insert it into the rotacap hole with its transparent end facing downwards.
- Hold the mouth piece firmly with one hand and rotate the base
- Breathe out fully and place the mouthpiece of the Rotahaler between your teeth.
- Close your lips tightly around it and tilt your head slightly backward, breathe in through the mouth rapidly and deeply.
- Hold your breath for 10 seconds or for as long as you are comfortable and then breathe out normally. In case some powder remains repeat step 4.
- Open the Cipla Rotahaler and dispose the empty capsule.
- You can continue to use your Rotahaler daily for up to six months. Then discard it and replace with a new one.
Missed Dosage Instructions for Duolin Rotacaps
Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time
Duolin rotacaps are contraindicated in persons with a hypersensitivity (allergy) to Levalbuterol Sulphate (Levosalbutamol Sulphate), Ipratropium Bromide, to Atropine and its derivatives or any of the other ingredients of this medicine. This medicine is also contraindicated in patients with a history of hypersensitivity to soya lecithin or related food products such as soyabean and peanut.
Storage Instructions for Duolin Rotacaps
Store Duolin Rotacaps (Levosalbutamol and Ipratropium Bromide Rotacaps) below 30°C. Do not freeze. Do not expose the capsules to high temperatures. Keep out of the reach of children and away from pets. Do not store in the bathroom.
Warnings and Precautions to be taken when using Duolin Rotacaps (Levosalbutamol and Ipratropium Bromide Rotacaps)
Before using Duolin rotacaps please inform your doctor about all the medicines that you take including no prescription medications, over the counter medicines and herbal remedies.
Duolin rotacaps can produce paradoxical bronchospasm that can be life- threatening. If it occurs, the preparation should be discontinued immediately and alternative therapy instituted.
Like other beta-adrenergic agonists, the Levosalbutamol Sulphate contained in Duolin rotacaps can produce clinically significant cardiovascular effects in some patients, as measured by pulse rate, blood pressure and/or symptoms. Although such effects are uncommon after administration of Duolin Rotacaps at recommended doses, if they occur, discontinuation of the drug may be indicated.
Fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs in patients with asthma. The exact cause of death is unknown, but cardiac arrest following an unexpected development of a severe acute asthmatic crisis and subsequent hypoxia is suspected.
Immediate hypersensitivity reactions may occur after administration of Ipratropium Bromide or Levosalbutamol Sulphate, as demonstrated by rare cases of urticaria, angio-oedema, rash, bronchospasm, anaphylaxis, and oropharyngeal oedema. If such a reaction occurs, Duolin rotacaps must be stopped at once and alternative treatment should be considered.
Duolin rotacaps contain ipratropium bromide and, therefore, should be used with caution in patients with narrow-angle glaucoma, prostatic hypertrophy, or bladder-neck obstruction.
Preparations containing sympathomimetic amines such as levosalbutamol sulphate should be used with caution in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus and in patients who are unusually responsive to sympathomimetic amines. Beta-adrenergic agents may also produce significant hypokalaemia in some patients (possibly through intracellular shunting), which has the potential to produce adverse cardiovascular effects. The decrease in serum potassium is usually transient, not requiring supplementation.
Advise patients to avoid spraying into eyes and to contact a physician if blurred vision, halos, or other visual disturbances occur. Monitor patients with narrow-angle glaucoma.
Use with caution in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus.
Effects On Ability To Drive And Use Machines
No studies on the effects on the ability to drive and use machines have been performed. However, patients should be advised that they may experience undesirable effects such as dizziness, accommodation disorder, mydriasis and blurred vision during treatment with Levalbuterol Sulphate and Ipratropium Bromide Rotacaps (Duolin Rotacaps). If patients experience the above mentioned side effects they should avoid potentially hazardous tasks such as driving or operating machinery.
Side Effects of Levalbuterol Sulphate and Ipratropium Bromide Rotacaps (Duolin Rotacaps)
The possible Side Effects of Duolin rotacaps (Levalbuterol Sulphate and Ipratropium Bromide Rotacaps) are Tremor, nervousness, tachycardia, dizziness, headache, hypokalaemia, dry mouth, throat irritation, urinary retention, nausea, arrhythmia, and anaphylactic reactions may occur. In very rare instances, paradoxical bronchoconstriction has been observed.
If, because of inappropriate handling, the Duolin rotacaps powder enters the eyes in patients with narrow-angle glaucoma, a rise in intraocular pressure may occur. In these cases, eye drops should be administered to induce miosis.
Potentially serious hypokalaemia may result from beta2-agonist therapy. This effect may be potentiated by hypoxia. Particular caution is advised in severe asthma, along with monitoring of serum potassium levels. Other side effects such as palpitation, fine tremors of the skeletal muscle (particularly the hand) and muscle cramps may occur. In a few cases, nervousness, headache, dizziness, fatigue, and sleeplessness have also been reported.
Duolin Rotacaps – Drug Interactions
The drug Interactions of are given below:
Although Ipratropium Bromide is minimally absorbed into the systemic circulation, there is some potential for an additive interaction with concomitantly used anticholinergic medications. Caution is therefore advised in the co-administration of Duolin rotacaps with other anticholinergic-containing medicines.
Caution is advised in the co-administration of Duolin rotacaps and other sympathomimetic agents due to the increased risk of adverse cardiovascular effects.
Beta-Receptor blocking agents and Levosalbutamol inhibit the effects of each other. Beta-receptor blocking agents should be used with caution in patients with hyper-reactive airways.
The ECG changes and/or hypokalaemia that may result from the administration of non-potassium-sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded.
Duolin rotacaps should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents, because the action of levosalbutamol on the cardiovascular system may be potentiated. Consider alternative therapy in patients taking MAOs or tricyclic antidepressants.
Duolin Rotacaps Overdosage
Duolin Rotacaps are a combination of Ipratropium Bromide, an anticholinergic (parasympatholytic) agent, and Levosalbutamol Sulphate, a relatively selective beta2-adrenergic agonist. Levalbuterol Sulphate: The expected symptoms with overdosage are those of excessive beta-adrenergic receptor stimulation and/or occurrence or exaggeration of any of the symptoms listed under adverse reactions, e.g., seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/minute, metabolic acidosis, and exaggeration of the pharmacologic effects list in side effects including arrhythmias, nervousness, headache, tremor, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, and sleeplessness. Hypokalaemia may also occur. As with all sympathomimetic medications, cardiac arrest and, even, death may be associated with the abuse of Levosalbutamol.
Treatment consists of discontinuation of Levalbuterol Sulphate (Levosalbutamol Sulphate) together with appropriate symptomatic therapy. The judicious use of a cardioselective beta-receptor blocker may be considered, bearing in mind that such medication can produce bronchospasm. There is insufficient evidence to determine if dialysis is beneficial in treating overdosage of Levosalbutamol.
Ipratropium Bromide: Acute overdose by inhalation is unlikely since ipratropium bromide is not well absorbed systemically after inhalation or oral administration. Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angio-oedema, rash, bronchospasm, anaphylaxis, and oropharyngeal oedema.
Duolin Rotacaps (Levalbuterol Sulphate and Ipratropium Bromide Rotacaps) During Pregnancy
Levalbuterol Sulphate and Ipratropium Bromide Rotacaps are classified by the US FDA as Pregnancy Category C. There are no adequate and well-controlled studies of Levalbuterol and Ipratropium Bromide combination rotacaps in pregnant women. Since animal reproduction studies are not always predictive of human response, Duolin Rotacaps should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
The safety of Duolin Rotacaps (Levalbuterol Sulphate and Ipratropium Bromide Rotacaps) during human pregnancy is not established. Because of the potential for beta-agonist interference with uterine contractility, use of Duolin Rotacaps for the treatment of COPD during labor should be restricted to those patients in whom the benefits clearly outweigh the risk.
Buy Cheap Duolin Rotacaps (Levalbuterol Sulphate and Ipratropium Bromide Rotacaps) Online For Only $0.50 Per Rotacap
You can buy Cheap Levalbuterol and Ipratropium Rotacaps online from the Swiss Pharmacy. Duolin Rotacaps manufactured by Cipla Ltd., India are available as capsules containing 40 mcg of Ipratropium Bromide and 100 mcg of Levosalbutamol Sulphate (Levalbuterol Sulphate). You can buy Duolin rotacaps for only $0.50 per unit when you place an order for 360 capsules.
This Product was added to our catalogue on Monday, 27. January 2014.
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