DuoNeb combines two well-known respiratory solutions, albuterol sulfate and ipratropium bromide, in one premixed, premeasured, unit-dose vial for nebulization. A clinical trial of 863 patients demonstrated that DuoNeb improves bronchodilation over albuterol alone by 24 percent, and over ipratropium alone by 37 percent, with no increased safety risk. The results of this trial were published in the September 1998 issue of the journal Respiration.

DuoNeb is indicated for the treatment of bronchospasm associated with COPD in patients requiring more than one bronchodilator. In a 12-week clinical study, the most common adverse reactions reported with DuoNeb Inhalation Solution were chest pain, pharyngitis, diarrhea, bronchitis, nausea and leg cramps. Caution is advised in patients with convulsive disorders, hyperthyroidism, diabetes mellitus, narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction.

The new drug can only be used in a nebulizer machine (such as the Pulmoaid), but for those who do benefit from the nebulizer, DuoNeb can offer greater convenience and effectiveness.

Most people with COPD do fine with inhalers (MDI's) and don't need nebulizers. For this group, there is already available a combination of albuterol and ipratropium available in an MDI form under the name Combivent.