Duoneb (Ipratropium & Albuterol)

Combination bronchodilator (albuterol beta-2 agonist + ipratropium anticholinergic) for management of bronchoconstriction and recurrent airway obstruction in horses; dual-mechanism bronchodilation. Short-acting beta-2 adrenergic agonist (SABA). Mechanism: stimulates beta-2 receptors on bronchial smooth muscle, activating adenylyl cyclase → increased cAMP → smooth muscle relaxation and bronchodilation. Onset of action: 5–15 min (inhaled); duration 4–6 hrs. Also inhibits mast cell mediator release. Minimal beta-1 cardiac effects at therapeutic doses. Key information Combined bronchodilator. Administer via nebulizer as directed. Monitor heart rate (albuterol tachycardia). Ipratropium component: avoid contact with eyes. Store at room temperature.

Inhaled (MDI/HFA): use appropriate veterinary inhaler device and spacer (e.g., AeroHippus for horses, AeroDawg for dogs). Shake inhaler well before each use. Administer 1–2 puffs; hold spacer in place for 5–10 breaths. Nebulized: dilute to appropriate concentration in sterile saline; nebulize over 10–15 min. Oral syrup: administer orally with food. If a dose is missed Use the missed dose as soon as you remember. If it is close to the next scheduled time, skip it. Albuterol is often used on an as-needed basis — contact your veterinarian if your animal is in respiratory distress.

Cardiovascular: tachycardia, palpitations, hypertension, arrhythmias (especially at high doses). CNS: tremors, nervousness, excitability, anxiety. Hypokalemia (beta-2 mediated intracellular potassium shift). GI: nausea, vomiting. Horses: sweating, tachycardia, muscle tremors.

For animals Use with caution in patients with cardiac arrhythmias, hypertension, hyperthyroidism, or diabetes mellitus (hypokalemia and hyperglycemia risk). Monitor heart rate and rhythm during administration. At high doses: risk of tachycardia, hypokalemia, tremors. Horses: risk of tachycardia and sweating — monitor closely. For people handling this medication Wash hands thoroughly with soap and water after handling. Avoid contact with eyes; if contact occurs, flush with water for 15 minutes and seek medical attention. Keep out of reach of children. If accidental ingestion occurs, contact Poison Control (1-800-222-1222). Inhaled: avoid exposure to aerosol spray. People with heart conditions or hyperthyroidism should minimize exposure.

Contact your veterinarian immediately. Albuterol overdose causes rapid heart rate, tremors, hypokalemia, and anxiety. Monitor heart rate closely. IV fluid support and beta-blockers may be needed in severe cases.