Ipratropium and salbutamol

Sounds like 'ip-ra-TRO-pee-um' and 'sal-BYOO-ta-mol'

Ipratropium and salbutamol is used to treat conditions where breathing is a problem, such as COPD. Ipratropium + salbutamol is commonly called Duolin.

 Type of medicine  Also called
  • Bronchodilator (opens the airways)
  • Reliever (relieves breathing problems)
  • Duolin HFA (inhaler)
  • Duolin (ampoules for a nebuliser)

What is ipratropium + salbutamol?

Ipratropium and salbutamol are mixed together in a puffer or inhaler. The combination is used to treat conditions where breathing is a problem, such as COPD, chronic bronchitis and emphysema. They work by relaxing and opening up the air passages, making breathing easier and improving shortness of breath, chest tightness and wheezing.

Ipratropium and salbutamol belong to a group of medicines known as bronchodilators or relievers (it is called a reliever medicine because it quickly relieves your breathing problems). 

Using an inhaler device enables the medicine to go straight into your airways when you breathe in. This means that your airways and lungs are treated, but very little of the medicine gets into the rest of your body.

In New Zealand ipratropium and salbutamol is available as an inhaler and nebulising solution. These are known by the brand name Duolin®. Nebulisers are used when using an inhaler is not suitable. The information on this page is about ipratropium and salbutamol inhaler. Read more about nebulisers.


  • The usual dose of ipratropium and salbutamol inhaler is 2 puffs 4 times a day. You should not use more than 12 puffs in any 24 hour period.
  • Follow your doctor's instructions carefully. The pharmacy label on your medicine will tell you how much to use, how often to use it and any special instructions.

How to use your inhaler

To get the most benefit, it is important to use the correct technique. Ask your doctor, pharmacist or nurse to explain how to use your inhaler. Even if you have been shown before, ask your doctor, pharmacist or nurse to explain again how to use your inhaler if you still have any questions. Here is some guidance.

 How to use your MDI (puffer)
Take off the cap and hold the inhaler upright.
Shake the inhaler to mix the medication.
  Sit upright, tilt your head back slightly (as if you are sniffing) and breathe out gently.
Hold the device upright, insert the inhaler into your mouth, ensuring that your lips firmly seal the mouthpiece.
At the beginning of a slow, deep breath, breathe in through the mouthpiece as you press the inhaler to release one dose or 'puff'.
Breathe in fully, remove the inhaler from your mouth and hold your breath for 10 seconds or as long as is comfortable.
Breathe out gently through your nose.

Learn more about metered dose inhalers

Using a spacer with your inhaler

A spacer is an attachment to use with your MDI. Using a spacer with your MDI makes it easier to use the inhaler and helps to get the medicine into your lungs, where it’s needed (with less medicine ending up in your mouth and throat). Spacers improve how well your medicine works. Read more about spacers.

Precautions before using ipratropium + salbutamol

  • Do you have heart disease?
  • Do you have an overactive thyroid (hyperthyroid)?
  • Do you have high blood pressure (hypertension)?
  • Do you have problems with your prostate, or have you had difficulty passing urine?
  • Do you have glaucoma?
  • Do you have heart problems such as an unusual heart rhythm?
  • Do you have diabetes?
  • Do you play competitive or professional sport?
  • Are you pregnant or breastfeeding?

If so, it’s important that you tell your doctor or pharmacist before you start using ipratropium + salbutamol. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

What are the side effects of ipratropium + salbutamol?

Like all medicines ipratropium + salbutamol can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Side effects What should I do?
  • Feeling shaky
  • Nervousness
  • Tremor
  • Headache
  • Muscle cramps
  • Problems sleeping
  • These are quite common when you first start using salbutamol + ipratropium and usually go away with time.
    Tell your doctor if troublesome.
  • Headache
  • Dry mouth
  • Sore throat
  • A change in voice (hoarse voice)
  • A different taste in your mouth
  • Difficulty urinating (peeing)
  • These may go away with time. If you have problems with a dry mouth or a different taste in your mouth, rinse your mouth after each dose.
  • Tell your doctor if troublesome.
  • Constipation (difficulty passing poos) or diarrhoea (runny poos)
  • Tell your doctor.
  • Changes in your heartbeat (faster)
  • Chest pain
  •  Tell your doctor immediately or phone Healthline on 0800 611 116.
  • Sudden worsening of breathing problems and you are using salbutamol + ipratropium very often
  •  Tell your doctor immediately or phone Healthline on 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product

Learn more

Salbutamol and ipratropium New Zealand Formulary Patient Information


  1. Ipratropium bromide + salbutamol New Zealand Formulary

Additional resources for healthcare professionals

Duolin Medsafe, NZ
The optimal management of patients with COPD – part 1 – the diagnosis BPAC, NZ, 2015
The optimal management of patients with COPD – part 2 – stepwise escalation of treatment BPAC, NZ, 2015

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 23 Jun 2019