Medicine Information

Dulamet

Name: Dulamet
Brand: Dulamet
Rating: 4.5 (117 reviews)

Metered Dose InhalerBudesonide 100 mcg + Formoterol 6 mcg per actuationAnti-asthmatic & COPD preparations, Corticosteroids & Combination PreparationsATC: R03AK07

Generic Name

Budesonide + Formoterol fumarate dihydrate

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
dulamet 100 mcg inhaler	৳ 695.00	N/A

Description

Overview of the medicine

Dulamet 100 mcg Inhaler is a combination medicine used for the maintenance treatment of asthma and chronic obstructive pulmonary disease (COPD). It contains Budesonide, an inhaled corticosteroid, and Formoterol, a long-acting beta2-agonist.

Uses & Indications

Maintenance treatment of asthma in adults and adolescents (12 years and older) where use of a combination (inhaled corticosteroid and long-acting beta2-agonist) is appropriate.

Maintenance treatment of COPD, including chronic bronchitis and emphysema, in adults.

Dosage

Adults

Asthma: Typically 2 inhalations twice daily. COPD: Typically 2 inhalations twice daily.

Elderly

No specific dose adjustment is generally required, but monitor for adverse effects.

Renal_impairment

No specific dose adjustment is considered necessary, but use with caution in severe impairment.

How to Take

For inhalation only. Prime the inhaler before first use or if not used for more than 7 days. Shake well before each use. Inhale slowly and deeply through the mouthpiece. Rinse mouth with water and spit out after each use to prevent oral thrush.

Mechanism of Action

Budesonide works as an anti-inflammatory agent, reducing swelling and irritation in the airways. Formoterol acts as a bronchodilator, relaxing the muscles in the airways and widening them, making it easier to breathe.

Pharmacokinetics

Onset

Formoterol: within 1-3 minutes. Budesonide: anti-inflammatory effects develop over days to weeks.

Excretion

Primarily excreted via urine for both components.

Half life

Budesonide: approximately 2-3 hours. Formoterol: approximately 8-10 hours.

Absorption

Both Budesonide and Formoterol are rapidly absorbed after inhalation. Budesonide undergoes high first-pass metabolism. Formoterol has low systemic bioavailability.

Metabolism

Both are primarily metabolized in the liver (Budesonide mainly by CYP3A4, Formoterol by CYP2D6, CYP2C9, CYP2C19).

Side Effects

Contraindications

Hypersensitivity to Budesonide, Formoterol, or any excipients.
Primary treatment of status asthmaticus or other acute episodes of asthma/COPD requiring intensive measures.

Drug Interactions

Diuretics

May potentiate hypokalemia associated with beta-agonists.

MAOIs, TCAs

May potentiate the cardiovascular effects of Formoterol.

Beta-blockers

May antagonize the bronchodilatory effects of Formoterol.

CYP3A4 inhibitors (e.g., Ketoconazole, Itraconazole)

May increase systemic exposure to Budesonide.

Storage

Store below 30°C. Protect from direct sunlight and freezing. Do not puncture or incinerate the container, even when empty.

Overdose

Symptoms of overdose may include increased severity of side effects such as tachycardia, tremors, headache (due to Formoterol) and Cushingoid features or adrenal suppression (due to Budesonide with very high doses). Treatment is symptomatic and supportive.

Pregnancy & Lactation

Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Budesonide is generally considered one of the safer inhaled corticosteroids during pregnancy. Exercise caution when administered to a nursing mother. Consult your doctor.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

120 actuations per inhaler

Shelf Life

Typically 2-3 years from the date of manufacture. Refer to the product packaging for specific expiry date.

Availability

Available in pharmacies and hospitals

Approval Status

Approved by major regulatory bodies

Patent Status

Generic versions available

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have demonstrated the efficacy and safety of Budesonide/Formoterol combination in the management of asthma and COPD.

Lab Monitoring

Monitor growth in children and adolescents receiving long-term corticosteroid therapy.
Monitor bone mineral density in patients on long-term treatment.
Rarely, monitor potassium levels due to potential hypokalemia with beta-agonists.

Doctor Notes

Emphasize proper inhalation technique and the importance of rinsing the mouth.
Educate patients on the distinction between maintenance inhalers (like Dulamet) and rescue inhalers.
Monitor patients for disease control, adverse effects, and compliance.

Patient Guidelines

Use regularly as prescribed, even when feeling well.
Do not use this inhaler for sudden breathing problems; use your rescue inhaler instead.
Rinse your mouth thoroughly with water and spit it out after each use to prevent oral thrush.
Ensure proper inhalation technique as advised by your doctor or pharmacist.
Seek medical advice if your symptoms worsen or your rescue inhaler becomes less effective.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Dulamet 100 mcg Inhaler is generally not expected to affect the ability to drive or operate machinery. However, if you experience side effects like dizziness or blurred vision, avoid these activities.