Salbutamol with ipratropium bromide (Duolin): Supply issue

Supply issue Active

Rex Medical have advised us that Duolin inhaler stock ran out in late 2020. Rex-Medical have not confirmed a re-supply date.

31 August 2021 update

Co-payment waiver is extended until 30 November 2021. 

We understand that small supplies of Duolin are entering the market. 

The issue was originally caused by quality issues at the manufacturing site in India. 

Alternative treatments

Our clinical advisors suggest that a suitable alternative is using 2 inhalers:

  • a salbutamol 100mcg inhaler and
  • an ipratropium bromide 20mcg inhaler (Atrovent).

Both inhalers are fully funded and there is enough stock.

Time for a review?

Our clinical advisors suggest that this stock issue may present an opportunity for prescribers to review the need for salbutamol/ipratropium. Have you considered other long-acting bronchodilators, such as long-acting muscarinic antagonists (LAMAs)?

BPACnz have up-to-date clinical resources on the pharmacological management of COPD.

Read An update on the pharmacological management of stable COPD (8 June 2020) - BPAC website(external link)

Only one co-payment

Patients will need a new prescription for both of the single component inhalers. At the pharmacy, people will only be charged a single co-payment (usually $5).

The pharmacy co-payment charge for patients dispensed ipratropium bromide 20mcg (Atrovent) inhaler will be waived from 1 January 2021 to 31 July 2021.

COPD burden of disease is high in Māori and Pacific people. We know that the cost of medicine can impact people's ability to access the medicines they need. Any increase in cost can be significant for our priority populations, Māori and Pacific People.

Next steps

PHARMAC continue to work with the supplier to source an alternative combination product.

Who to contact

If you have questions about the co-payments, email enquiry@pharmac.govt.nz

If you have questions about supply, contact Rex Medical or your supplier.