In the case of acute or rapidly worsening dyspnea, a doctor should be consulted immediately. Increasing use of b2 agonists to control symptoms of bronchial obstruction, especially administration on a regular basis or in high amounts, indicates deterioration of asthma control. Under these conditions, the patient's therapy plan has to be revised. Concomitant use of Duovent UDV with other sympathomimetic agents is not recommended since the combined use may lead to deleterious cardiovascular effects. If concomitant use is necessary, this should take place only under strict medical supervision.
Caution is advised against accidental release of the solution into the eyes.
Duovent UDV should be used with caution in patients with glaucoma, prostatic hypertrophy or urinary retention and in asthmatic or emphysematous patients who also have acute and recurring congestive heart failure or in patients sensitive to sympathomimetic amines. Failure to respond to a previously effective dose usually indicates a significant deterioration in the patient's asthmatic condition. Three retrospective case-control studies, from one group in New Zealand, have suggested that there may be an increased risk of death in those patients using fenoterol whom the studies classified as severe' asthmatics. These conclusions have not been confirmed by other studies and are subject to considerable debate and ongoing studies. To ensure the proper dosage administration, the patient should be instructed by the physician or other health professional on the proper use and maintenance of the nebulizer.