Salbutamol with ipratropium (Duolin) nebuliser: Supply issue

Supply issue Section 29A Active

Due to issues at the manufacturer, the supplier can no longer source Duolin nebulisers (Pharmacode: 2039281)

21 April 2026 | New alternative listed

A new alternative will be listed from 1 May 2026. The alternative is not Medsafe approved. 

Details of the new alternative

Affected product

The supplier can no longer supply this product:

  • Chemical: Salbutamol 2.5 mg with ipratropium bromide 0.5 mg per vial
  • Presentation: Nebuliser soln, 2.5 ml ampoule
  • Brand: Duolin
  • Pharmacode: 2039281
  • Subsidy: $11.04
  • Measure / Qty: per 20

Schedule listing for Duolin nebulisers(external link)

Combiprasal box, top is mostly white, with blue highlights, description of the medicine and a diagram of the vial. One side is mostly blue with details in white text and some braille..

Alternative listed 1 May 2026

The supplier has sourced another alternative for Duolin nebules. It is not Medsafe approved and will need to be prescribed and dispensed in line with section 29A of the Medicines Act. Please note it comes in a 60-pack.

  • Chemical: Salbutamol 2.5 mg with ipratropium bromide 0.5 mg per vial
  • Presentation: Nebuliser soln, 2.5 ml vial
  • Brand: Combiprasal
  • Pharmacode: 2729512
  • Subsidy: $96.50
  • Measure / Qty: per 60
  • Section 29 and wastage apply

Like the Cipla alternative, Combiprasal comes in vials. 

Previous alternative listed 1 February 2026

The supplier, Rex Medical, secured stock of an alternative. This was listed in the Schedule from 1 February 2026. This medicine has not been approved by Medsafe. It will need to be prescribed and dispensed in line with section 29A of the Medicines Act. This product expires on 30 June 2026.

Differences 

  • Cipla S29 is a 30-pack, where Duolin is a 20-pack.
  • Cipla S29 is a 3 ml vial where Duolin is a 2.5 ml ampoule.
  • The vials are labelled "albuterol". This is the American spelling for salbutamol.
  • Albuterol sulfate 3 mg is the same as salbutamol 2.5 mg

Listing details

  • Chemical: Salbutamol 2.5 mg with ipratropium bromide 0.5 mg per vial
  • Presentation: Nebuliser soln, 3 ml vial
  • Brand: Cipla S29
  • Pharmacode: 2719959
  • Subsidy: $16.56
  • Measure / Qty: per 30
  • Section 29 and Wastage apply
.
Cipla S29 box labelling

Managing acute severe asthma

The Asthma and Respiratory Foundation has published algorithms for managing acute and severe asthma in adults and children.

NZ Asthma Guidelines | Quick reference guide | Asthma + Respiratory Foundation website [PDF](external link)

Prescribing and supplying an unapproved medicine

Section 29A of the Medicines Act 1981 allows for medicines that are not Medsafe approved to be prescribed and supplied to people. However, unapproved medicines cannot be supplied under PSO. 

We know supplying a medicine under section 29A is not ideal. In this case, however, this will allow people to continue to access an appropriate treatment. 

We apologise for any inconvenience this causes. 

Advice for prescribing under section 29 – BPAC website(external link) 

Prescriber and pharmacist requirements for section 29 and 29A medicines – Medsafe website(external link)

What patients need to know about unapproved medicines – Healthify website(external link)

Who to contact

If you have questions about this issue, email enquiry@pharmac.govt.nz

Please include as much information as you can about the product (presentation, brand, pharmacode) and who your wholesaler is.

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