Berodual®
If shortness of breath (difficulty breathing) suddenly increases rapidly, you should consult a doctor immediately.
Hypersensitivity
After using BERODUAL®, immediate hypersensitivity reactions may occur, signs of which, in rare cases, may be: urticaria, angioedema, rash, bronchospasm, oropharyngeal edema, anaphylactic shock.
Paradoxical bronchospasm
BERODUAL®, like other inhaled drugs, can cause paradoxical bronchospasm, which can be life-threatening. If paradoxical bronchospasm develops, the use of BERODUAL® should be stopped immediately and switched to alternative therapy
Long-term use
— in patients suffering from bronchial asthma, BERODUAL® should be used only as needed;
- in patients with mild forms of chronic obstructive pulmonary disease, symptomatic treatment may be preferable to regular use;
- in patients with bronchial asthma, one should remember the need to carry out or intensify anti-inflammatory therapy to control the inflammatory process of the respiratory tract and the course of the disease.
Regular use of increasing doses of drugs containing β2-adrenergic agonists, such as BERODUAL®, to relieve bronchial obstruction can cause uncontrolled worsening of the disease. In case of increased bronchial obstruction, increasing the dose of β2-agonists, including BERODUAL®, more than recommended for a long time is not only not justified, but also dangerous. To prevent life-threatening worsening of the disease, consideration should be given to reviewing the patient's treatment plan and adequate anti-inflammatory therapy with inhaled corticosteroids.
Other sympathomimetic bronchodilators should be prescribed simultaneously with BERODUAL® only under medical supervision.
Gastrointestinal disorders
In patients with a history of cystic fibrosis, gastrointestinal motility disorders are possible.
BERODUAL® should be used with caution in patients predisposed to acute-angle glaucoma
. There are isolated reports of complications from the organ of vision (for example, increased intraocular pressure, mydriasis, angle-closure glaucoma, eye pain) that developed when inhaled ipratropium bromide (or ipratropium bromide in combination with β2-adrenergic receptor agonists) entered the eyes. Symptoms of acute angle-closure glaucoma may include pain or discomfort in the eyes, blurred vision, the appearance of a halo on objects and colored spots in front of the eyes in combination with corneal edema and redness of the eyes due to conjunctival vascular injection.
If any combination of these symptoms develops, the use of eye drops that reduce intraocular pressure and immediate consultation with a specialist are indicated.
Patients should be instructed on the correct use of BERODUAL® inhalation solution. To prevent the solution from getting into the eyes, it is recommended that the solution used with a nebulizer be inhaled through the mouthpiece. If there is no mouthpiece, a mask that fits tightly to the face should be used. Patients predisposed to developing glaucoma should take special care to protect their eyes.
Systemic effects
For the following diseases:
recent myocardial infarction, diabetes mellitus with inadequate glycemic control, severe organic heart and vascular diseases, hyperthyroidism, pheochromocytoma or urinary tract obstruction (for example, prostatic hyperplasia or bladder neck obstruction) BERODUAL® should be used only after a thorough risk/benefit assessment , especially when using doses higher than recommended.
Effect on the cardiovascular system
In post-marketing studies, rare cases of myocardial ischemia have been reported when taking beta-agonists. Patients with concomitant serious heart disease (for example, coronary heart disease, arrhythmias or severe heart failure) receiving BERODUAL® should be warned to consult a doctor if they develop heart pain or other symptoms indicating worsening of heart disease. It is necessary to pay attention to symptoms such as shortness of breath and chest pain, as they can be of both cardiac and pulmonary etiology.
Hypokalemia
When using β2-agonists, hypokalemia may occur (see section "Overdose").
In athletes, the use of BERODUAL® due to the presence of fenoterol in its composition can lead to positive results of doping tests.
The drug contains a preservative, benzalkonium chloride, and a stabilizer, disodium edetate dihydrate. During inhalation, these components may cause bronchospasm in sensitive patients with airway hyperresponsiveness.
Berodual, 1 piece, 20 ml, 0.25 mg+0.5 mg/ml, solution for inhalation
Inhalation.
Solution for inhalation.
For adults and children over 12 years of age, to relieve attacks - 20–80 drops (1–4 ml). For long-term therapy - 1-2 ml (20-40 drops) up to 4 times a day. In cases of moderate bronchospasm or the need for auxiliary ventilation - 0.5 ml (10 drops). For children 6-12 years old, to relieve attacks - 0.5-1 ml (10-20 drops) once, for severe attacks - 2-3 ml (40-60 drops), for long-term therapy - 0.5-1 ml ( 10–20 drops) 4 times a day, with moderate bronchospasm - 0.5 ml (10 drops). Children under 6 years of age (body weight less than 22 kg) (only under medical supervision) at the rate of 25 mcg of ipratropium bromide and 50 mcg of fenoterol hydrobromide per 1 kg of body weight, up to 0.5 ml (10 drops) up to 3 times a day.
The recommended dose, immediately before use, is diluted with saline to a volume of 3–4 ml and inhaled through a nebulizer for 6–7 minutes until the solution is completely consumed. Berodual solution for inhalation should not be diluted with distilled water. The solution should be diluted immediately before use; the diluted solution remaining after inhalation should be destroyed.
The dose depends on the inhalation mode and the technical characteristics of the nebulizer. The duration of inhalation can be controlled through the volume of diluted solution.
Berodual solution for inhalation can be used using various commercially available inhalation units. If there is a centralized stationary oxygen supply, the solution is best administered at a rate of 6–8 l/min. If necessary, repeated inhalations are carried out at intervals of at least 4 hours.
Aerosol.
Adults and children over 6 years of age are prescribed 2 inhalation doses. If breathing relief does not occur within 5 minutes, 2 more inhalation doses can be prescribed. If 4 inhalations are ineffective, you should immediately seek medical help.
For long-term and intermittent therapy - 1-2 doses 3 times a day (up to 8 inhalations per day).
To obtain maximum effect, it is necessary to use a dosed aerosol correctly.
Before using the metered-dose aerosol for the first time, shake the can and press the bottom of the can twice.
Each time you use a metered dose aerosol, the following rules must be observed:
1. Remove the protective cap.
2. Take a slow, deep breath.
3. Hold the balloon and wrap your lips around the tip. The cylinder should be pointing upside down.
4. While inhaling as deeply as possible, simultaneously quickly press the bottom of the balloon until one inhalation dose is released. Hold your breath for a few seconds, then remove the tip from your mouth and exhale slowly. Repeat steps to receive the second inhalation dose.
5. Put on the protective cap.
6. If the aerosol can has not been used for more than 3 days, before use, press the bottom of the can once until a cloud of aerosol appears.
The cylinder is designed for 200 inhalations. After this, the cylinder should be replaced. Although some contents may remain in the canister, the amount of drug released during inhalation may be reduced.
The cylinder is opaque, so the amount of drug in the cylinder can only be determined in the following way: by removing the protective cap, the cylinder is immersed in a container filled with water. The amount of the drug is determined depending on the position of the cylinder in the water.
The tip should be kept clean and can be washed in warm water if necessary. After using soap or detergent, rinse the handpiece thoroughly with clean water.
Warning:
The plastic mouth adapter is designed specifically for the Berodual N metered aerosol and serves for precise dosing of the drug. The adapter must not be used with other metered aerosols. You also cannot use metered tetrafluoroethane-containing aerosol Berodual N with any other adapters other than the adapter supplied with the cylinder.
The contents of the cylinder are under pressure. The cylinder must not be opened or exposed to temperatures above 50 °C.
BERODUAL N (aerosol)
, in your purse, under your pillow, in the glove compartment of your car, and of course a copy at the dacha.
One day, a pulmonologist prescribed Berodual for me under VHI. I prescribed it for a reason, but in combination with Aerosol Klenil. Berodual should relieve spasms, expand the bronchi, and Klenil should treat inflammation. Aerosol Berodual N is packaged in this small cardboard box. In addition to the aerosol, the box also contains instructions for use, which you should study carefully.
Considering that the text is printed on both sides, then simply reading the instructions is a Herculean task. I usually focus only on contraindications and side effects. In terms of side effects, nothing new, ALL such drugs cause tachycardia and palpitations, if you spray a cold drug (from the cold), you can get pharyngitis. There are a lot of side effects described, but personally I didn’t experience anything other than what was already stated. “What, what, what, what are our…” medicines made of?
The ingredients are printed directly on the box. It is impossible to pronounce the names of the ingredients out loud to a non-specialist. On the Internet, I read that a mixture of these substances ensures the expansion of the bronchi necessary for normal breathing. Actually, nothing more is required. The inhaler itself looks like this
Under the lid you can see the hole from which the active substance is sprayed. Taking it apart
Any inhaler requires maintenance. The plastic casing must be washed from time to time. When used, air enters the spout, which is covered by the lips, in addition to the medicine, which is mixed with the medicine. Along with the air, dust gets inside, which then settles on the walls. The photo shows dust particles settled on the walls.
The casing can be washed in running water.
You need to wash not only the inside, but also the outside, because we put it in our mouths. The next photo shows that the dust has disappeared from the walls.
How to use the inhaler correctly is also in the instructions.
Using the Berodual N inhaler is not much different from using other inhalers. The effect is different! The drug relieves the attack in 2-3 minutes. The duration of action lasts for 6-8 hours, this is in the phase of sharp exacerbation. If an attack is caused by a random allergen or a strong emotion, then there are no relapses. At one time, I also kept Salbutamol in my medicine cabinet, but Berodual won. On our favorite website Otzovik, there is a review where the author complains about the addictive effect. I can tell you for myself, it is NOT addictive. Although I have been using the drug for more than 5 years. Another thing is that Berodual serves as an “ambulance”; it relieves an attack. And for treatment (there is no cure for asthma in general), in order to drive the disease into a corner, you need to use other drugs and means. The pulmonologist recommended that I use Clenil, see link above. In addition, you need to do breathing exercises and avoid overcooling. If you have bronchitis in the acute stage, or you are in constant contact with allergens, Berodual will simply relieve the spasm for a while, and if you do not take any action, but simply continue to use Berodual, the intervals between attacks will become shorter and shorter...
Now about the price, below is a comparative table of prices for bronchodilators.
The number of doses in the inhalers is the same, but the mass is different. As a result, the price for 1 gram of Berodual N turned out to be the highest. Let's write the result as a minus. On average, I “breathe” with an inhaler 1.5 times a day (it’s not necessary once at a time), multiply by 365 days, we get 547.5 doses per year, divide by 200, resulting in 2.7 packs per year. Using the World Wide Web (Internet), you can compare prices in different pharmacies and choose one that is closer and cheaper. I usually take several pieces at once, since the expiration date allows.
I recommend the drug Berodual N for use, BUT only if it has been prescribed by a doctor. We must not forget about the long list of “side effects”. Only a certified specialist can understand a specific case and prescribe medicine. In general, good health to everyone!
Berodual n 20mcg+50mcg/dose 200doses 10ml aerosol for inhalation dosed
Release form:
Aerosol for inhalation dosed.
Composition 1 dose contains:
Active ingredients: fenoterol hydrobromide 50 mcg; ipratropium bromide monohydrate 21 mcg, which corresponds to the content of ipratropium bromide 20 mcg.
Excipients: absolute ethanol, purified water, citric acid, tetrafluoroethane (HFA 134a, propellant).
Packaging: Bottle 10 ml.
Pharmachologic effect:
Combined bronchodilator drug. Contains two components with bronchodilator activity: ipratropium bromide - an m-anticholinergic blocker, and fenoterol hydrobromide - a beta2-adrenergic agonist. With inhaled ipratropium bromide, bronchodilation is due primarily to local rather than systemic anticholinergic effects.
Berodual N, indications for use:
Prevention and symptomatic treatment of obstructive airway diseases with reversible bronchospasm: COPD. Bronchial asthma. Chronic bronchitis, complicated or not complicated by emphysema.
Contraindications: Hypertrophic obstructive cardiomyopathy. Tachyarrhythmia. I trimester of pregnancy. Children's age up to 6 years. Hypersensitivity to the components of the drug. Hypersensitivity to atropine-like substances.
With caution: use the drug for angle-closure glaucoma, coronary insufficiency, arterial hypertension, poorly controlled diabetes mellitus, recent myocardial infarction, severe organic diseases of the cardiovascular system, hyperthyroidism, pheochromocytoma, prostatic hypertrophy, bladder neck obstruction, cystic fibrosis, children over 6 years old.
Method of administration and dosage: The dose is set individually. To relieve attacks of bronchial asthma, adults and children over 6 years of age are prescribed 2 inhalation doses. If breathing relief does not occur within 5 minutes, 2 more inhalation doses can be prescribed. The patient should be informed that if there is no effect after 4 inhalation doses and additional inhalations are necessary, consult a doctor immediately.
Rules for using the drug: The patient must be instructed on the correct use of the metered-dose aerosol.
Before using the metered-dose aerosol for the first time, press the bottom of the can twice.
Storage conditions:
Store out of the reach of children at a temperature not exceeding 25°C. The contents of the cylinder are under pressure. The container must not be opened or heated above 50°C.
Shelf life: 3 years.
Berodual
Use during pregnancy and breastfeeding
Data from preclinical studies and human experience indicate that fenoterol or ipratropium bromide do not have a negative effect during pregnancy.
The possibility of an inhibitory effect of fenoterol on uterine contractility should be taken into account.
The drug is contraindicated in the 1st and 3rd trimesters (possibility of weakening labor by fenoterol).
The drug should be used with caution in the second trimester of pregnancy.
Fenoterol is excreted in breast milk. There is no data confirming that ipratropium bromide passes into breast milk. However, Berodual® should be prescribed to nursing mothers with caution.
Clinical data on the effect of the combination of ipratropium bromide and fenoterol hydrobromide on fertility are not known.
Use for renal impairment
The drug should be prescribed with caution for obstruction of the bladder neck.
Use in children
In adolescents over 12 years of age during acute attacks of bronchospasm, depending on the severity of the attack, doses can vary from 1 ml (1 ml = 20 drops) to 2.5 ml (2.5 ml = 50 drops). In especially severe cases, it is possible to use doses reaching 4 ml (4 ml = 80 drops).
In children aged 6-12 years during acute attacks of bronchial asthma, depending on the severity of the attack, doses can vary from 0.5 ml (0.5 ml = 10 drops) to 2 ml (2 ml = 40 drops).
In children under 6 years of age (body weight <22 kg), due to the fact that information on the use of the drug in this age group is limited, the following dose is recommended (only under medical supervision): about 25 mcg ipratropium bromide and 50 mcg fenoterol hydrobromide = 0.1 ml (2 drops) per kg of body weight (per dose), but not more than 0.5 ml (10 drops) (per dose). The maximum daily dose is 1.5 ml.
special instructions
The patient should be informed that if shortness of breath (difficulty breathing) suddenly increases rapidly, consult a doctor immediately.
Hypersensitivity
After using Berodual, immediate hypersensitivity reactions may occur, signs of which in rare cases may include urticaria, angioedema, rash, bronchospasm, oropharyngeal edema, anaphylactic shock.
Paradoxical bronchospasm
Berodual®, like other inhaled drugs, can cause paradoxical bronchospasm, which can be life-threatening. If paradoxical bronchospasm develops, the use of Berodual should be stopped immediately and switched to alternative therapy.
Long-term use
In patients with bronchial asthma, Berodual® should be used only as needed. In patients with mild COPD, symptomatic treatment may be preferable to regular use.
In patients with bronchial asthma, one should remember the need to carry out or intensify anti-inflammatory therapy to control the inflammatory process of the respiratory tract and the course of the disease.
Regular use of increasing doses of drugs containing β2-adrenergic agonists, such as Berodual®, to relieve bronchial obstruction can cause uncontrolled worsening of the disease. In case of increased bronchial obstruction, increase the dose of β2-agonists, incl. Beroduala, more than recommended for a long time is not only not justified, but also dangerous. To prevent life-threatening worsening of the disease, consideration should be given to reviewing the patient's treatment plan and adequate anti-inflammatory therapy with inhaled corticosteroids.
Other sympathomimetic bronchodilators should be prescribed concomitantly with Berodual only under medical supervision.
Gastrointestinal disorders
In patients with a history of cystic fibrosis, gastrointestinal motility disorders are possible.
Berodual® should be prescribed with caution to patients predisposed to the development of glaucoma. There are isolated reports of complications from the organ of vision (for example, increased intraocular pressure, mydriasis, angle-closure glaucoma, eye pain) that developed when inhaled ipratropium bromide (or ipratropium bromide in combination with β2-adrenergic receptor agonists) entered the eyes. Symptoms of acute angle-closure glaucoma may include pain or discomfort in the eyes, blurred vision, the appearance of a halo on objects and colored spots in front of the eyes in combination with corneal edema and redness of the eyes due to conjunctival vascular injection. If any combination of these symptoms develops, the use of eye drops that reduce intraocular pressure and immediate consultation with a specialist are indicated. Patients should be instructed on the correct use of Berodual® inhalation solution. To prevent the solution from getting into the eyes, it is recommended that the solution used with a nebulizer be inhaled through the mouthpiece. If you do not have a mouthpiece, use a mask that fits tightly to your face. Particular care should be taken to protect the eyes of patients predisposed to the development of glaucoma.
Systemic effects
For the following diseases: recent myocardial infarction, diabetes mellitus with inadequate glycemic control, severe organic diseases of the heart and blood vessels, hyperthyroidism, pheochromocytoma or urinary tract obstruction (for example, prostatic hyperplasia or bladder neck obstruction), Berodual® should be prescribed only after careful assessment of the risk/benefit ratio, especially when used in doses higher than recommended.
Effect on the cardiovascular system
In post-marketing studies, rare cases of myocardial ischemia have been reported when taking beta-adrenergic agonists. Patients with concomitant serious heart disease (for example, coronary artery disease, arrhythmias or severe heart failure) receiving Berodual® should be warned to consult a doctor if they develop heart pain or other symptoms indicating worsening of heart disease. It is necessary to pay attention to symptoms such as shortness of breath and chest pain, because... they can be of both cardiac and pulmonary etiology.
Hypokalemia
Hypokalemia may occur when using β2-adrenergic agonists.
In athletes, the use of Berodual, due to the presence of fenoterol in its composition, can lead to positive results of doping tests.
The drug contains a preservative, benzalkonium chloride, and a stabilizer, disodium edetate dihydrate. During inhalation, these components may cause bronchospasm in sensitive patients with airway hyperresponsiveness.
Ipratropium-aeronativ, 20 mcg/dose, 200 doses, dosed aerosol for inhalation, 1 pc.
Hypersensitivity
Immediate hypersensitivity reactions may occur after use of Ipratropium-Aeronativ, as indicated by rare cases of rash, urticaria, angioedema, oropharyngeal edema, bronchospasm and anaphylaxis.
Paradoxical and bronchospasm
The drug Ipratropium-aeronativ, like other inhaled drugs, can cause paradoxical bronchospasm, which can be life-threatening. If paradoxical bronchospasm occurs, the use of Ipratropium-Aeronativ should be stopped immediately and alternative therapy should be prescribed.
Visual disorders
The drug Ipratropium-aeronativ should be used with caution in patients predisposed to the development of angle-closure glaucoma.
There are isolated reports of cases of eye complications (including the development of mydriasis, increased intraocular pressure, the development of angle-closure glaucoma, eye pain) in cases where inhaled ipratropium bromide, used alone or in combination with a β2-adrenergic receptor agonist, got into my eyes.
Symptoms of acute angle-closure glaucoma may include pain or discomfort in the eyes, blurred vision, the appearance of a halo around objects and colored spots in front of the eyes, combined with redness of the eyes due to conjunctival hyperemia and corneal edema. If any combination of these symptoms develops, the use of eye drops that reduce intraocular pressure and immediate consultation with a specialist is indicated.
Patients should be instructed on the correct use of the drug Ipratropium-aeronativ.
Care should be taken to prevent aerosol from getting into the eyes. Since the aerosol is released from the canister only when the patient presses it and flows from the mouthpiece into the oral cavity, the risk of it getting into the eyes is low.
Effect on kidney and urinary tract function
Ipratropium-aeronativ should be used with caution in patients with existing urinary tract obstruction (for example, prostatic hyperplasia or bladder neck obstruction).
Gastrointestinal motility disorders
Patients with cystic fibrosis may be predisposed to gastrointestinal motility disorders.
Patients should be able to correctly use the drug Ipratropium-aeronative dosed inhalation aerosol. The patient should be informed that if inhalations are not effective enough, or if the condition worsens, they should consult a doctor to change the treatment plan. In case of sudden onset and rapid progression of shortness of breath, the patient should also immediately consult a doctor.
Impact on the ability to drive vehicles and machinery
No studies have been conducted to study the effect of ipratropium bromide on the ability to drive vehicles and operate machinery. However, since the use of the drug may develop such undesirable effects as dizziness, disturbances of accommodation, mydriasis and blurred vision, patients should be careful when driving vehicles and machinery.
