Berodual

Berodual – the drug used at treatment of bronchial asthma and chronic obstructive bronchitis.

Form of release and structure

Berodual release in the form of solution for inhalations: transparent, colourless or almost colourless liquid, free from the suspended particles, with hardly notable smell (on 20 ml in bottles droppers of dark glass, 1 bottle in a cardboard pack).

Contains in 1 ml (20 drops):

• Active ingredients: an ipratropiya bromide anhydrous – 0,25 mg, Fenoterolum hydrobromide – 0,5 mg;
• Auxiliary components: sodium chloride, dinatrium of an edetat a dihydrate, a benzalkoniya chloride, Acidum hydrochloricum of 1 N, the purified water.

Indications to use

Berodual appoint for prevention and a symptomatic treatment of chronic obstructive diseases of respiratory tracts with a reversible bronchospasm:

• Bronchial asthma;
• Chronic obstructive bronchitis, uncomplicated or complicated by emphysema.

Contraindications

Absolute:

• Hypertrophic subaortic stenosis;
• Tachyarrhythmia;
• I and III trimesters of pregnancy;
• Hypersensitivity to the components which are a part of medicine.

Relative (drug should be used with extra care in connection with the increased risk of side reactions):

• Closed-angle glaucoma;
• Arterial hypertension;
• Diabetes mellitus;
• The myocardial infarction postponed for the last 3 months;
• Heart disease and vessels (aortal stenosis, coronary heart disease, heart failure, heart disease, the expressed damages of peripheral and cerebral arteries);
• Hyperthyroidism;
• Pheochromocytoma;
• Prostate hyperplasia;
• Obstruction of a neck of a bladder;
• Mucoviscidosis;
• II trimester of pregnancy;
• Period of a lactation (breastfeeding).

Route of administration and dosage

Drug in the form of solution for inhalations for stopping of attacks is appointed to adults and children of 12 years till 20-80 of drops (1-4 ml of Berodual). At prolonged treatment the lowered dosages – till 20-40 drops (1-2 ml) to 4 times a day are applied. At moderately expressed bronchospasm or in cases of need of carrying out assisted ventilation of lungs appoint 10 drops (0,5 ml of solution).

To children of 6-12 years for stopping of attacks Berodual appoint once till 10-20 drops (0,5-1 ml). At heavy attacks increase in a dosage drops (2-3 ml) is admissible till 40-60. In need of performing long therapy drug is used to 4 times a day till 10-20 of drops (0,5-1 ml), at moderately expressed bronchospasm – on 10 drops (0,5 ml).

At children up to 6 years with body weight to 22 kg Berodual apply only under medical observation. The dosage is calculated individually proceeding from body weight, but no more than 10 drops (0,5 ml) 3 times a day.

Solution for inhalations just before use needs to be dissolved up to the volume of 3-4 ml with normal saline solution (it is impossible to dilute with the distilled water). Inhalate Berodual via the nebulizer till the moment until solution is spent completely (within 6-7 minutes). The divorced solution which remained after inhalation cannot be used further.

Side effects

• Nervousness, small tremor, dizziness, headache, accommodation disturbance, change of mentality (central nervous system);
• Rash, urticaria, Quincke's disease of lips, language and person (allergic reactions);
• Tachycardia, heartbeat (cardiovascular system);
• Vomiting, nausea (digestive tract);
• Cough, local irritation, paradoxical bronchospasm (respiratory system);
• Ischuria, hypopotassemia, weakness, strengthening of sweating, spasm, mialgiya (others).

In some cases at Berodual's use in high doses decrease in diastolic pressure, increase in systolic pressure, development of arrhythmia is possible. Also there are data on the undesirable effects developing from organs of sight.

Special instructions

At unexpectedly bystry strengthening of an asthma it is necessary to see a doctor immediately.

It is necessary to appoint along with Berodual other sympathomimetic bronchodilators only under medical observation.

Medicinal interaction

As active component of Berodual represents a combination of m-holinoblokatora and _{β2-адреномиметика}, at the combined use with other substances / drugs the following interactions are possible:

• Anticholinergics for system use, other β-adrenomimetik, ksantinovy derivatives (including theophylline): can strengthen side reactions and bronchodilatory effect of Berodual;
• β-adrenoblockers:::::::::: perhaps considerable decrease in bronchodilatory effect of Berodual;
• Glucocorticosteroids (GKS) and/or kromoglitsiyevy acid: increase efficiency of treatment;
• Digoxin: increase in risk of emergence of arrhythmias owing to the hypopotassemia connected using β-adrenomimetik is probable, besides, on a cordial rhythm the hypoxia (in need of such combination of drugs it is regularly necessary to check potassium level in blood serum) can strengthen a negative impact of a hypopotassemia;
• The inhalation halogenated anesthetics (for example, a halothane, trichloroethylene or энфлуран): can strengthen influence of β-adrenergic funds for cardiovascular system;
• Ksantinovy derivatives, corticosteroids and diuretics: strengthening of the hypopotassemia connected using β-adrenomimetik is possible (it is especially important to consider such interaction at therapy of severe forms of obstructive respiratory diseases);
• Tricyclic antidepressants and monoamine oxidase inhibitors (MAO): are capable to strengthen action of β-adrenergic means.

Terms and storage conditions

To store in the dry, dark place unavailable to children, at a temperature not above 30 °C. Drug cannot be frozen.

Period of validity – 5 years.