Berodual – composition, action, dosage, indications, contraindications, side effects

Proven content

Berodual is a nebuliser solution used to treat the symptoms of bronchial asthma or chronic bronchitis. The active substances of Berodual are fenoterol hydrobromide and ipratropium bromide monohydrate. Berodual is available in stationary pharmacies and can only be obtained with a prescription. What are the indications and contraindications to the use of Berodual? How to properly dose this drug? Can its use cause side effects in a patient?

Berodual – general characteristics of the drug

Berodual is a drug used primarily to reduce symptoms caused by bronchial asthma or chronic bronchitis. This preparation is available only on prescription in stationary pharmacies.

The active substances of Berodual are fenoterol hydrobromide and ipratropium bromide monohydrate. This drug is primarily a bronchodilator.

Berodual is available as a nebuliser solution. The solution is contained in a type III amber glass bottle placed in a cardboard box. The bottle is fitted with a dropper and closed with a plastic cap. The package size of the drug is 20 ml.

Boehringer Ingelheim International GmbH is responsible for the production and distribution of Berodual. The company was founded in 1885 by Albert Boehringer in Ingelheim on the Rhine in Germany. It is now one of the world’s 20 leading pharmaceutical companies. The company is still headquartered in Ingelheim and operates worldwide through 140 subsidiaries and employs over 46 people. employees. The most important research areas of Boehringer Ingelheim International GmbH are: respiratory diseases, cardiovascular diseases, HIV, thromboembolism and cerebrovascular diseases.

Berodual – composition and action of the drug

The active substances of Berodual are fenoterol hydrobromide and ipratropium bromide monohydrate. 1 ml of nebuliser solution contains 0,5 mg of fenoterol hydrobromide and 0,25 mg of ipratropium bromide monohydrate.

Fenoterol is a drug belonging to the group of beta-mimetics. It is a preparation that widens the respiratory tract. After taking the drug, bronchodilation takes place, which lasts about 4-6 hours.

Mechanism of action of fenoterol it is based on the selective stimulation of beta-adrenergic receptors present in the target cell membrane.

When a drug is bound to a receptor, the receptor is stimulated and the processes that lead to a specific cell response begin.

Fenoterol has an affinity for beta2 receptors and a low affinity for beta1 receptors. Stimulation of the beta2-receptors found in bronchial smooth muscle cells causes their relaxation and leads to bronchodilation, which improves lung ventilation.

Fenoterol also acts on beta2 receptors found in mast cells of the respiratory system by inhibiting the release of pro-inflammatory factors and mediators of an allergic reaction from them.

Therefore, fenoterol reduces the effects of local mediators, such as bronchospasm, increased mucus secretion, mucosal congestion, swelling and infiltration of inflammatory cells.

Ipratropium bromide, on the other hand, is a derivative of atropine, i.e. an anticholinergic bronchodilator. Taking the drug causes bronchodilation lasting up to 6 hours.

Anticholinergic drugs, including ipratropium, block cholinergic receptors, thus canceling the effects of acetylcholine.

Ipratropium bromide blocks muscarinic M3 receptors located in the airways. Blocking these receptors in bronchial smooth muscle cells reduces smooth muscle tone, improves bronchial patency, improves lung ventilation, and prevents contractile reflexes.

Combination of ipratropium with fenoterol increases the effectiveness of action and stronger relaxation of bronchial smooth muscles.

The other ingredients are benzalkonium chloride, disodium edetate, sodium chloride, concentrated hydrochloric acid (for pH adjustment) and purified water.

How our bronchi work? Check: Bronchi – structure and functions. Bronchial disorders

Berodual – indications for the use of the drug

Berodual works primarily by expanding the bronchial tubes. The indications for the use of Berodual are:

1. bronchial asthma;
2. chronic bronchitis with emphysema;
3. chronic bronchitis without emphysema;
4. chronic obstructive pulmonary disease (COPD).

How to cure asthma in Poland? Read: How is asthma treated in Poland? These are the biggest problems

Berodual – contraindications to use

Berodual, despite its effectiveness in treating the symptoms of asthma or bronchitis, cannot be used by every patient struggling with this type of ailments.

Contraindications to the use of the drug Berodual are:

1. hypersensitivity to fenoterol hydrobromide, atropine-like substances or any of the excipients;
2. obstructive hypertrophic cardiomyopathy;
3. tachyarytmia.

What should you know about drug hypersensitivity? Check: Drugs are also allergenic

Berodual – precautions

Before and during the use of Berodual, observe the precautions contained in the package leaflet.

Precautions to keep in mind include:

1. in the case of long-term use of the drug, it should be under the constant supervision of a doctor;
2. in patients with bronchial asthma and mild COPD, the drug should be used as needed;
3. in patients with bronchial asthma and corticosteroid-responsive chronic obstructive pulmonary disease, physicians should consider additional anti-inflammatory drugs (or increasing their dose) to control airway inflammation and prevent worsening of the disease;
4. the dose of the drug should not be increased in the case of worsening bronchial patency;
5. the use of other sympathomimetic drugs is allowed only under medical supervision;
6. in the following diseases, the drug, especially when used in doses higher than recommended, can be used only after careful consideration of the benefits and risks: insufficiently controlled diabetes, recent myocardial infarction and / or severe cardiac or vascular diseases, hyperthyroidism, tumor pheochromocytoma;
7. the drug may reduce the amount of potassium in your blood;
8. caution should be exercised in the use of the drug in the presence of diseases: prostatic hyperplasia, narrowing of the bladder neck, predisposition to narrow-angle glaucoma;
9. the drug may cause symptoms of acute narrow-angle glaucoma;
10. do not apply the drug to the eye;
11. gastrointestinal motility disorders may occur in patients with cystic fibrosis;
12. Hypersensitivity reactions may occur after using the drug.

You should also remember to keep the drug out of the reach and sight of children. Store below 25 ° C. Keep in the outer carton in order to protect from light. Do not use the drug after the expiry date stated on the package.

What should you know about proper drug storage? Check: Medications that are stored wrongly are poisonous

Dosage of the drug Berodual

Berodual is in the form of inhalation drops and should be used as prescribed by your doctor. For inhalation, you can use, for example, the TM-NEB NANO portable membrane inhaler or the VICKS Sinus Inhaler VH200E steam sinus inhaler.

Always use Berodual exactly as described in the package leaflet or as directed by your doctor or pharmacist.

First of all, remember that the nebuliser solution should be inhaled using a nebuliser and never taken by mouth. 20 drops of the drug correspond to 1 ml of solution, corresponding to 0,25 mg of ipratropium bromide monohydrate and 0,5 mg of fenoterol hydrobromide.

Correct dosage of Berodual it depends on the patient’s age and the condition being treated.

In the case of adults and adolescents over 14 years of age the dose should be dosed as described below.

Treatment of acute asthma attacks:

1. mild and moderate symptoms – 1 ml (20 drops);
2. severe symptoms – up to 2,5 ml (50 drops);
3. especially severe cases – up to 4 ml (80 drops).

Periodic and long-term treatment:

1. multiple dosing of the drug – from 1 to 2 ml (20 – 40 drops) for each administration up to 4 times a day;
2. moderate bronchospasm or artificial ventilation – 0,5 ml (10 drops).

In the case of children from 6 to 14 years of age the dose should be dosed as described below.

Treatment of acute asthma attacks:

1. the usual dose – from 0,5 to 1 ml (10 to 20 drops);
2. severe symptoms – up to 2 ml (40 drops);
3. especially severe cases – up to 3 ml (60 drops).

Periodic and long-term treatment:

1. multiple dosing of the drug – from 0,5 to 1 ml (10 – 20 drops) for each administration up to 4 times a day;
2. moderate bronchospasm or artificial ventilation – 0,5 ml (10 drops).

In the case of children under 6 years of age (weighing less than 22 kg) should be dosed as described below

1. the dosage is individually determined by the doctor;
2. approximately 25 micrograms of ipratropium hydrobromide and 50 micrograms of fenoterol hydrobromide per kg of body weight per dose up to a maximum of 1 ml (0,5 drops) up to 10 times daily.

Berodual – proper use of the drug

Berodual nebuliser solution should be administered by inhalation using nebulizers.

Treatment with this preparation should always be started with the lowest recommended dose. The dose recommended by your doctor should be diluted with 0,9% sodium chloride solution to a volume of 3 to 4 ml and inhaled until the solution is completely consumed. The drug should not be diluted with distilled water.

The nebuliser solution should be diluted before each use and any unused diluted solution should be discarded. The diluted solution should be used immediately after preparation.

The dosage of Berodual may depend on the inhalation method and the type of nebuliser. The inhalation time may be controlled by the volume of the solution.

The drug can be administered with various pneumatic nebulizers available on the market. If an oxygen wall installation is available, use a flow of 6-8 liters per minute.

Patients should follow the instructions provided by the nebuliser manufacturer for proper use, storage and cleaning of the nebuliser.

If necessary, the dose may be inhaled repeatedly at intervals of at least 4 hours. If you have the impression that the effect of the drug is too strong or too weak, consult your doctor.

How to take medication correctly? Check: How to take medications effectively?

Berodual – improper use of the drug

Taking more than the recommended dose of the drug or omitting the indicated dose during the day is considered inappropriate use of Berodual.

If you use more medicine than recommended, consult your doctor immediately. These may occur after taking a higher dose of the drug overdose symptoms such as:

1. redness of the face;
2. increased heart rate;
3. acceleration of the heart rate;
4. palpitations;
5. increase or decrease in blood pressure;
6. angina pains;
7. Heart arythmia;
8. trembling.

What should you know about side effects of drugs? Check: Adverse drug reactions

Berodual – side effects

Berodual, like any other drug, may cause side effects in patients. It is important to report any suspected adverse reactions after authorization of the medicinal product so that the benefit / risk balance of the medicinal product can be monitored.

While taking Berodual, you may experience:

1. increased nervous excitability;
2. dry mouth;
3. Headache;
4. dizziness;
5. skeletal muscle tremors;
6. increased heart rate;
7. palpitations.

Among other reported side effects, the following are indicated:

1. gastrointestinal motility disorders, vomiting, constipation, diarrhea;
2. urinary retention;
3. eye accommodation disorders, glaucoma;
4. allergic reactions e.g. rash, angioedema of the tongue, lips and face, hives, laryngospasm;
5. anaphylactic reactions;
6. weakness;
7. muscle cramps.

As with any inhalation medication, you may experience:

1. local irritation;
2. cough;
3. inflammation, throat irritation;
4. bronchospasm.

Berodual – interactions with other drugs

Before starting treatment with Berodual, please inform your doctor or pharmacist about all the medicines you are taking or have taken recently. You should also inform what medications the patient plans to take in the near future.

Concomitant administration of Berodual with the following drugs may increase the bronchodilating effect and increase the side effects:

1. beta-adrenergic drugs;
2. anticholinergic drugs;
3. xanthine derivatives.

In addition, Berodual reduces the amount of potassium in your blood. Therefore, special care should be taken when used together with:

1. xanthine derivatives;
2. cortykosteroidami;
3. diuretics;
4. digoxin.

You should also be careful with drugs that increase the effect of Berodual. These are:

1. inhibitory monoaminooksydazy;
2. tricyclic antidepressants;
3. halothane;
4. trichlorethylene;
5. swelling.

Which drugs should never be combined with each other? Check: Dangerous interactions

Berodual and pregnancy and breastfeeding

The use of any medications or dietary supplements during pregnancy requires consultation with the attending physician. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking Berodual.

Studies on the drug do not show any adverse effects of fenoterol and ipratropium during pregnancy. The doctor individually assesses the risk of using the drug during pregnancy. Berodual should not be used in the first trimester of pregnancy, unless your doctor tells you otherwise. The drug inhibits uterine contractions.

Fenoterol hydrobromide is excreted in human milk, while it is not known whether ipratriopic bromide is excreted in human milk. The doctor individually assesses the risk of using the drug during breastfeeding.

What is worth knowing about proper supplementation during pregnancy? Check: Conscious choices. Diet and supplementation in pregnancy

Berodual — cena

Cena Berodual place may differ depending on the city in which the preparation will be purchased or the pharmacy chosen by the patient.

A 20 ml package of Berodual costs about PLN 20. The drug is free of charge for people over 75 years of age, but only in reimbursed indications. In addition, it is reimbursed for all patients in such indications as:

1. asthma;
2. COPD;
3. eosinophilic bronchitis;
4. cystic fibrosis;
5. bronchopulmonary dysplasia;
6. ciliary dyskinesia.

How much money does the average Pole spend on treatment? Check: The Pole is not expected to see a doctor