Top 10 Bronchodilators
Bronchodilators are an integral part of the treatment of bronchial diseases. They help to get rid of an attack of suffocation, shortness of breath, dry cough. This is especially true for smokers and for patients with bronchial asthma, when during an attack it is not possible to breathe as before.

To date, there is a huge selection of drugs that differ in the method of administration, duration and mechanism of action. Consider the most effective bronchodilators, which are prescribed by doctors for the treatment of respiratory diseases.

What are bronchodilators in simple words

Bronchodilators are drugs whose main task is to relieve bronchospasm. They do not affect the cause of the spasm, but only relieve the symptoms (shortness of breath, shortness of breath, feeling short of breath, dry cough, heaviness in the chest)1.

Bronchospasm – narrowing of the lumen of the bronchi, caused by contraction of the smooth muscles of the bronchi and swelling of the mucous membrane1. Its symptoms can range from minor discomfort to life-threatening conditions.

Bronchodilators are used in the treatment of bronchial asthma, chronic obstructive pulmonary disease, pneumonia and emphysema.2. Some drugs have an immediate effect, others have a delayed effect and are not suitable for immediate relief of symptoms.2.

Bronchodilators also differ in the duration of the therapeutic effect on short-acting (several hours) and long-acting drugs (up to a day).

List of top 10 inexpensive and effective bronchodilators according to KP

1. Salbutamol

The drug belongs to the group of β2-agonists and contains salbutamol. Salbutamol is available as an aerosol for inhalation. The maximum effect is achieved in a few minutes, and the action lasts 4-6 hours. The main indication is the prevention of an attack of bronchial asthma.4.

Contraindications:

  • allergy to the components of the drug;
  • serious diseases of the heart and blood vessels;
  • decompensated diabetes;
  • thyrotoxicosis;
  • children up to 2 years;
  • the likelihood of premature birth;
  • pregnancy.

The manufacturer also warns the risk of side effects: rapid heart rate, arrhythmia, tremor.

fast action, ease of use, affordable price in the segment.
a large number of contraindications.

2. Berotek

The drug belongs to the group of β2-agonists and contains fenoterol.

Berotek is produced in the form of an aerosol for inhalation, which begins to act after 5-10 minutes and reaches its maximum effect after 1-1,5 hours. The duration of action of the drug is 3-6 hours.

Contraindications:

  • an allergic reaction to the components of the drug;
  • tachyarrhythmia;
  • obstructive hypertrophic cardiomyopathy;
  • children’s age up to 4 years.

The manufacturer also warns the risk of side effects: tremors, rapid heart rate, nausea.

fast action, suitable for the prevention of asthma attacks.
with regular use in high doses worsens the course of the disease.

3. Atrovent N

The drug belongs to the group of anticholinergics and contains ipratropium bromide. Antrovent H is an aerosol for inhalation. It relieves bronchospasm in COPD and bronchial asthma, and also reduces the amount of secretion secreted from the bronchial mucosa, which improves well-being. The effect of the drug occurs after 5-10 minutes, the duration of action is 5-6 hours.

Contraindications:

  • allergic reaction to atropine and ipratropium bromide.

Be wary appoint during pregnancy and lactation, children under 6 years of age, patients with angle-closure glaucoma and prostatic hyperplasia.

Side effects are observed in the form of headache, nausea and dry mouth.

a small number of contraindications, a complex action – expands the lumen of the bronchi and reduces the amount of sputum.
can cause visual impairment, which must be taken into account by drivers of vehicles and those who work with complex mechanisms.

4. Berodual N

The drug belongs to the group of combined drugs and contains ipratropium bromide and fenoterol. Berodual N is an aerosol for inhalation, which is prescribed for bronchial asthma, COPD, chronic obstructive bronchitis. Improvement in well-being is felt after 15 minutes, and the duration of action is 6 hours4.

Contraindications:

  • allergy to the components of the drug;
  • tachyarrhythmia;
  • hypertrophic obstructive cardiomyopathy;

Side effects are observed in the form of cough, dry mouth, headache.

effective combination drug, suitable for the prevention of bronchospasm.
during treatment, care must be taken when driving vehicles and complex mechanisms, since the drug can cause visual impairment, tremor and dizziness.

5. Asthmasol for nebulizer

The drug belongs to the group of combined drugs and contains ipratropium bromide and fenoterol. Astmasol is available as a solution for inhalation. It is convenient because the box immediately contains a capsule of medicine and a solvent (saline solution). Improvement in well-being is felt after 15 minutes when used through a nebulizer, and the duration of action is 6 hours.

Contraindications:

  • allergy to the components of the drug and atropine-like substances;
  • pregnancy (1 trimester);
  • children’s age up to years;
  • tachyarrhythmia;
  • hypertrophic obstructive cardiomyopathy.

Side effects are observed in the form of cough, dry mouth, headache, tremor, rapid heart rate.

combined action, long-term effect.
Not everyone is comfortable using a nebulizer.

6. Ascoril

The drug belongs to the group of combined agents and contains a combination of active substances: Bromhexine, Guaifenesin and Salbutamol.

Ascoril is available in the form of tablets and syrup, which is especially convenient for children. The drug has a bronchodilator, expectorant and mild antitussive effect. It will not help to relieve an acute attack of suffocation, but is effective in acute and chronic bronchopulmonary diseases, which are accompanied by the formation of viscous sputum. It is used in children from 6 years of age.

Contraindications:

  • allergy to the components of the drug;
  • glaucoma;
  • diabetes mellitus in the stage of decompensation;
  • myocarditis, heart defects;
  • renal, hepatic insufficiency;
  • arterial hypertension;
  • peptic ulcer, gastric bleeding;
  • pregnancy and lactation.

Side effects are observed in the form of headache, tremor, heart palpitations.

combined drug with a complex action, two dosage forms – syrup and tablets.
a wide range of contraindications, not for children under 6 years of age.

7. Josette

The drug belongs to the group of combined drugs and contains Bromhexine, Guaifenesin and Salbutamol. Joset is available in the form of syrup and tablets Joset Active. The drug has a bronchodilator, expectorant and mild antitussive effect. It is not prescribed to relieve an acute attack of suffocation, but helps to reduce the viscosity of sputum and facilitate breathing in various bronchopulmonary diseases.4.

The concentration of salbutamol in Joset is less than in Ascoril, so side effects in the form of tremors and palpitations are less common. Joset syrup is allowed for children under 6 years of age.

Contraindications:

  • an allergic reaction to the components of the drug;
  • thyrotoxicosis;
  • decompensated diabetes;
  • serious heart disease (myocarditis, defects);
  • renal, hepatic insufficiency;
  • glaucoma;
  • peptic ulcer, gastric bleeding;
  • pregnancy and lactation.

Side effects are observed in the form of headache, tremor, heart palpitations.

available in the form of tablets and syrup, suitable for young children, acts in a complex way – it reduces bronchospasm, reduces the viscosity of sputum.
a large number of contraindications.

8. Фостер

The drug belongs to the group of combined drugs and contains formoterol and beclamethasone. Foster is available as an aerosol for inhalation, is prescribed for the treatment of the respiratory system, helps relieve bronchospasm and reduces inflammation. Since the composition contains a local glucocorticoid, the drug is ideal for patients with bronchial asthma, both for the main treatment and for relieving attacks. Begins to work in 1 – 3 minutes, and the duration of action lasts up to 12 hours

Contraindications:

  • an allergic reaction to the components of the drug;
  • children’s age up to 18 years.

Side effects are observed in the form of headache, hoarseness.

fast effect, long lasting.
Not suitable for children and adolescents under 18 years of age.

9. Symbicort Turbohaler 4,5/160

The drug belongs to the group of combined drugs and contains formoterol and budesonine. Symbicort Turbuhaler 4,5/160 is available as a powder for inhalation. A positive effect is observed after 1 – 3 minutes, and the duration of the drug lasts up to 12 hours. Since the composition contains the local hormone budesonide, the drug is ideal for patients with bronchial asthma, both for the main treatment and for relieving attacks.

Contraindications:

  • allergy to the components of the drug;
  • children’s age up to 6 years.

Side effects are observed in the form of headache, hoarseness, increased heart rate, tremor.

fast action, ease of use, minimum contraindications.
high price in the segment.

10. Spiriva

The drug belongs to the group of anticholinergics and contains tiotropium bromide. Spiriva is available in the form of powder capsules for inhalation. There is also Spiriva Respimat in the form of a solution for inhalation with a cartridge. It is used to treat COPD, bronchial asthma, emphysema, chronic bronchitis. Spiriva will not allow you to remove the attack immediately, but provides a long-term gentle expansion of the bronchi up to 24 hours. The effect of the drug occurs after 30 minutes.

Contraindications:

  • allergic reaction to atropine and drug components;
  • the first trimester of pregnancy;
  • children’s age up to 18 years.

Side effects are observed in the form of dry mouth.

long-term action – up to 24 hours.
will not help relieve an acute attack of bronchospasm.

How to choose a bronchodilator

The selection of a bronchodilator should be selected by the doctor individually for each patient, otherwise improperly selected therapy can worsen a person’s health. For example, if a patient with bronchial asthma takes only a bronchodilator without primary therapy, then there is a high risk of extremely severe exacerbations – up to death.

There are 3 main groups of bronchodilators3.

1. Anticholinergics

Their main task is to block specific muscarinic receptors in the airways.

The benefits of anticholinergics include:

  • lack of “addiction” – with prolonged use, the sensitivity of receptors to drugs does not decrease;
  • rare side effects (dry mouth is possible, but its presence does not force you to refuse treatment).

2. β2-agonists

Their main task is to expand the bronchi. Most often produced in inhalation form, less often – in tablets.3.

The features of β2-agonists include:

  • frequent use “masks” the symptoms of the inflammatory process (therefore, they are often prescribed together with hormonal drugs);
  • with prolonged use or at high doses, efficiency decreases;
  • excessive use may cause tremors, increased heart rate and blood pressure;
  • be used with caution in elderly patients.

3. Methylxanthines

Their main task is to relax the smooth muscles of the respiratory system. They are mainly used in the form of intravenous or intramuscular injections, tablets.

The features of methylxanthines include:

  • are second-line drugs when other drugs no longer have the desired positive effect;
  • given to those who cannot use inhaled forms.

Previously, these drugs were extremely popular because of their availability, ease of use (tablets), quick effect. However, in recent years, due to the high risk of developing complications from the heart (up to rhythm disturbances), these drugs are very rarely prescribed by doctors.

In a separate group are combination drugs. They use a combination of β2-agonists and anticholinergics in the form of inhaled drugs (Berodual). Combinations with hormonal drugs (Seretide) are also possible. Additionally, if ineffective, methylxanthines may be prescribed. The use of several drugs is much more effective than monotherapy.

Reviews of doctors about bronchodilators

According to many experts, one of the widely used combined bronchodilators is Berodual N. This drug is the undisputed leader among drugs for relieving an acute attack of bronchospasm – both in bronchial asthma and in COPD and other clinical situations.

Another bronchodilator that is often prescribed by doctors is Symbicort Turbuhaler 160/4,5. According to most pulmonologists, the drug provides a long-term positive effect, reduces the frequency of exacerbations.

Popular questions and answers

We discussed important issues related to the prescription of bronchodilators with pulmonologist Ludmila Berdnikova.

What are the side effects of bronchodilators?

— The most popular method of drug administration is inhalation. This method results in dry mouth. This does not cause severe inconvenience, but after using the inhaler, it is recommended to rinse your mouth with plain water. Tachycardia, headache, tremor are also possible. If any side effects occur, it is important to consult a doctor to correct therapy.

When are bronchodilators prescribed?

– Bronchodilators are prescribed in the following situations:

to eliminate bronchospasm in bronchial asthma;

for the treatment of bronchial asthma, COPD, pulmonary emphysema, chronic obstructive bronchitis;

to eliminate bronchospasm during exercise.

What bronchodilators are used to relieve an attack of bronchial asthma?

– The first stage uses short-acting β2-agonists (fenoterol, salbutamol) 2 doses. If there is no improvement after 20 minutes, repeat the dose. If the attack is not stopped, then call an ambulance. Separate use of only a bronchodilator for bronchial asthma is unacceptable!

Sources of:

  1. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition. https://bme.org/index.php/BRONCHOSPASM
  2. Klyachkina I.L.// Bronchodilators in the treatment of respiratory diseases // Medical scientific and practical portal Attending physician // 2005 https://www.lvrach.ru/2005/08/4532859
  3. Yurenev G.L. // Advantages of combined bronchodilators in the treatment of acute broncho-obstructive syndrome // Practical pulmonology. 2012. №3. https://cyberleninka.ru/article/n/preimuschestva-kombinirovannyh-bronholiticheskih-preparatov-v-lechenii-ostrogo-bronhoobstruktivnogo-sindroma
  4. Vizel A.A., Vizel I.Yu., Belevsky A.S. // A new approach to the treatment of bronchial asthma of any severity // Doktor.Ru. 2020. https://cyberleninka.ru/article/n/novyy-podhod-k-lecheniyu-bronhialnoy-astmy-lyuboy-stepeni-tyazhesti
  5. 2000-2022. REGISTER OF DRUGS OF RUSSIA® https://www.rlsnet.ru/

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