1 ml inhalation solution has the following pharmaceutical components:
- ipratropium bromide - 0.261 mg (0.25 mg when converting the dosage form to the dry residue);
- fenoterol hydrobromide - 0.5 mg;
- benzalkonium chloride;
- disodium edetate dihydrate;
- sodium chloride;
- 1 molar hydrochloric acid;
- purified water.
Composition 1 injection dosed inhalation aerosol:
- ipratropium bromide - 0, 021 mg (corresponds to 0.02 mg in the mass part of the anhydrous active substance);
- fenoterol hydrobromide - 0.05 mg;
- 1,1,1,2-tetrafluoroethane (HFA 134a) as a propellant;
- anhydrous citric acid;
- distilled water.
Transparent, colorless (or almost colorless) inhalation solution without suspended particles and practically odorless. A pharmaceutical preparation is packaged in 2 ml dropper bottles (1 ml corresponds to 20 drops). A cardboard box holds a container with medicinal fluid and annotation to it.
Metered-dose aerosol for inhalation in special cylinders with a 10 ml mouthpiece, designed for 200 injections (1 dose equals 1 injection). An annotation and a container with a medicinal product are placed in a cardboard package.
Berodual N - This is an enhanced pharmaceutical form of this drug, which does not differ in operation, since it is also supplied in the form of an aerosol for inhalation and a solution for inhalation. It has its therapeutic properties, respectively, it is somewhat more effective.
The group of the drug Berodual (the international name of the drug is identical to the commercial one) - combined bronchodilator drugs of the inhaled type of action, that is, the active components provide an active expansion of the bronchial lumen when they are inhaled. The mechanism of its therapeutic effect depends on two biological active substances that form the basis of the pharmaceutical mixture used in pulmonary hospitals.
Ipratropium bromide is an ammonium derivative that possesses anticholinergicproperties. Bronchodilation is due to its local action, since it is administered in the form of fine particles when inhaling an aspiration aerosol or solution for inhalation. The biologically active component prevents the release of acetylcholine, the main mediator of parasympathetic synapses, which is manifested in the normalization of calcium concentration inside cell structures. Thus, the neutralization of the action vagus nerve and the lumen of the bronchus expands.
Fenoterol hydrobromidein turn is beta adrenoreceptor stimulant, the selectivity of the therapeutic effect of which depends on a quantitative factor. So small doses of the biologically active component selectively act on beta2 receptors, which is what is expected from Berodual's use in the course of conservative treatment of bronchopulmonary pathology.
The mechanism of biochemical effects of Fenoterol is to counteract agents such as histamine, methacholine, cold air and allergens of plant and animal nature (a special case of inhibition of an immediate hypersensitivity reaction). Immediately after administration in a therapeutic dose, the release of inflammatory mediators from mast cells is blocked, which inevitably leads to relaxation of the smooth muscles of the bronchial tree and the local vascular bed. In addition, there has been an increase in productivity mucociliary clearance.
Separately, it should be noted heart effects Fenoterol, since when it enters the main bloodstream for a biologically active component, it is possible to interact with beta-adrenergic receptors localized in the myocardium, accordingly, the following manifestations can be observed:
- increased heart rate;
- progressive increase in the strength of the muscular organ;
- lengthening of the QT interval on the electrocardiogram.
The combined use of two active bronchodilators allows you to realize the necessary therapeutic effect by various pharmacological mechanisms, since the targets for the action of the active components are different. Complementary Impact fenoterol and ipratropium provides reliable achievement of the desired clinical result, which is manifested in the strengthening of the antispasmodic properties of the muscular apparatus of the bronchi and their sufficient expansion to ensure the normal functioning of a healthy body.
Pharmacodynamics and pharmacokinetics
With active inhalation of the drug solution, improvement of the functioning of the bronchopulmonary system occurs in a short time, even if only 10-39% of the total dose settles in the tissues of the respiratory tract (the rest of the drug remains on the tip of the inhaler, in the oral cavity and in the upper respiratory ways).
Therapeutic effects ipratropium bromide develop within 15 minutes and represent an increase in forced expiration in 1 second (an important parameter for assessing the normal functioning of the respiratory system) and peak expiratory flow by 15 percent. The maximum effect of this biologically active component is achieved after 1-2 hours from the moment of injection, and the achieved effects remain for 6 hours.
General systemic bioavailability fenoterol hydrobromide slightly lower than ipratropium and is about 1.5%, however, Berodual is a local pharmaceutical drug of action, therefore, the rate of the therapeutic effect with the inhalation route of administration, which is no less than that of the first active component of the drug, is more clinically significant.
Indications for use
- bronchial asthma of various origin (allergic and endogenous, asthma of physical stress);
- chronic lung tissue disease accompanying bronchospastic syndrome;
- chronic bronchitis with violation of patency of the bronchopulmonary tract;
- other chronic obstructive diseases of the respiratory system with reversible obstruction of the respiratory tract;
- preventative reorganizationnosological units affecting the respiratory system;
- preparatory measures for the lumen of the respiratory tract before aerosol administration antibioticscorticosteroids or other mucolytic drugs.
- hereditary or acquired intolerance to the constituents of a pharmaceutical preparation;
- heart rhythm disturbance type tachyarrhythmias;
- hypertrophic obstructive cardiomyopathy;
- first trimester of pregnancy;
- the prenatal period of the fetus;
- hypersensitivity to the active or excipients that make up the drug.
The purpose of a pharmaceutical preparation against the background of the following pathological conditions necessarily requires the observance of increased caution (for example, taking a conservative course in a specialized pulmonary hospital):
- angle angle glaucoma;
- heart failure;
- arterial hypertension;
- coronary heart disease;
- myocardial infarction a history of the past three months;
- severe damage to the cerebral and peripheral bloodstream;
- obstruction of the neck of the bladder (of a special organogenic nature);
- pheochromocytomaor other hormone-dependent neoplasms;
- benign hyperplasiaprostate gland;
- cystic fibrosis.
The adverse effects of the use of a pharmaceutical preparation are associated with extremely high biochemical activity of the active components of the inhaled drug, as they have anticholinergicand beta adrenergic properties. Also, the use of Berodual can cause local irritation, which is characteristic of any kind of inhalation therapy.
The most commonly observed side effects from the widest list of adverse effects are dry mouth, headache and dizzinessintentional tremor, cough, pharyngitis, nausea, tachycardia,impaired sound function, subjective feeling of heartbeat, vomiting, nervousness and increased systolic blood pressure.
Other side effects:
- From the organs of cardio-vascular system: arrhythmias, fibrillation atrial, supraventricular tachycardia, ischemia myocardium, increased diastolic blood pressure.
- Organs of vision may respond in the following manner to the administration of a pharmaceutical preparation: increased intraocular pressure, disturbance of the accommodation process, mydriasisdevelopment glaucoma, pain, corneal edema, blurred vision, conjunctival hyperemia, the appearance of a mild halo around objects.
- Respiratory tract: dysphonia, bronchospastic syndrome, pharyngeal irritation followed by its edema, laryngospasm, paradoxical bronchospasm.
- By the immune system: anaphylactic manifestations, reaction hypersensitivity.
- Nervous system and mental health inhalation mixtures may also be susceptible to adverse effects: excitationmental disturbance nervousnesstrembling of the upper extremities when performing a conscious movement (especially pronounced with small coordinated motor acts).
- By metabolic processes: lower potassium blood.
- Digestive system: stomatitis, glossitisdisorders of adequate motility of the gastrointestinal tract, diarrhea or constipationswelling of the oral cavity.
- By skin and subcutaneous tissue: itching hiveslocal angioedema, hyperhidrosis.
- By urinary system: delay in the physiological duration of the act of urination.
Instructions for use Berodual (method and dosage)
Aerosol Berodual, instructions for use
Before conducting independent inhalations with a pharmaceutical preparation, you should carefully read the recommendations for the proper use of Berodual aerosol, which are usually presented as follows:
- The spray is in a spray can with a protective cap, which must be removed before use. If the drug was not in use for the last 3 days, then before using it actively, you must press the valve 1 time until an aerosol for inhalation appears in the form of a small cloud.
- Make a deep and slow exhale.
- Grasp the inhaler with its lips at its tip so that the arrow on the spray can with the medicine is turned up and the mouthpiece down.
- Press the bottom of the container at the same time, releasing 1 measured dose of the drug, and inhale deeply "full breast"to increase the area of interaction of biologically active components and structures of the respiratory system.
- After use, put the protective cap back on, returning the bottle to its original position.
Berodual inhaler: dosage of the aerosol form of the pharmaceutical preparation
Adults and children over 6 years of age during an acute attack - 2 inhalations. If relief does not occur within 5 minutes, then 2 more inhalation doses are prescribed. With further inefficiency of this treatment tactic, it is urgent to seek qualified medical help. At prolonged conservative rehabilitation - 1-2 inhalations 3 times a day, but so that in total there should be no more than 8 manipulations within one day.
Berodual solution for inhalation, instructions for use
A pharmaceutical product in this form of release requires special medical equipment for proper use, which is called nebulizer. This is an apparatus due to which Berodual (or another medicine) is sprayed into a fine cloud. In this form, the drug almost freely enters even poorly ventilated areas bronchopulmonary system, and the dosage for a nebulizer is much lower than for a traditional inhaler, because the "miracle of technology" has especially taken root in pulmonary hospitals and is now widely used for the rehabilitation of respiratory diseases.
Before the direct use of the drug, you should definitely learn how to breed correctly for inhalation, since the effectiveness of the exposure and the completeness of the therapeutic capabilities of the active components of Berodual depend on this stage. As a rule, as a solvent used isotonic sodium chloride solution with a concentration of 0.9%, because it is closest to the composition of the aqueous portion of the plasma (in no case can you use distilled water to dilute the pharmaceutical product, this threatens with adverse effects). How to dilute with saline - add up to 3-4 ml of liquid to the recommended dose.
General conservative treatment regimens for inhalation solution
Adults and children over 12 years of age to eliminate acute attacks - 20-80 drops (1-4 ml) 4 times, and for a long-term course - 1-2 ml (20-40 drops) up to 4 times a day. With a moderately developing bronchospastic syndrome, to facilitate ventilation of the bronchopulmonary system - 0.5 ml (10 drops).
In pediatric practice for children from 6 to 12 years old - 0.5-1 ml (10-20) drops to counteract the attack (in severe clinical cases, the dosage can increase to 2-3 ml, which corresponds to 40-60 drops). With prolonged therapy, for example, with an allergic cough, 0.5-1 ml (10-20 drops) 4 times a day.
In the younger age category of patients under 6 years old and weighing less than 22 kg, the dosage of the pharmaceutical preparation is calculated individually, based on the following needs of the therapeutic course - 25 μg Ipratropium and 50 μg Fenoterol per 1 kg of body weight (total amount of the drug up to 0.5 ml) 3 times a day.
Instructions for use Berodual N
The practical use of this pharmaceutical form of the drug does not differ from the previously invented Berodual. Enhanced variation is also supplied as an aerosol in special containers for active inhalation and a solution for inhalation through a nebulizer or other similar medical equipment. As for the dosages, you should visit a qualified pulmonologist separately and find out this issue individually, as at the moment there are no general protocols for conservative rehabilitation with Berodual N.
When using a pharmaceutical product in clinical practice, a pathological condition such as an overdose of active active ingredients can be observed, which, as a rule, is associated with excessive stimulation of beta-adrenergic receptors. In this case, the most likely symptoms intoxication represent the following:
- subjective sensation of palpitations and tachycardia confirmed by hardware methods;
- increase or decrease in blood pressure (depending on individual predisposition);
- increased bronchial obstructive pathological process;
- an increase in the difference between systolic and diastolic blood pressure;
- angina pectoris and the symptoms accompanying it (for example, a feeling of heaviness behind the sternum);
- hyperemiaskin of the face and associated sensation of heat;
- metabolic acidosis.
Also, an overdose may be due to excess intake ipratropium bromideHowever, in this case, it is weakly expressed and has a transient (passing) character. This is due to the breadth of therapeutic use of this component in pharmacy. In this case, it can be observed dry mouthor disturbance of accommodative abilityorgans of vision.
As a specific pharmacological antidote, selective beta1-blockers. Having the opposite mechanism of therapeutic action, these drugs will help get rid of the pathological condition that threatens the life and well-being of the patient. But in patients with chronic obstructive pulmonary disease and bronchial asthma under the influence of biologically active components of this nature of pharmacological action, there is a chance of developing bronchial blockage, which can only be avoided by careful selection of the exact dosage.
Also, as therapeutic measures, the introduction is used sedatives, tranquilizers(when the symptoms are too violent). In case of severe overdose syndrome, intensive conservative reorganization should be immediately carried out using all possible medicines that can adequately help the patient.
Terms of sale
The medicine belongs to list B. Therefore, upon its purchase, the pharmacist must present a certified document from the attending physician, which confirms the appointment of Berodual by a qualified specialist. Of course, no one will require a prescription in Latin in a pharmacy, but you must have an official form with you.
Like inhalation solution, Berodual aerosol should be stored out of the reach of young children at a temperature not exceeding 30 degrees Celsius.
Is Berodual hormonal or not?
Bronchial asthma - This is a polyetiological disease, one of the factors of which are allergic disorders and sensitization of the body, therefore the conservative treatment of this respiratory pathology is so difficult from a medical point of view. Very often in therapy asthmatic conditions or in clinically severe cases, pharmaceutical preparations based on natural human hormones are used. Since bronchial asthma is present among the indications for the use of Berodual, an ordinary logical question for ordinary people without a medical education is: “Is Berodual a hormonal drug or not?”
The solution to this problem lies in the chemical composition of the drug, which is represented by ipratropium bromide and Fenoterol hydrobromide. The first active substance is an amine derivative with anticholinergic properties, and the second active component of the drug is a non-selective beta-adrenergic agonist. Based on this, it can be stated with confidence that Berodual is not a hormonal drug and, according to its mechanism of action, it cannot affect the hormonal balance in the body.
Analogs of BerodualMatches for ATX Level 4 code:TevacombFosterForadil CombiSeretide
Analogues of Berodual are medicines that have a similar or identical ATX code that marks absolutely all pharmaceutical products on the official market, or INN of Berodual (international non-proprietary name). Analogs for inhalation in pharmacy kiosks are usually cheaper, because the price factor for choosing a drug is sometimes one of the most important, especially in the conservative treatment of chronic, sluggish diseases. Bronchodilators of various nature, which can be replaced Berodual are the following list:Berotex, Ventolin, Duolin, Salbroxol, Salbutamol.
Which is better: Berodual or Pulmicort?
Pulmicort - a synthetic hormonal drug, which is a glucocorticosteroid for inhalation use. That is, the active component of the drug in its chemical structure is identical to the structure of biological substances produced by the adrenal glands. The mechanism of therapeutic action is a direct effect on cellular elements in order to regulate metabolic processes and cycles of formation of new substances.
The effectiveness of local use of Pulmicort is 15 times higher than that of Prednisone, since synthetic active ingredients have a higher chemical affinity for glucocorticosteroid receptors, therefore, the drug is the drug of choice in the treatment of bronchial asthma in clinically advanced cases (or when the pathological process cannot be stopped by other, safer conservative drugs).
Therefore, comparing Berodual and Pulmicort is extremely difficult. Medical researchers have not reached a consensus on this issue and regularly publish "new" arguments in favor of a particular pharmaceutical product. More experienced doctors have found the only true and very acceptable option, which is the use of Pulmicort and Berodual together, in combination therapy diseases of the respiratory system. Thus, the therapeutic effects of two strong pharmaceuticals are combined, which eliminates even the most clinically severe attacks of bronchial asthma or chronic obstructive pulmonary disease.
Inhalation dosage with Berodual and Pulmicort it is selected individually for each patient empirically, starting from the minimum border of the therapeutic range of pharmaceuticals (for Berodual - 0.5 ml, and for Pulmicort - 0.25 mg for one inhalation).
Which is better: Berodual or Ventolin?
Ventolin is a pharmaceutical that is selective beta2-adrenergic agonists, the therapeutic effect of which is to actively expand the bronchial lumen and facilitate ventilation of the pulmonary parenchyma. As a rule, this drug is prescribed for the prevention and conservative relief of spastic contractions that develop upon contact with an allergen in the pathogenesis of bronchial asthma.
Berodual, in turn, has fenoterol, which, like Ventolin, has a stimulating effect on this type of bronchial tree receptors. However, this is not the only biologically active component of Berodual, due to which the indications for its use are much wider than that of Ventolin, because this pharmaceutical preparation is considered better by most qualified pulmonologists, and its use is more rational.
Berotek or Berodual - which is better?
Like Ventolin, Berotek belongs to the pharmaceutical group beta2-adrenoreceptor agonists, that is, the active component of the drug, as in the previous drug, selectively affects the bronchi, which is manifested in the relaxation of the smooth muscles of the airways, and the expansion of their lumen. Thus, the appointment of Berotek as a symptomatic treatment of bronchial asthma is quite justified, but Berodual covers a wider range of actions, and the therapeutic effect develops faster, therefore, it is not necessary to talk about drug comparisons separately.
Salbutamol or Berodual - which is better?
Salbutamol - a medicine that has been described since time immemorial in the medical literature. According to its chemical structure and the therapeutic effect exerted, it is non-selective beta-adrenergic stimulant, spreading its biochemical effects on both the respiratory system and the heart. The active component of the same name of a pharmaceutical preparation is uniquely stronger in its effects than fenoterol, because it is salbutamol that is included in the protocol for the treatment of bronchial asthma.
But when comparing it with Berodual, one should not forget about ipratropia, the use of which is associated with fewer side effects and adverse effects of the passage of a conservative course of rehabilitation of the respiratory system. It should also be noted a faster onset of relief in the treatment of such a nosological unit, such as, for example, Chronical bronchitis, which is also very revealing.
Based on the above facts, it can be recognized that Berodual is better in the treatment of sluggish respiratory tract diseases with possible or already occurring obstructive processes, but for reorganization bronchial asthma Salbutamol should be chosen, because not only recommendations for maintaining this nosological unit say so, but official protocols for pulmonologists and pediatricians.
Berodual for Children
The drug is actively used in pediatric practice from very young age for several reasons. First of all, of course, the therapeutic effectiveness of the drug should be taken into account when the child is inhaled for chronic obstructive diseases of the respiratory system. The complex of ipratropium bromide and fenoterol allows not only to expand the bronchial lumen, but also to a large extent facilitate ventilation of the lung parenchyma. The dosage of the nebulizer for children can be found in the paragraph with instructions for use, which will also be useful to parents who prefer an aerosol form of the pharmaceutical product.
Separately, it is worth noting that the pharmaceutical preparation can be used not only with nosological units, the pathogenesis of which is inextricably linked with spasmodic narrowing of the bronchi, but also with a dry cough, because the active ingredients improve mucociliary clearance, which stimulates regulatory and immune processes. Thus, the problem of sluggish idiopathic dry cough is eliminated.
The most frightening young parents cough is definitely the so-called barking coughthat develops with laryngitis in children. This disease, affecting the upper respiratory tract, is especially dangerous, because the pathological process in the larynx is associated with the risk of developing an acute form of laryngitis and false croup. Therefore, when identifying this nosological unit, the dosage for inhalation to children is slightly higher than prescribed for chronic obstructive diseases of the respiratory system.
Berodual during pregnancy and lactation
Reliable studies on the ability of the active components to influence the fetus and mother in one way or another during pregnancy have not been carried out, however, the preclinical practice of using Fenoterol and Ipratropium in past years indicates that biologically active substances do not negatively affect the physiological processes in the body women.
It is not recommended to use a pharmaceutical preparation only in the first and third trimesters, since Fenoterol has an inhibitory effect in relation to the muscular apparatus of the uterus. Accordingly, this component of Berodual is able to slow down labor or give artificial hypotension, which can also adversely affect the early stages of ontogenesis.
Clinically proven that fenoterol is able to pass into breast milk during lactationHowever, there is no such data on ipratropia, because young mothers, breastfeedingIt is recommended that Berodual be prescribed only with increased precautions.
Reviews about Berodual
Reviews of Berodual for inhalation are confirmed by clinical and theoretical studies of biologically active components of the pharmaceutical preparation, since the vast majority are colored with positive emotions. Aerosol and nebulizer are convenient in everyday use and do not require additional medical knowledge or special professional skills.
The doctors' reviews about this drug praise the combined approach to expanding the lumen of the bronchial tree, which is carried out through Berodual, because the active active ingredients combine two different mechanisms for the development of bronchodilation, which allows you to effectively deal with pathological conditions in the respiratory tract even in the most difficult clinical cases.
Reviews of Berodual for children do not differ from those for the adult category of patients. Of course, the parents of their recovered children more actively recommend the use of a pharmaceutical product in conservative treatment, since they personally observed how inhalation with Berodual facilitates pulmonary respiration and significantly improves the quality of life for children of even the youngest age.
Berodual price, where to buy
The price of Berodual aerosol in Ukraine is on average 250 hryvnias, and the solution for inhalation can be purchased much cheaper - for 150 hryvnias.
A similar trend is observed in the Russian Federation. A solution for a nebulizer can already be bought for 270 rubles, and the price of Berodual for inhalation in the form of an aerosol rises almost twice and reaches 500 rubles. Separately, it is worth noting that in Russia such a pharmaceutical form of the drug is extremely difficult to find in the pharmacy stall.
The price of Berodual N, as a rule, is in an even higher range, since this pharmaceutical form of the drug is a strengthened analogue, and accordingly the therapeutic effect occurs more fully and much faster, because the cost of Berodual N should be found in the nearest pharmacy separately.
- Online Pharmacies in Russia
- Online pharmacies in UkraineUkraine
- Online pharmacies in Kazakhstan
- Berodual rr d / inhal. 0.25mg + 0.5mg 20ml n1Istituto de Angeli S.r.l274 rub.order
- Berodual N (aer. 200 doses of 10 ml) 490 rub.order
- Berodual (fl. 20 ml) 262 rub.order
Eurofarm * 4% discount on the promotional code medside11
- Berodual n aerosol for inhalation 200 dosesBeringer Ingelheim Pharma GmbH & Co.KG553 rub.order
- Berodual solution for inhalation 20 ml Institut de Andgeli S.R.L. / Berin296 rub.order
- Berodual H 10 ml 200 doses aerosol Beringer Ingelheim Pharma GmbH i Ko. KG, Nіmechchina 244 UAH to order
- Berodual 20 ml Іstіtuto de елngelі С.р.л., Італія solution 244 UAH to order
- Berodual liquid Berodual solution d / ing. 20ml Italy, Instituto de Angeli 245 UAH order
- Berodual aerosol Berodual-N aer. 10ml 200doses Germany, Boehringer Ingelheim Pharma 237 UAH order
- Berodual N 200 doses of 10 ml aerosol. Dose. Boehringer Ingelheim Pharma KG (Germany) 3 tg.
- Berodual 20 ml solution d / inhal. Institute de Angeli S.R.L. (Italy) 1 tg.order