"Berodual" for inhalation: instructions for use

For many chronic respiratory diseases, doctors prescribe inhalations with Berodual to patients. This drug relieves unpleasant symptoms and alleviates the general condition of the patient. It must be used during every asthma attack, as well as for coughs and spasms. "Berodual" helps patients who are on artificial ventilation.

Compound

"Berodual" for inhalation consists of many useful components:

ipratropium bromide - 0.261 mg (dry residue - 0.25 mg);
water;
fenoterol hydrobromide - 0.5 mg;
disodium salt EDTA (ethylenediaminetetraacetic acid);
saline solution (sodium chloride);
benzalkonium chloride;
monomolar hydrochloric acid (1N).

There is another pharmaceutical form of this medicine, which includes additional components.

Metered aerosol has a slightly different composition:

ipratropium bromide - 0.021 mg (dry residue - 0.02 mg);
citric acid (powdered, anhydrous);
fenoterol hydrobromide – 0.05 mg
ethanol;
HFA 134a - 1,1,1,2-tetrafluoroethane;
water.

The transparent, colorless inhalation solution has no odor. It is filled into an inhaler and inhaled as needed.

special instructions

Berodual - hormonal or not?

Bronchial asthma is a polyetiological disease, one of the factors of which is allergic disorders and sensitization of the body, which is why conservative treatment of this respiratory pathology is so complex from a medical point of view. Very often, pharmaceutical preparations based on natural human hormones are used of asthmatic conditions Since bronchial asthma is among the indications for the use of Berodual, ordinary people without medical education have a completely logical question: “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 ingredient 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, we can confidently state that Berodual is not a hormonal drug and, according to its mechanism of action, cannot affect the hormonal balance in the body.

In what forms is it available?

"Berodual" is produced in three release forms:

The solution is a liquid of uniform consistency, colorless, transparent. It is packaged in 2 ml bottles (40 drops). The bottles are packed in a box.
Aerosol - packaged in 10 ml containers for 200 injections. Cylinders are stored in packaging.
"Berodual N" is available both in the form of an aerosol and in the form of a solution. Has a stronger effect.

Depending on the form of release of Berodual, the instructions for its use may vary.

Berodual during pregnancy and lactation

There have been no reliable studies on the ability of the active ingredients to influence the body of the fetus and mother in one way or another during pregnancy, however, the preclinical practice of using Fenoterol and Ipratropium in past years indicates that biologically active substances do not have a negative effect on the physiological processes occurring in the body women.

It is not recommended to use the pharmaceutical drug only in the 1st and 3rd trimesters, since Fenoterol has an inhibitory effect on the muscular apparatus of the uterus. Accordingly, this component of Berodual can slow down labor or create conditions of artificial hypotension, which can also adversely affect the early stages of ontogenesis.

It has been clinically proven that Fenoterol is able to pass into breast milk during lactation , however, there is no such data on ipratropium, therefore, for young mothers who are breastfeeding, it is recommended to prescribe Berodual only with increased precautions.

How it affects the body

"Berodual" is a bronchodilator (bronchodilator) drug that belongs to the group of selective m-anticholinergic blockers and beta2-adrenergic agonists.

When inhaled, the active substances expand the lumen of the bronchi and ensure normal ventilation of the respiratory tract. Berodual contains two active ingredients:

Ipratropium bromide - neutralizes the influence of the vagus nerve and thereby dilates the bronchi. This substance blocks the release of acetylcholine, which plays an important role in the functioning of the vagus nerve.
Fenoterol hydrobromide - stimulates individual beta-adrenergic receptors, which affect the functioning of the bronchi. It relaxes the smooth muscles of the bronchi and intrapulmonary vessels. This substance improves the protection of the mucous membranes of the respiratory tract from allergens, cold and other harmful influences.

Ipratropium and fenoterol complement each other and enhance the therapeutic effect of the drug.

The medicine is effective even if only 10–39% of the dose enters the respiratory tract, and the rest remains in the inhaler. Within 15 minutes after inhalation, the patient’s condition will improve. The therapeutic effect lasts for 6 hours.

Procedure technique

1 hour before and for an hour after the procedure, you should not eat, smoke, use expectorant medications, or gargle with antiseptic solutions. The duration of one inhalation should not exceed 7-10 minutes. It is forbidden to talk during treatment. It is permissible to take up to 5-6 inhalations per day, the average number is 2-3 episodes of treatment using different medications. The interval between them is 1.5-3 hours.

To understand how to do inhalations with a nebulizer, you need to remember the following algorithm:

Place the device in a stable position.
Sit comfortably and relaxed in a chair or on a bed.
Place the mask tightly on your face or wrap your lips around the mouthpiece.
Turn on the device.
Breathe evenly and deeply, inhaling through your mouth and exhaling through your nose. After inhaling, it is recommended to hold your breath for 2 seconds.
After completing the procedure, rinse your mouth with water.
Wash the washable parts of the device, dry it and put it away for storage.

Steam inhalers are easy to use. You need to pour the medicine into the reservoir, turn on the device and press your face tightly to the mask. Before breathing with a steam-type inhaler, you must make sure that there are no contraindications: hyperthermia, bleeding, swelling of the respiratory tract. The duration of the procedure reaches 15-20 minutes. Inhalations are taken slowly to avoid burns from hot steam. After completing therapy, you need to refrain from leaving the house for 1-3 hours, especially in the cold season.

On a note

: deep breathing can provoke hyperaeration phenomena: dizziness, weakness, incoordination. To avoid this, short breaks are required during inhalation.

Indications for use

The instructions for Berodual for inhalation list the main diagnoses for which this drug is prescribed. It is necessary for many diseases and pathological conditions:

emphysema;
COPD (chronic obstructive pulmonary disease) with spasms in the bronchi;
asthma of any origin;
Chronical bronchitis;
all respiratory obstructive diseases, in which the airways are partially blocked;
for preparation before injection of antibiotics, corticosteroids and mucolytics;
for prevention.

"Berodual" should be used only in accordance with doctor's prescriptions and in recommended doses.

Content:

Preparation of equipment
Preparing the medicine
Procedure technique
Inhalation for children

An inhaler is a device that allows you to deliver a fine aerosol of medicinal substances into the lungs and upper respiratory tract. It is used for cough, difficulty breathing, hoarseness, rhinorrhea, chest pain caused by bronchitis, and difficult sputum discharge. Bronchodilators, antiseptics and antibiotics, mucolytic medications, regenerative agents, decoctions and infusions of medicinal herbs, and moisturizing substances are administered using the aerosol method. People prone to inflammatory diseases of the upper respiratory tract need to know how to use the inhaler correctly.

Contraindications

It is important to remember about the many diseases for which Berodual is contraindicated:

intolerance to substances included in the medicine;
the beginning of pregnancy and the last days before childbirth;
hypersensitivity to these components;
tachyarrhythmia;
obstructive hypertrophic cardiomyopathy.

Fenoterol contained in the solution can affect the heart muscle. Because of this, it contracts more often and with greater force. This can harm the health and well-being of patients suffering from heart disease.

Berodual should be used with great caution for the following ailments:

heart failure and ischemic heart disease;
diabetes;
high blood pressure (hypertension and hypertension;
glaucoma;
hyperthyroidism;
the first three months after myocardial infarction;
cystic fibrosis;
vascular pathologies;
tumors dependent on the activity of hormones (especially pheochromocytoma);
prostate adenoma;
pathology of the bladder neck.

The treating doctor will prescribe another analogue drug that is equally effective, but safe for a particular patient.

Berodual's analogs

Berodual analogues are medicines that have a similar or identical ATC code, which is used to mark absolutely all pharmaceutical products on the official market, or INN Berodual (international nonproprietary name). Analogs for inhalation in pharmacy kiosks are usually cheaper, because the price factor in choosing a drug is sometimes one of the most important, especially in the conservative treatment of chronic, indolent diseases. Bronchodilators of various natures that can replace Berodual are the following list: Berotex , Ventolin , Duolin , Salbroxol , Salbutamol .

Which is better: Berodual or Pulmicort?

Pulmicort is a synthetic hormonal drug, which is a glucocorticosteroid for inhalation use. That is, the active component of the drug is identical in its chemical structure to the structure of biological substances produced by the adrenal glands. The mechanism of therapeutic action is to directly influence 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 Prednisolone , since the 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 others , safer conservative means).

Therefore, it is extremely difficult to compare Berodual and Pulmicort. Medical researchers have not reached a consensus on this issue and regularly publish “new” arguments in favor of a particular pharmaceutical drug. More experienced doctors have found the only correct and very acceptable option, which is the use of Pulmicort and Berodual together in the combined treatment of diseases of the respiratory system. Thus, the therapeutic effects of two strong pharmaceutical drugs are combined, which makes it possible to eliminate even the most clinically severe attacks of bronchial asthma or chronic obstructive pulmonary disease.

The dosage of inhalations with Berodual and Pulmicort is selected individually for each patient empirically, starting from the minimum limit 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 drug that belongs to 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, contains fenoterol , which, like Ventolin, has a stimulating effect on this type of receptors in the bronchial tree. However, this is not the only biologically active component of Berodual, due to which the indications for its use are much wider than those of Ventolin, therefore this pharmaceutical drug 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 group of pharmaceutical beta2-adrenergic receptor agonists , that is, the active component of the drug, like 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 prescription of Berotek as a symptomatic treatment of bronchial asthma is quite justified, but Berodual covers a wider range of action, and the therapeutic effect develops faster, so there is no need to talk about comparing drugs separately.

Salbutamol or Berodual - which is better?

Salbutamol is a drug that has been described since time immemorial in medical literature. According to its chemical structure and therapeutic effect, it is a non-selective stimulator of beta-adrenergic receptors, extending its biochemical effects to both the respiratory system and the heart. The active component of the pharmaceutical drug of the same name is clearly stronger in its effects than fenoterol, which is why Salbutamol is included in the protocol for the treatment of bronchial asthma.

But when comparing it with Berodual, one should not forget about ipratropium, the use of which is associated with fewer side effects and adverse consequences of undergoing a conservative course of sanitation of the respiratory system. It should also be noted that relief occurs more quickly when treating a nosological entity such as, for example, chronic bronchitis , which is also very significant.

Based on the above facts, it can be admitted that Berodual is better in the treatment of indolent diseases of the respiratory tract with possible or already occurring obstructive processes, but for the rehabilitation of bronchial asthma one should choose Salbutamol, because this is not just the recommendations for the management of this nosological unit, but also the official protocols for pulmonologists and pediatricians.

Side effects

The substances contained in Berodual have an extremely active effect on biochemical processes in the body. This often leads to side effects:

anxiety, nervousness, excitement;
mydriasis;
dry mouth;
corneal edema;
eye pain, redness, swelling;
dizziness and headache;
vomiting and nausea;
cough;
trembling of limbs;
tachycardia;
increased blood pressure;
pharyngitis;
atrial fibrillation;
throat irritation and swelling;
violation of visual accommodation;
spasms in the bronchi and larynx;
allergy;
urinary retention;
hives;
Quincke's edema;
skin itching;
increased sweating;
stomatitis;
constipation, impaired intestinal motility, diarrhea.

Patients often feel that they cannot pronounce certain sounds correctly. They can see a slight halo around surrounding objects. Vision becomes blurred.

To reduce side effects, the doctor may prescribe additional medications to the patient.

Interactions of the drug Berodual n

The simultaneous administration of β-adrenergic agonists for systemic use, anticholinergics and xanthines (theophylline) can increase the bronchodilator effect of Berodual N and lead to an increase in the severity of side effects. A significant reduction in the bronchodilator effect of Berodual N is possible with simultaneous administration of β-adrenergic receptor blockers. The severity of hypokalemia caused by the use of β-adrenergic agonists may increase with the simultaneous administration of xanthines, corticosteroids and diuretics. This fact should be given special attention when treating patients with severe forms of airway obstruction. Hypokalemia may lead to an increased risk of arrhythmias in patients using digoxin. In this case, it is recommended to monitor the level of potassium in the blood serum. Beta-adrenergic agents should be prescribed with caution to patients taking MAO inhibitors and tricyclic antidepressants, since these drugs may increase the severity of the action of beta-adrenergic agents. Inhalation of halogenated carbohydrate anesthetics, such as halothane, trichloroethylene or enflurane, may enhance the cardiovascular effects of beta-adrenergic agents.

Instructions for use and dosage

Directions for use and dosage may vary depending on the dosage form.

Aerosol with dosages

Adult patients and children over 6 years old take 2 breaths. If there is no improvement, you need to add 2 more breaths. If even after this the condition does not improve, you must urgently call a doctor. For daily procedures, the dosage is 1-2 breaths 3 times a day. But within 24 hours you cannot take more than 8 inhalations.

Solution for inhalation

To use the inhalation solution, you will need a nebulizer. This solution must be diluted in saline so that the drug concentration is 0.9%. Add 3-4 drops of saline solution to the prescribed dose of Berodual. It is forbidden to dilute the medicine with water.

Patients 12 years old are prescribed 20–80 drops (1–4 ml) 4 times a day to relieve acute attacks, and 20–40 drops (1–2 ml) 4 times a day for long-term treatment. For persistent bronchospasms, the dose can be increased to 10 drops (0.5 ml).

Children aged 6 to 12 years are prescribed 10–20 drops (0.5–1 ml) 4 times a day during a sudden attack and the same amount during a long course of treatment. In severe cases, the dose can be increased to 40–60 drops (2–3 ml).

For children under 6 years of age and everyone who weighs less than 22 kg, the dose is calculated individually.

"Berodual N" is used according to the same scheme strictly under the supervision of the attending physician.

Preparing the medicine

Working solution

for compressor and ultrasonic type nebulizers, it is made from a mixture of the main drug with physiological sodium chloride solution. Typically, the combination is prepared in a ratio of 1 part of the drug to 3 parts of NaCl, however, the attending physician may recommend other mixing options. When coughing, use alkaline mineral water or herbal decoctions. The product must be heated to 37-38°C.

Solutions intended for steam inhalation are not heated. Devices of this type allow you to work only with herbal remedies, mineral water and essential oils (sandalwood, cedarwood, eucalyptus). It is also permissible to use an inhaler with pure saline solution. Medicines heated to 60-70°C are destroyed and have no effect.

On a note

: when the body temperature is above 37°C, steam inhalations are not performed. Cold steam procedures are not recommended for use in cases of inflammatory diseases of the middle ear.

Overdose symptoms

If a person inhales too much, they may show signs of overdose:

increased process of bronchial obstruction;
palpitations, tachycardia;
decrease or increase in pressure;
heaviness in the chest, angina pectoris;
acidosis;
feeling hot, sweating;
facial redness;
increasing the difference between “upper” and “lower” pressure.

The doctor carefully selects the exact dosage. If necessary, the patient may be prescribed tranquilizers.

Overdose of the drug Berodual n

It is caused mainly by the action of fenoterol and excessive stimulation of β-adrenergic receptors. The most likely symptoms are tachycardia, palpitations, tremor, hypertension (arterial hypertension) or hypotension, increased pulse pressure, angina attacks, arrhythmia and flushing. Symptoms of an overdose of ipratropium bromide (a feeling of dryness of the oral mucosa, impaired accommodation) are usually mild and transient due to the very low systemic bioavailability of inhaled ipratropium bromide. Treatment: administration of sedatives, tranquilizers, and in severe cases, intensive care. β-adrenergic receptor blockers, preferably β1-selective, are used as specific antidotes; however, the dose should be carefully selected for patients with asthma or COPD, taking into account the possibility of increased bronchial obstruction under their influence, even death.

Berodual price, where to buy

A solution for a nebulizer can be bought for 250 rubles, and the price of Berodual for inhalation in the form of an aerosol almost doubles and reaches 500 rubles. Separately, it is worth noting that in Russia it is extremely difficult to find such a pharmaceutical form of the drug in a pharmacy kiosk.

The price of Berodual N, as a rule, is in an even higher range, since this pharmaceutical form of the drug is an enhanced analogue, and, accordingly, the therapeutic effect occurs more fully and much faster, therefore, how much Berodual N costs, you should find out at your nearest pharmacy separately.

The price of Berodual aerosol in Ukraine is on average 250 hryvnia; an inhalation solution can be purchased at about the same price.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Berodual solution for ing 0.25mg+0.5mg 20mlIstituto de Angeli Srl
RUB 246 order

Pharmacy Dialogue

Berodual (flask 20ml)Boehringer Ingelheim
RUB 263 order
Berodual N (aerial 200doses 10ml)Boehringer Ingelheim
460 rub. order
Berodual (bottle 20ml)Sanofi/Boehringer Ingelheim/Institut de Angeli
RUB 291 order
Berodual N (aerial 200doses 10ml)Boehringer Ingelheim
516 RUR order

Pharmacy24

Berodual H 10 ml 200 doses aerosol Boehringer Ingelheim Pharma GmbH & Co.
KG, Nimechchina 244 UAH. order
Berodual 20 ml solution Istituto de Angeli S.r.l., Italy
244 UAH order

PaniPharmacy

Berodual liquid Berodual d/ing solution. 20ml Italy, Instituto de Angeli
245 UAH order
Berodual aerosol Berodual-N aer. 10ml 200doses Germany, Boehringer Ingelheim Pharma
237 UAH order

Reviews about Berodual

Reviews of Berodual for inhalation are confirmed by clinical and theoretical studies of the biologically active components of the pharmaceutical drug, since the overwhelming majority are colored with positive emotions. The aerosol and nebulizer are convenient for everyday use and do not require additional medical knowledge or special professional skills.

Reviews from doctors about this drug praise the combined approach to expanding the lumen of the bronchial tree, which is carried out through Berodual, because the active ingredients combine two different mechanisms for the development of bronchodilation, which makes it possible to effectively combat pathological conditions in the respiratory tract even in the most complex clinical cases.

Reviews of Berodual for children do not differ from those for adult patients. Of course, the parents of their recovered children more actively recommend the use of the pharmaceutical drug in conservative treatment, since they have personally observed how inhalations with Berodual facilitate pulmonary breathing and significantly improve the quality of life for children even of the youngest age.