Pharmacy No. 84. Delivery of medicines to your home and office.

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Berodual® N

If shortness of breath (difficulty breathing) suddenly increases rapidly, you should consult a doctor immediately.

Hypersensitivity

After using BERODUAL®, immediate hypersensitivity reactions may occur, signs of which in rare cases may include: urticaria, angioedema, rash, bronchospasm, oropharyngeal edema, anaphylactic shock.

Paradoxical bronchospasm

BERODUAL®, like other inhaled drugs, can cause paradoxical bronchospasm, which can be life-threatening. If paradoxical bronchospasm develops, the use of BERODUAL® should be stopped immediately and switched to alternative therapy

Long-term use:

— in patients suffering from bronchial asthma, BERODUAL® should be used only as needed;

- in patients with mild forms of chronic obstructive pulmonary disease, symptomatic treatment may be preferable to regular use;

- in patients with bronchial asthma, one should remember the need to carry out or intensify anti-inflammatory therapy to control the inflammatory process of the respiratory tract and the course of the disease.

Regular use of increasing doses of drugs containing β2-adrenergic agonists. such as BERODUAL®, to relieve bronchial obstruction can cause uncontrolled worsening of the disease. In case of increased bronchial obstruction, increasing the dose of β2-agonists, including BERODUAL®, more than recommended for a long time is not only not justified, but also dangerous. To prevent life-threatening worsening of the disease, consideration should be given to reviewing the patient's treatment plan and adequate anti-inflammatory therapy with inhaled corticosteroids.

Other sympathomimetic bronchodilators should be co-administered with BERODUAL only under medical supervision.

Gastrointestinal disorders

In patients with a history of cystic fibrosis, gastrointestinal motility disorders are possible.

BERODUAL® should be used with caution in patients predisposed to acute-angle glaucoma. There are isolated reports of complications from the organ of vision (for example, increased intraocular pressure, mydriasis, angle-closure glaucoma, eye pain) that developed when inhaled ipratropium bromide (or ipratropium bromide in combination with β2-adrenergic receptor agonists) entered the eyes. Symptoms of acute angle-closure glaucoma may include pain or discomfort in the eyes, blurred vision, the appearance of a halo on objects and colored spots in front of the eyes in combination with corneal edema and redness of the eyes due to conjunctival vascular injection. If any combination of these symptoms develops, the use of eye drops that reduce intraocular pressure and immediate consultation with a specialist are indicated.

Patients should be instructed on the correct use of BERODUAL® inhalation solution. To prevent the solution from getting into the eyes, it is recommended that the solution used with a nebulizer be inhaled through the mouthpiece. If there is no mouthpiece, a mask that fits tightly to the face should be used. Patients predisposed to developing glaucoma should take special care to protect their eyes.

Systemic effects

For the following diseases: recent myocardial infarction, diabetes mellitus with inadequate glycemic control, severe organic diseases of the heart and blood vessels, hyperthyroidism, pheochromocytoma or urinary tract obstruction (for example, prostatic hyperplasia or bladder neck obstruction).

BERODUAL® should be used only after a careful risk/benefit assessment, especially when using doses higher than recommended.

Effect on the cardiovascular system

In post-marketing studies, rare cases of myocardial ischemia have been reported when taking beta-agonists. Patients with concomitant serious heart disease (for example, coronary heart disease, arrhythmias or severe heart failure) receiving BERODUAL® should be warned to consult a doctor if they develop heart pain or other symptoms indicating worsening of heart disease. It is necessary to pay attention to symptoms such as shortness of breath and chest pain, as they can be of both cardiac and pulmonary etiology.

Hypokalemia

When using β2-agonists, hypokalemia may occur (see section "Overdose").

In athletes, the use of BERODUAL® due to the presence of fenoterol in its composition can lead to positive results of doping tests.

The drug contains a preservative, benzalkonium chloride, and a stabilizer, disodium edetate dihydrate. During inhalation, these components may cause bronchospasm in sensitive patients with airway hyperresponsiveness.

Compound

1 ml of solution for inhalation contains the following pharmaceutical components:

ipratropium bromide – 0.261 mg (0.25 mg when converting the dosage form into a dry residue);
fenoterol hydrobromide – 0.5 mg;
benzalkonium chloride;
disodium edetate dihydrate;
sodium chloride;
1-molar hydrochloric acid;
purified water.

Composition of the 1st injection of metered-dose 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 propellant;
anhydrous citric acid;
ethanol;
distilled water.

pharmachologic effect

The group of the drug Berodual (the international name of the drug is identical to the commercial one) are combined bronchodilator drugs of inhalation type of action, that is, the active components provide active expansion of the bronchial lumen when inhaled. The mechanism of its therapeutic effect depends on two biological active substances that form the basis of the pharmaceutical mixture used in pulmonology hospitals.

Ipratropium bromide is an ammonium derivative that has anticholinergic properties. Bronchodilation is due to its local action, since it is administered in the form of fine particles by inhalation of an aspiration aerosol or inhalation solution. The biologically active component prevents the release of acetylcholine, the main mediator of parasympathetic synapses, which manifests itself in the normalization of calcium concentrations inside cellular structures. In this way, the action of the vagus nerve is neutralized and the bronchial lumen expands.

Fenoterol hydrobromide , in turn, is a beta-adrenergic receptor stimulant, the selectivity of the therapeutic effect of which depends on the quantitative factor. Thus, small dosages of the biologically active component selectively act on beta2 receptors, which is what is expected from the use of Berodual 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 local vascular bed. In addition, there is an increase in the productivity of mucociliary clearance .

Separately, the cardiac effects of fenoterol should be noted, since when it enters the main bloodstream, the biologically active component becomes able 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 muscle organ;
prolongation of the QT interval on the electrocardiogram.

The combined use of two active bronchodilators allows the desired therapeutic effect to be achieved through different pharmacological mechanisms, since the targets for the action of the active components differ. The complementary influence of fenoterol and ipratropium ensures reliable achievement of the desired clinical result, which manifests itself in enhancing the antispasmodic properties of the muscular apparatus of the bronchi and their sufficient expansion to ensure the normal functioning of a healthy body.

Indications for use

bronchial asthma of various origins (allergic and endogenous, asthma of physical exertion);
chronic disease of the lung tissue accompanying bronchospastic syndrome;
chronic bronchitis with obstruction of the bronchopulmonary tract;
emphysema;
other chronic obstructive diseases of the respiratory system with reversible blockage of the airways;
preventive sanitation of nosological units affecting the respiratory system;
preparatory measures regarding the lumen of the respiratory tract before aerosol administration of antibiotics , corticosteroids or other mucolytic drugs.

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 N aerosol for injection.
dosage 20mcg+50mcg/dose 200 doses 10mlBoehringer Ingelheim RUB 493 order
Berodual solution for ing 0.25mg+0.5mg 20mlIstituto de Angeli Srl
RUB 246 order

Pharmacy Dialogue

Berodual (flask 20ml)Boehringer Ingelheim
RUB 278 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