Berodual, 1 piece, 20 ml, 0.25 mg+0.5 mg/ml, solution for inhalation

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

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.

Release form

• A clear, colorless (or almost colorless) solution for inhalation without suspended particles and practically odorless. The pharmaceutical drug is packaged in dropper bottles of 2 ml (1 ml corresponds to 20 drops). The cardboard box contains a container with a medicinal liquid and an annotation for it.
• Metered-dose aerosol for inhalation in special cylinders with a mouthpiece of 10 ml, designed for 200 injections (1 dose equals 1 injection). The cardboard package contains an annotation and a container with the medicine.
• Berodual N is an enhanced pharmaceutical form of this drug, which does not differ in use, as it is supplied in the form of an aerosol for inhalation and a solution for inhalation. Accordingly, it exerts its therapeutic properties somewhat more effectively.

In what forms is it available?

"Berodual" is produced in three release forms:

1. 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.
2. Aerosol - packaged in 10 ml containers for 200 injections. Cylinders are stored in packaging.
3. "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.

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.

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:

1. 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.
2. 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.

Pharmacodynamics and pharmacokinetics

With active inhalation of a medicinal solution, improvement in the functioning of the bronchopulmonary system occurs in a short time, even if only 10-39% of the total dose is deposited in the tissue 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 tract). paths).

The therapeutic effects of ipratropium bromide develop within 15 minutes and represent an increase in forced expiratory time 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 within 1-2 hours from the moment of injection, and the achieved effects persist for 6 hours.

The overall systemic bioavailability of fenoterol hydrobromide slightly lower than that of ipratropium and is about 1.5%, however, Berodual is a pharmaceutical drug of local action, therefore the rate of therapeutic effect through the inhalation route of administration is more clinically significant, which is no less than that of the first active component of the drug.

Pharmacological properties of the drug Berodual n

Berodual N contains two active bronchodilator ingredients: ipratropium bromide, which has an anticholinergic effect, and fenoterol hydrobromide, which is a β-adrenergic agonist. Ipratropium bromide is a quaternary ammonium compound with anticholinergic (parasympatholytic) properties. Inhibits vagal reflexes due to antagonistic interaction with acetylcholine, a mediator that ensures the transmission of impulses in the vagus nerve. Anticholinergics prevent the increase in intracellular concentrations of cGMP, which occurs due to the interaction of acetylcholine with muscarinic smooth muscle receptors. Bronchodilation after inhaled administration of ipratropium bromide is mainly due to the local specific effect of the drug. In patients with bronchospasm caused by COPD (chronic bronchitis and emphysema), there was a significant improvement in lung function within 15 minutes after using the drug (increase in forced expiratory volume in 1 second and average forced expiratory volumetric flow rate in the range of 25–75% forced expiratory vital capacity of the lungs (by 15% or more); the maximum effect is observed after 1–2 hours and in most cases lasts up to 6 hours. After using Berodual N for bronchospasm caused by asthma, a significant improvement in lung function (increase in forced expiratory volume1 by 15% and more) noted in 40% of patients. Ipratropium bromide does not have a negative effect on mucus secretion in the respiratory tract, mucociliary clearance and gas exchange in the lungs. Fenoterol hydrobromide is a sympathomimetic, in a therapeutic dose it selectively stimulates β2-adrenergic receptors, but when used in higher doses has a stimulating effect on β1-adrenergic receptors.Binding to β2-adrenergic receptors leads (with the help of the activating Gs protein) to the activation of adenylate cyclase. When the level of cAMP increases, protein kinase A is activated and the corresponding proteins are phosphorylated in smooth muscle cells, which in turn leads to the phosphorylation of myosin light chain kinase, blocking the hydrolysis of phosphoinositide and the opening of calcium-dependent potassium channels. Fenoterol causes relaxation of the smooth muscles of the bronchi and blood vessels and prevents bronchospasm caused by the effects of bronchoconstrictor agents (histamine, methacholine, cold air and allergens). Fenoterol blocks the release of bronchoconstrictor and proinflammatory mediators. When the drug was administered in high doses, an improvement in mucociliary clearance was noted. At higher concentrations of fenoterol in the blood plasma, which is usually achieved by oral administration or intravenous administration, the contractile activity of the myometrium is reduced. When using the drug in high doses, its metabolic effect may occur: lipolysis, glycogenolysis, hyperglycemia and hypokalemia, the latter caused by an increase in the uptake of K+ ions by cells, especially skeletal muscles. The effect of fenoterol on myocardial β2-adrenergic receptors is accompanied by tachycardia and an increase in the force of heart contractions, which is associated with the vascular effect of fenoterol, stimulation of cardiac β2-adrenergic receptors, and in doses exceeding therapeutic doses - stimulation of β1-adrenergic receptors. As with the action of other β-adrenergic substances, a prolongation of the Q-Tc . For fenoterol, these indicators are discrete and are recorded at doses exceeding the recommended ones. The clinical significance of this has not been established. The side effect most often reported with β-sympathomimetics is tremor. In contrast to the effect on bronchial smooth muscle, the systemic effects of β-sympathomimetics are a reason for the development of tolerance. Fenoterol prevents the development of bronchospasm caused by various factors, such as physical activity, cold air, as well as the influence of allergens (immediate reaction). With the simultaneous use of two bronchodilators, bronchial dilation occurs due to the implementation of two different pharmacological mechanisms. The mechanism of action of this combination of drugs allows them to be widely used for diseases of the bronchopulmonary apparatus associated with obstruction of the airways. Thus, the two active substances have a synergistic bronchodilator effect, which allows them to be used in a proportionally reduced dose and, therefore, reduce the risk of side effects. According to clinical studies, in patients with asthma and COPD, Berodual N corresponds in effectiveness to a double dose of fenoterol prescribed without ipratropium bromide, but has better tolerance with long-term use. In case of bronchospasm, the effect of Berodual N develops immediately after administration, so the drug can be used to relieve asthma attacks. Pharmacokinetics. The therapeutic effect of Berodual N manifests itself through a local effect on the respiratory tract. After inhalation, about 16% of the drug settles in the respiratory tract, the rest is swallowed. The active ingredients are absorbed very quickly in the respiratory tract, their maximum concentration in the blood plasma is reached within a few minutes. There is no evidence that the pharmacokinetics of the combination of both ingredients differs from that of each monosubstance. Fenoterol hydrobromide , which enters the digestive tract, is mainly metabolized to sulfate conjugates. Bioavailability after oral administration is low (about 1.5%). Fenoterol and its conjugates are rapidly excreted in the urine (renal clearance - 267 ml/min). About 40–55% of the drug binds to blood plasma proteins. In the unmetabolized state, fenoterol hydrobromide can slowly penetrate the placental barrier and enter breast milk. Ipratropium bromide . Absolute bioavailability after oral administration is about 2%. The half-life in the terminal elimination phase is about 1.6 hours. The total clearance is 2.3 l/min. About 40% of the drug is excreted in the urine (renal clearance - 0.9 l/min), 60% undergoes hepatic clearance. The main metabolites detected in urine bind to muscarinic receptors to a small extent. Renal excretion of unchanged active substance is 4.4–13.1% of the dose after inhalation. The drug minimally (less than 20%) binds to blood plasma proteins. Ipratropium ion does not penetrate the BBB; it is not known whether it penetrates the placental barrier.

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.

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.

Contraindications

• hereditary or acquired intolerance to the constituent components of a pharmaceutical drug;
• disturbance of the rhythm of cardiac activity such as tachyarrhythmia ;
• hypertrophic obstructive cardiomyopathy ;
• first trimester of pregnancy;
• prenatal period of intrauterine gestation;
• hypersensitivity to the active or auxiliary substances included in the drug.

Prescribing a pharmaceutical drug against the background of the following pathological conditions necessarily requires extreme caution (for example, undergoing a conservative course in a specialized pulmonology hospital):

• angle-closure glaucoma ;
• heart failure;
• arterial hypertension;
• cardiac ischemia;
• diabetes;
• of myocardial infarction within the last three months;
• severe damage to the cerebral and peripheral bloodstream;
• hyperthyroidism;
• obstruction of the bladder neck (of a special organogenic nature);
• pheochromocytoma or other hormone-dependent neoplasms;
• benign prostatic hyperplasia
• cystic fibrosis.

Side effects

The adverse effects of using a pharmaceutical drug are associated with the extremely high biochemical activity of the active components of the inhaled drug, as they have anticholinergic and beta-adrenergic properties . Also, the use of Berodual can cause local irritation, which is typical for any kind of inhalation therapy.

The most commonly observed side effects from the entire wide list of adverse effects are dry mouth, headache and dizziness , intention tremor , cough, pharyngitis , nausea, tachycardia, impaired sound production, subjective feeling of heartbeat, vomiting, nervousness and increased systolic blood pressure. .

Other side effects:

• From the cardiovascular system: arrhythmias, atrial fibrillation, supraventricular tachycardia , ischemia , increased diastolic blood pressure.
• The organs of vision may respond to the administration of a pharmaceutical drug in the following ways: increased intraocular pressure, disruption of the accommodation process , mydriasis , development of glaucoma , pain, corneal edema, blurred vision, conjunctival hyperemia, the appearance of a faint halo around objects.
• Respiratory tract: dysphonia, bronchospastic syndrome , pharyngeal irritation followed by swelling, laryngospasm, paradoxical bronchospasm.
• From the immune system: anaphylactic manifestations, hypersensitivity .
• The nervous system and mental health may also be adversely affected by inhaled mixtures: agitation, mental disturbances, nervousness, trembling of the upper limbs when performing conscious movements (especially pronounced during small coordinated motor acts).
• From the side of metabolic processes: decrease in blood potassium.
• Digestive system: stomatitis , glossitis , disturbances of adequate motility of the gastrointestinal tract, diarrhea or constipation , swelling of the oral cavity.
• From the skin and subcutaneous tissue: itching, urticaria , local angioedema, hyperhidrosis .
• From the urinary system: delay in the physiological duration of the act of urination.

Side effects of the drug Berodual n

The most common symptoms are fine tremor of skeletal muscles and increased excitability, a feeling of dry mouth, and in some cases headache, dizziness, and tachycardia. There are isolated reports of side effects from the organ of vision, including impaired accommodation and glaucoma (see SPECIAL INSTRUCTIONS). Very rarely, allergic reactions are possible: skin rash, angioedema of the tongue, lips and face, urticaria, laryngospasm and anaphylactic reactions. Severe hypokalemia may potentially result from β2-agonist therapy. As with the use of other inhaled drugs, coughing, local irritating effects (for example, pharyngitis, throat irritation), and in some cases bronchospastic reactions were noted. As with the use of other β-adrenergic agonists, Berodual N can cause nausea, vomiting, increased sweating, general weakness, myalgia and spasms. Very rarely, when used in high doses, a decrease in diastolic blood pressure, an increase in systolic blood pressure, arrhythmias, atrial fibrillation and supraventricular tachycardia are observed. In some cases, the development of mental changes under the influence of inhaled therapy with β-adrenergic agonists was reported. Disturbances of accommodation, motility of the digestive tract and urinary retention are rare and are reversible.

Instructions for use of Berodual (Method and dosage)

Aerosol Berodual, instructions for use

Before carrying out self-inhalations with a pharmaceutical drug, you should carefully read the recommendations for the correct use of the Berodual aerosol, which are usually presented as follows:

• The spray is in a can with a protective cap, which must be removed before use. If the medicine has not been in use for the last 3 days, then before actively using it, you must press the valve once until the inhalation aerosol appears in the form of a small cloud.
• Exhale deeply and slowly.
• Place your lips around the tip of the inhaler so that the arrow on the medicine bottle is facing up and the mouthpiece is facing down.
• At the same time, press on the bottom of the container, releasing 1 measured dose of the drug, and take a deep breath “full chest” 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 cylinder to its original position.

Berodual inhaler: dosage of an aerosol form of a pharmaceutical drug

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. If this treatment tactic continues to be ineffective, it is necessary to urgently seek qualified medical help. For long-term conservative rehabilitation - 1-2 inhalations 3 times a day, but so that in total there are no more than 8 manipulations within one day.

Berodual solution for inhalation, instructions for use

A pharmaceutical drug in this form of release requires special medical equipment for proper use, which is called a nebulizer . This is a device through which Berodual (or other medicine) is sprayed into a fine cloud. In this form, the drug almost freely enters even poorly ventilated areas of the bronchopulmonary system, and the dosage for a nebulizer is much lower than for a traditional inhaler, which is why the “miracle of technology” has especially taken root in pulmonology hospitals and is now widely used for the treatment of respiratory diseases.

Before using the drug directly, you should definitely learn how to dilute it correctly for inhalation, since the effectiveness of the effect and the complete implementation of the therapeutic capabilities of the active components of Berodual depend on this stage. As a rule, an isotonic solution of sodium chloride with a concentration of 0.9% is used as a solvent, because it is closest to the composition of the aqueous portion of plasma (in no case should distilled water be used to dilute a pharmaceutical drug, this can lead to adverse consequences). How to dilute with saline - add liquids up to 3-4 ml to the recommended dose.

General schemes of conservative treatment with inhalation solution

For 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. For 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 an attack (in severe clinical cases, the dosage can increase to 2-3 ml, which corresponds to 40-60 drops). For long-term therapy, for example, for 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 drug is calculated individually, based on the following need for the therapeutic course - 25 mcg of Ipratropium and 50 mcg of Fenoterol per 1 kg of body weight (total amount of drug up to 0.5 ml) up to 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. An enhanced variation is also supplied in the form of an aerosol in special cylinders for active inhalation and a solution for inhalation through a nebulizer or other similar medical equipment. As for dosages, you should separately visit a qualified pulmonologist and find out this issue on an individual basis, since at the moment there are no general protocols for conservative treatment with Berodual N.

Overdose

When using a pharmaceutical drug in clinical practice, a pathological condition such as an overdose of active ingredients may occur, which is usually associated with excessive stimulation of beta-adrenergic receptors. In this case, the most likely symptoms of intoxication are the following:

• subjective feeling of heartbeat and tachycardia confirmed by hardware methods;
• increase or decrease in blood pressure (depending on individual predisposition);
• strengthening of the broncho-obstructive pathological process;
• an increase in the difference between systolic and diastolic blood pressure;
• angina pectoris and the symptoms that accompany it (for example, a feeling of heaviness in the chest);
• hyperemia of the skin of the face and accompanying sensation of heat;
• metabolic acidosis .

Also, an overdose may be due to excessive intake of ipratropium bromide , but in this case it is weakly expressed and has a transient (passing) nature. This is explained by the breadth of therapeutic use of this component in pharmacy. In this case, dry mouth or impaired accommodative ability of the visual organs may occur.

beta1-blockers can be used as a specific pharmacological antidote . Having the opposite mechanism of therapeutic action, these drugs will help get rid of a 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 type of pharmacological action, there is a possibility of developing bronchial blockage, which can only be avoided by careful selection of the exact dosage.

The administration of sedatives and tranquilizers is also used as therapeutic measures (when the symptoms are too severe). In case of severe overdose syndrome, intensive conservative treatment should be immediately carried out using all possible medications that can adequately help the patient.

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.

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.

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'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.

Berodual for Children

The drug is actively used in pediatric practice from a very young age for several reasons. First of all, of course, the therapeutic effectiveness of the drug should be taken into account when inhalations are administered to a child 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 significantly facilitate ventilation of the lung parenchyma. The dosage of the nebulizer for children can be found in the instructions for use section, which will also be useful for parents who prefer the aerosol form of the pharmaceutical drug.

Separately, it is worth noting that the pharmaceutical drug can be used not only for nosological entities, the pathogenesis of which is inextricably linked with spasmodic narrowing of the bronchi, but also for dry cough, because the active components improve mucociliary clearance, which has a stimulating effect on regulatory and immune processes. This eliminates the problem of sluggish idiopathic dry cough.

The most frightening cough for young parents is definitely the so-called “barking” cough, which develops with laryngitis in children. This disease, which affects 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 this nosological unit is identified, the dosage for inhalation for children is slightly higher than that prescribed for chronic obstructive diseases of the respiratory system.

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.

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.

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
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ZdravCity

• Berodual N aerosol for injection.
  dosage 20mcg+50mcg/dose 200 doses 10mlBoehringer Ingelheim RUB 466 order
• Berodual solution for ing 0.25mg+0.5mg 20mlIstituto de Angeli Srl

  RUB 265 order

Pharmacy Dialogue

• Berodual N (aerial 200doses 10ml)Boehringer Ingelheim

  489 RUR order

• Berodual (flask 20ml)Boehringer Ingelheim

  RUB 284 order

• Berodual (bottle 20ml)Sanofi/Boehringer Ingelheim/Institut de Angeli

  RUB 282 order

• Berodual N (aerial 200doses 10ml)Boehringer Ingelheim

  485 rub. order

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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

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How to use the aerosol

The medication is available in two forms, and the aerosol has certain advantages. You can always carry it with you to use as needed as follows:

• the cap is removed;
• turn the container over with the spray side down;
• exhale air from the pulmonary area;
• insert the mouthpiece directly into the mouth;
• press the bottom of the inhaler and take a deep breath;
• pull out the sprayer and don’t forget to exhale.

One click corresponds to the same number of injections of the drug into the problem area.

The canister contains 200 doses of aerosol, which usually coincides with the frequency of applications.

It is recommended to carry out no more than two sprays at one time.

• Berodual for laryngitis in children