Berodual 10ml is a combination drug used to relax smooth bronchial muscles.This drug is available as a metered-dose inhaler and is used for managing Bronchospasm in diseases like bronchial asthma and chronic obstructive pulmonary disease (COPD).
1. Uses of Berodual 10ml
Berodual inhaler contains two main active ingredients: Fenoterol and Ipratropium. In addition to the 10ml inhaler, a 20ml version of Berodual is also available. Both substances act as bronchodilators via distinct mechanisms. When combined, they produce a synergistic effect
- Ipratropium bromide, an anticholinergic agent that works by antagonizing acetylcholine, a chemical mediator released from the vagus nerve.It works by blocking the rise in intracellular calcium, thereby preventing smooth muscle contraction.Bronchodilating action of ipratropium bromide after inhalation is a site-specific effect without systemic impact.
- Fenoterol hydrobromide, a direct-acting sympathomimetic drug selectively activates beta-adrenergic receptors, promoting smooth muscle relaxation.Fenoterol hydrobromide exerts bronchodilation and vasodilation, while inhibiting bronchoconstrictive factors like histamine, methacholine, and allergens. Furthermore, it activates cardiac beta-receptors, resulting in tachycardia and increased myocardial contractility.
The combined use of these two active ingredients results in bronchodilation due to their action on different sites of the bronchial smooth muscle. These agents enhance each other's effects,help bronchial relaxation, thereby allowing their widespread use in the treatment of respiratory conditions associated with bronchoconstriction. Studies show that patients with asthma and COPD benefit more from the combination than from ipratropium or fenoterol individually at similar doses.
2. Indications and Contraindications
2.1 Indications
Berodual is indicated for the following conditions:
- In acute bronchoconstriction, such as during an acute asthma exacerbation, due to its rapid bronchodilatory effect.
- For maintenance and prophylaxis of dyspnea in chronic obstructive pulmonary diseases (COPD), emphysema, and bronchopulmonary disorders causing bronchoconstriction.
- Long-term control of asthma, to reduce the occurrence of sudden acute bronchoconstriction.
2.2 Contraindications
Berodual 10ml is contraindicated in the following conditions:
- Hypersensitivity to the active ingredients, substances similar to atropine, or being allergic to any of the excipients of the product.
- In patients with hypertrophic obstructive cardiomyopathy and tachyarrhythmia.
Berodual should be used with caution in the following cases:
- narrow-angle glaucoma,hyperthyroidism, vascular occlusion, benign prostatic hyperplasia
- bladder-neck obstruction
- Hypokalemia
3. Administration and Dosage of Berodual 10ml
3.1. Administration
This is a 10ml metered dose inhaler of Berodual, so you need to follow the instructions carefully to avoid overdosing or underdosing as prescribed.
- For first use, remove the protective cap and depress the valve twice. If the inhaler has not been used for more than three days the valve has to be actuated twice.
- Breathe out deeply.
- Hold the inhaler, and close lips around the mouthpiece. The arrow and the base of the container should be pointing upwards.
- Breathe in as deeply as possible, pressing the base of the canister firmly at the same time, this releases one pressurised inhalation. Hold the breath for a few seconds, then remove the mouthpiece from the mouth and breathe out. The same action should be repeated for a second inhalation.
- When using, the inhaler should be cleaned once a week. When using, you need to clean the inhaler once a week by first removing the protective cap and taking the canister out of the mouthpiece. Rinse warm water through the mouthpiece until no medication build-up and/or dirt is visible. After cleaning, shake out the mouthpiece and let it air-dry without using any heating system. Once the mouthpiece is dry, replace the canister and the dust cap.
3.2 Dosage
Dosage will depend on various factors including the patient's individual response, age... Below are the suggested dosages for specific situations:
- Acute asthma episodes: 2 puffs are sufficient for prompt symptom relief. In more severe cases, if breathing has not noticeably improved after 5 minutes, two additional puffs may be administered. If the attack has not been relieved after 4 puffs, further doses may be required and patients should seek immediate medical attention at the nearest hospital.
- Intermittent and long-term treatment : 1-2 puffs for each administration, up to a maximum of 8 puffs per day. ( average 1-2 puffs 3 times daily )
- For children, the correct prescribed dosage should be followed and under the supervision of an adult.
4. Adverse Reactions of Berodual 10ml
When using Berodual 10ml, some possible adverse effects may occur, including:
- The most frequent side effects include cough, dry mouth, headache, pharyngitis, nausea, dizziness, dysphonia, tachycardia, palpitations, vomiting, blood pressure systolic increase and nervousness or tremors.
- Hypokalemia, nervousness, agitation, mental disorder
- intraocular pressure Increased, accommodation disorder, mydriasis, eye pain, vision blurred, conjunctival hyperaemia, and halo vision.
- Rarely, it may cause arrhythmias, atrial fibrillation, myocardial ischemia, supraventricular tachycardia, bronchospasm paradoxical, muscle weakness, myalgia, and urinary retention.
- Hypersensitivity reactions may include urticaria, dyspnea, facial swelling, tachycardia, and potentially coma.
If any side effects occur, stop using the medication and consult your doctor or visit the nearest healthcare facility for immediate care.
5. Precautions for using Berodual 10ml
- You should use the medication as prescribed by the physician, follow the proper administration guidelines and avoid overdose. Before using, you should inform your doctor about your medical history, including any history of drug or food allergies.
- When using the medication, Overdose may occur if the medication is used incorrectly or if too many puffs are taken.The effects of overdosage are expected to be primarily related to fenoterol.The expected symptoms with overdosage are those of excessive beta-adrenergic stimulation, the most prominent being tachycardia, palpitation, tremor, hypertension, widening of the pulse pressure, anginal pain.
- Expected symptoms of overdosage with ipratropium bromide (such as dry mouth, visual accommodation disturbances) are mild, because the systemic concentration of inhaled ipratropium is very low. In case of overdose or symptoms of overdose, medical attention should be sought immediately.
- Berodual may interact with other medications, including those targeting the respiratory system, such as Salbutamol, Salmeterol, Formoterol, Bambuterol, Oxitropium, and Tiotropium. Xanthine derivatives such as theophylline and corticosteroids (e.g., prednisolone, methylprednisolone...).
- These substances can either enhance or inhibit the effects of the medication, so it is important to consult a doctor before combining them.
Ensure that the medication does not reach the eyes while being applied.
- Read the instructions carefully to avoid spraying too many times without being sure if the medication has been administered. Especially for children, ensure you supervise them closely and do not let them use the inhaler on their own.
- Regularly clean the mouthpiece to ensure that the medication does not build up in the cap or obstruct the spray, and to prevent bacterial contamination.
- Use the correct inhaler mouthpiece provided by the manufacturer. Do not replace it with a mouthpiece from another medication, and do not use the Berodual mouthpiece for other medications.
- Specific foods may cause drug interactions.Consult with your healthcare provider to ensure you follow an appropriate diet. It is also important to refrain from using tobacco, stimulants, or drinking alcohol while on this medication.
Berodual 10ml is used as a bronchodilator to help control both acute and chronic asthma attacks, as well as other cases of bronchospasm. However, the use of this prescription medication requires a doctor's prescription, and it should not be used independently without professional guidance.
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