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Berodual solution for inhalation: instructions for use

Berodual solution for inhalation

Berodual is a combined bronchodilator for the treatment of diseases of the respiratory tract, accompanied by bronchospasm.

Release form and composition

Berodual is produced in the form of a solution for inhalation, in a 20 ml bottle-dropper.

The main active ingredients (in 1 ml of solution):

  • Fenoterol hydrobromide - 500 µg:
  • Ipratropium bromide monohydrate - 260 mcg (corresponding to 250 mcg of anhydrous ipratropium bromide).

Auxiliary components: sodium chloride, disodium edetate dihydrate, hydrochloric acid, benzalkonium chloride, purified water.

pharmachologic effect

Berodual - combined bronchodilator. It contains two active components: ipratropium bromide (belongs to the group of M-anticholinergics) and fenoterol hydrobromide (belongs to the group of β-2 adrenergic mimetics).

Ipratropium bromide has anticholinergic properties. Slows down the reflexes caused by the vagus nerve, by counteracting acetylcholine (a mediator released from the endings of the vagus nerve). The effect of ipratropium on inhalation is due to the local, not systemic, anticholinergic effect. With inhalation administration of the substance in patients with bronchospasm, a marked improvement in lung function is noted for 15 minutes. The maximum therapeutic effect is achieved within 1–2 hours after inhalation, lasts up to 6 hours. Ipratropium bromide does not adversely affect mucociliary clearance, mucus production in the respiratory tract and gas exchange processes.

Fenoterol hydrobromide has a selective stimulatory effect on β-2 adrenoreceptors. It relaxes the smooth muscles of the bronchi, counteracting the development of spasm. Fenoterol blocks the release of inflammatory and inflammatory mediators from mast cells. With the introduction of fenoterol in higher doses, increased mucociliary clearance.

Fenoterol also has a stimulating effect on the β-2 adrenoreceptors of the heart and blood vessels, as a result of which the frequency and strength of heart contractions increase. If the recommended dosage of fenoterol is exceeded, β-1 adrenoreceptors are stimulated.

The mechanisms of action of fenoterol and ipratropium are different. The active components complement each other, which contributes to the enhancement of the antispasmodic effect on the muscles of the bronchi and the achievement of a pronounced therapeutic effect in various bronchopulmonary diseases with obstruction.

Indications for use

Berodual is used for the prevention and symptomatic treatment of chronic obstructive diseases of the respiratory tract, namely:

  • bronchial asthma;
  • chronic obstructive pulmonary disease;
  • chronic obstructive bronchitis;
  • emphysema.


Contraindications to the use of Berodual are:

  • tachyarrhythmia;
  • hypertrophic obstructive cardiomyopathy;
  • hypersensitivity or intolerance to the main or auxiliary components of the drug.

Dosing and Administration

Dosages of the drug are selected individually, taking into account the indications and the age of the patient.

For adults (including the elderly) and children over 12 years old:

  • Relief of an acute attack of bronchial asthma - 1 ml (20 drops) with a mild and moderate attack, in difficult cases - 2.5 ml (50 drops), in extremely difficult situations under strict medical supervision - 4 ml (80 drops);
  • long course therapy - 1–2 ml (20–40 drops) 4 times a day;
  • as an aid during ventilation of the lungs - 0.5 ml (10 drops) of solution.

For children from 6 to 12 years:

  • relief of an acute attack of bronchial asthma — from 0.5 ml to 1 ml (10–20 drops) with a mild and moderate attack, in difficult cases — 2 ml (40 drops), in extremely difficult situations under strict medical control — 3 ml (60 drops);
  • long course therapy - 0.5–1 ml (10–20 drops) 4 times a day;
  • as an aid during ventilation of the lungs - 0.5 ml (10 drops) of solution.

For children under 6 years old (weighing less than 22 kg):

The recommended single dose is 0.1 ml (2 drops) of solution per 1 kg of body weight, but not more than 0.5 ml (10 drops); Reception frequency - up to 3 times per day.

Treatment should begin with the lowest recommended dose. The required amount of solution is diluted with saline to a volume of 3-4 ml. Inhalations are carried out using a special inhalation device - a nebulizer. Before each inhalation, a fresh solution should be prepared; the agent remaining after the previous procedure should not be used. The minimum time interval between two procedures is 4 hours.

Side effects

Berodual is usually well tolerated. In some situations, the development of undesirable side effects from various systems.

On the part of the respiratory system:

  • cough;
  • irritation of the respiratory tract mucosa;
  • development of paradoxical bronchospasm (rare).

From the nervous system:

  • headache;
  • dizziness;
  • change in taste and dry mouth;
  • nervousness;
  • tremor.

Since the cardiovascular system:

  • heart palpitations;
  • tachycardia ;
  • increase systolic and lower diastolic pressure;
  • arrhythmia.

From the digestive system:

  • digestive disorders (nausea, vomiting);
  • violation of intestinal motility (mainly in patients with cystic fibrosis).

From other systems:

  • hypokalemia;
  • increased sweating;
  • weakness;
  • myalgia (muscle aches) and muscle cramps ;
  • violation of visual accommodation;
  • urinary retention.

Allergic reactions:

When the solution gets into the eye, the pupil expands, the intraocular pressure rises, which is accompanied by pain or discomfort in the eyeball, blurred vision of objects, the appearance of colored spots before the eyes and redness of the conjunctiva.

The occurrence of symptoms of overdose is usually caused by the action of fenoterol - excessive stimulation of β-adrenoreceptors. Perhaps a decrease or increase in blood pressure (depending on the predisposition of the body), an increase in the difference between upper and lower pressure, increased heart rate and tachycardia, finger tremor, extrasystole, angina , arrhythmia, blood rush to the face and upper body, increased bronchial obstruction. Symptoms of ipratropium bromide overdose are a violation of visual accommodation and dry mouth is usually mild.

Treatment for symptomatic overdose of Berodual includes the use of tranquilizers, sedatives. In case of severe intoxication, intensive therapy measures are taken. Β-adrenoreceptor blockers (preferably β-1 blockers) are used as a specific antidote. But in patients with chronic obstructive pulmonary disease and bronchial asthma, the use of these drugs can cause an increase in bronchial obstruction, so the dose of the antidote must be carefully and carefully selected.

special instructions

The drug should be administered with caution in certain diseases and conditions, including:

  • angle-closure glaucoma;
  • high blood pressure;
  • coronary insufficiency;
  • recent myocardial infarction;
  • cystic fibrosis;
  • diabetes;
  • severe organic pathology of the heart and blood vessels;
  • pheochromocytoma;
  • hyperthyroidism;
  • prostatic hypertrophy;
  • cystic fibrosis;
  • bladder neck obstruction;
  • pregnancy and lactation;
  • age up to 6 years.

During treatment with Berodual, one should take into account that:

  • Berodual inhibits the contractile activity of the uterus;
  • Fenoterol is absorbed into breast milk, so the drug is administered with caution to breastfeeding mothers;
  • symptomatic therapy with a Berodual solution may be preferable to long-term treatment (for mild or moderate diseases);
  • The effectiveness of long-term treatment with Berodual in patients with severe pathologies increases in combination with anti-inflammatory therapy with inhaled corticosteroids.


The analogues of Berodual include the drug Ipraterol-Nativ solution.

Terms and conditions of storage

The drug is kept out of the reach of children, protected from the sun at room temperature (below 30 ° C). Shelf life is 5 years. Do not use the solution after the expiration date on the packaging.

Berodual for inhalation price

Berodual solution for inhalation 0.25 mg + 0.5 mg / ml 20 ml - from 270 rubles.

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