Berotek solution for inhalation: instructions for use
Berotec is a drug belonging to the group of selective β-2-adrenomimetics. The drug helps to relax the smooth muscles of the bronchi and blood vessels and thus prevents the development of bronchospasm.
Release form and composition
Berotek solution for inhalation is available in vials with a dropper with a capacity of 20 ml, 40 ml or 100 ml. The bottle with the instruction is placed in a cardboard box.
The main active ingredient of Berotec is fenoterol hydrobromide. 1 ml of the solution for inhalation contains 1 mg of fenoterol hydrobromide.
Auxiliary components: benzalkonium chloride, edetate disodium dihydrate, hydrochloric acid, sodium chloride, distilled water.
Pharmacodynamics. Berotec stimulates β-2 adrenoreceptors, located mainly in the organs of the respiratory system. Fenoterol stops the release of inflammatory and allergic mediators from mast cells, thereby preventing the development of bronchial obstruction. The drug prevents the development of bronchospasm of various origins. It begins to act 5 minutes after inhalation. The maximum therapeutic effect is noted in 30–90 minutes, lasts from 3 to 6 hours.
In addition to the respiratory tract, β-adrenoreceptors are present in the heart muscle. Accordingly, Berotek has an effect on the work of the cardiovascular system (if the recommended doses are exceeded): it increases the strength and frequency of heart contractions, increases blood flow and peripheral blood circulation.
Fenoterol in high dosages also acts on β-1 adrenoreceptors, thereby enhancing mucociliary transport, inhibiting the contractile activity of the uterus, reducing potassium in the blood plasma, and disrupting fat and carbohydrate metabolism.
Pharmacokinetics. After inhalation of lower calving of the respiratory tract reaches from 10% to 30% of fenoterol (depending on the inhalation device and method of inhalation). The rest of the sprayed active substance is deposited in the upper respiratory tract, swallowed, falling into the digestive tract. Bioavailability of fenoterol is 18–19%.
Absorption from the surface of the respiratory tract proceeds in two phases. During the first 11 minutes after inhalation, about 30% of the active substance is absorbed. In the next 2 hours, the remaining 70% of fenoterol slowly penetrates the soft tissue. The maximum plasma concentration of the drug occurs within 15 minutes after inhalation. 40–55% of active ingredients bind to plasma proteins.
Fenoterol splitting to sulfates and glucuronides occurs in the liver. After passing through all stages of metabolism and providing a therapeutic effect, inactive metabolites are excreted in the bile and kidneys. Fenoterol hydrobromide in unchanged form penetrates the placental barrier and into breast milk.
Indications for use
Indications for appointment Beroteka are:
- relief of bronchospasm and asthma attack arising on the background of bronchial asthma;
- symptomatic therapy of bronchial asthma and other pathologies characterized by reversible narrowing of the airways (chronic obstructive bronchitis , chronic obstructive pulmonary disease, pulmonary emphysema);
- prevention of asthma attacks that occur on the background of physical effort;
- the need to expand the bronchi before inhalation with other drugs (antibiotics, glucocorticosteroids, mucolytics);
- conducting bronchodilation tests to determine the indicators of respiratory function.
Berotek is contraindicated for use in the presence of certain pathologies, including:
- hypertrophic obstructive cardiomyopathy;
- uncompensated diabetes;
- aortic stenosis;
- heart defects;
- hypersensitivity or individual intolerance of one of the components of the drug.
Also, Berotek can not be prescribed to pregnant women in the first trimester, women who are breastfeeding and children under 4 years old.
Dosing and Administration
Inhalations are carried out using a special device - a nebulizer. The recommended single dose of the drug is dissolved in a physiological solution, bringing the volume to 3-4 ml. It is strictly forbidden to dilute the drug with distilled water. The medicinal solution is prepared immediately before the inhalation. The time interval between inhalations should be 4 hours.
In accordance with the pharmaceutical dosage: 1 drop of solution contains 20 drops, 1 drop contains 50 μg of fenoterol hydrobromide. Recommended doses of the drug depend on the patient's age and indications.
Recommended dosages for adults (including the elderly) and children over 12 years old:
- relief of bronchial asthma attack - 0.5 ml (10 drops of solution), in severe cases - from 1 to 1.25 ml (20-25 drops), in extremely severe cases, under the supervision of a physician - 2 ml;
- prevention of an asthma attack caused by physical stress - 0.5 ml (10 drops) up to 4 times a day;
- symptomatic treatment of asthma and other pathologies with reversible narrowing of the airways - 0.5 ml (10 drops) 4 times a day.
Recommended dosages for children from 6 to 12 years old (with a body weight of 22 to 36 kg):
- relief of bronchial asthma attack - from 0.25 to 0.5 ml (5-10 drops of solution), in severe cases - 1 ml (20 drops), in extremely severe cases, under the supervision of a physician - 1.5 ml (30 drops);
- prevention of an asthma attack caused by physical stress - 0.25–0.5 ml (5–10 drops) 4 times a day;
- symptomatic treatment of asthma and other pathologies with reversible narrowing of the airways — 0.25–0.5 ml (5–10 drops) 4 times a day.
Recommended dosages for children from 4 to 6 years old (weighing up to 22 kg):
- 1 drop (0.05 ml) per 1 kg of body weight, but not more than 10 drops (0.5 ml) of the solution at a time; Reception frequency - up to 3 times per day.
Treatment usually starts with the lowest recommended dose.
When using the solution for inhalation of berotec, undesirable side effects from various body systems can develop.
On the part of the respiratory system:
- local irritation of the mucous membranes;
- paradoxical bronchospasm (extremely rare).
Since the cardiovascular system:
- heart palpitations;
- tachycardia ;
- increase in systolic blood pressure;
- decrease in diastolic blood pressure;
- angina pains.
From the side of the central nervous system:
- accommodation disturbance (the ability to clearly see objects at different distances);
- small tremor;
On the part of the digestive system - nausea and vomiting.
From other organs and systems:
- hypokalemia - a decrease in the concentration of potassium ions in the blood (most often observed in patients with severe forms of bronchial asthma who take glucocorticosteroids, diuretics, xanthines);
- hyperglycemia (increased blood glucose);
- myalgia (muscle aches) and muscle cramps;
- urinary retention;
- increased sweating.
Allergic reactions - rash, urticaria , angioedema of the lips, tongue, face.
With an overdose of the drug develops tachycardia, arrhythmia, palpitations, angina pain and angina, hypotension or hypertension (depending on the characteristics and susceptibility of the body), intense redness of the face and skin of the upper half of the body, fine tremor. Specific antidotes for Berotec are cardio selective β-blockers, especially β-1 receptor blockers. But the use of such funds can enhance the bronchial obstruction, so the dosage of the antidote should be chosen very carefully. Along with the use of antidotes, symptomatic treatment with sedatives and tranquilizers is carried out. According to indications, intensive therapy is carried out.
Conservative treatment with Berotek under constant strict medical supervision is carried out in patients with the following pathologies:
- uncontrolled arterial hypertension;
- severe diseases of the heart and blood vessels;
- compensated diabetes mellitus;
- recent myocardial infarction.
When prescribing, it is necessary to take into account drug interaction with other drugs:
- The overall therapeutic effect of Berotec is enhanced with simultaneous use with anticholinergics, tricyclic antidepressants, β-adrenoreceptor agonists, monoamine oxidase (MAO) enzyme inhibitors;
- simultaneous use of Berotec with β-adrenomimetics, anticholinergics, xanthine derivatives (including theophylline) stimulates the development of side effects;
- the combination of Berotec with β-adrenoreceptor blockers leads to a pronounced decrease in bronchodilation (expansion of the bronchial lumen);
- simultaneous administration with halogenated hydrocarbon antiseptics (enflurane, halothane, etc.) enhances the influence of the active components of Berotec on the cardiovascular system.
The therapeutic effect of conservative treatment of bronchial asthma and chronic obstructive pulmonary disease Berotek increases with its combined use with anti-inflammatory drugs (inhaled glucocorticosteroids). However, this treatment is recommended in the hospital for continuous monitoring of the patient.
In cases of increased bronchial obstruction, it is unacceptable to uncontrolledly exceed the prescribed dosages of Berotec and the duration of the recommended course - this may lead to a worsening of the course of the disease.
Complete structural analogues of Berotec (preparations with the same active ingredient) are: Fenoterol-Nativ, Fenoterol Hydrobromide, Partusisten.
Terms and conditions of storage
Berotek solution for inhalation is stored at a temperature of up to 30 ° C, in a dry place, protected from sunlight and inaccessible to children. Keep the product away from open flame, do not freeze. Shelf life is 5 years. Do not use the drug after the expiration date on the package.
Berotek for inhalation price
Berotek solution for inhalation 0.1% 20ml - from 280 rubles.