Ipratropium bromide + fenoterol

Fenoterol exerts a bronchodilator effect, selectively exciting beta-2 bronchial adrenergic receptors . Ipratropium bromide eliminates m-anticholinergic effects on the smooth muscles of the bronchi and reduces sputum overproduction, does not adversely affect mucociliary clearance and gas exchange . This combination increases the effectiveness of bronchodilator therapy of diseases accompanied by increased tone of bronchial muscles and mucus hypersecretion, and also allows the use of drugs at lower doses than with monotherapy. After inhalation of the drug, the therapeutic effect is observed after 15 minutes, reaches a maximum after 1-2 hours and lasts up to 6 hours.

Chronic obstructive pulmonary disease , bronchial asthma (treatment and prevention of acute asthma attacks). Airway preparation for aerosol administration of drugs ( antibiotics , mucolytic drugs, corticosteroids , etc.).

Hypersensitivity (including to atropine and its compounds), tachyarrhythmia , hypertrophic obstructive cardiomyopathy , pregnancy (I trimester), children's age (up to 6 years).

Caution

Coronary insufficiency , arterial hypertension , diabetes mellitus (not well controlled), recent myocardial infarction , severe organic heart and vascular diseases, hyperthyroidism , pheochromocytoma , prostatic hyperplasia , obstruction of the bladder neck , angle - closure glaucoma , cystic fibrosis , childhood.

Inhalation. Aerosol for inhalation: adults and children over 6 years of age - usually 1-2 doses of aerosol 3 times a day. If there is a risk of respiratory failure - 2 doses of aerosol, if necessary - after 5 minutes, 2 more doses, subsequent inhalations should be carried out no earlier than 2 hours later. Inhalation solution: for adults and children over 12 years old for stopping attacks - 1 ml (20 drops) solution, in severe cases, the dose can be increased to 2.5-4 ml (50-80 cap). Long intermittent therapy - 1-2 ml (20-40 cap) up to 4 times a day. In the case of moderate bronchospasm or the need for auxiliary (artificial) ventilation of the lungs, lower doses of 0.5 ml (10 cap) are recommended. Children 6-12 years: relief of attacks - 0.5-1 ml (10-20 cap), in severe cases, the dose can be increased to 3 ml (60 cap). Long and intermittent therapy: 0.5-1 ml (10-20 cap) up to 4 times a day. In case of moderate bronchospasm or the need for auxiliary (artificial) ventilation, lower doses of 0.5 ml (10 cap) are recommended. Children under 6 years old (body weight up to 22 kg): the dose is calculated based on 25 μg ipratropium bromide and 50 μg fenoterol per 1 kg of body weight, respectively up to 0.5 ml (10 cap) 3 times a day. The recommended dose of the drug is diluted immediately before use in a 0.9% NaCl solution (do not dilute in distilled water !) To a total volume of 3-4 ml and inhaled through a nebulizer for 6-7 minutes, until the solution is completely consumed. The dose may depend on the inhalation regimen and the technical characteristics of the nebulizer. The duration of inhalation can be controlled through the volume of the diluted solution. If multiple inhalations are necessary, the interval between them should be at least 4 hours.

Angioedema , paradoxical bronchospasm, skin rash, cough , dry mouth, taste change, nausea , dizziness , nervousness, finger tremor , tachycardia , tachyarrhythmia ; upon contact with eyes - mydriasis , accommodation paralysis , conjunctival hyperemia , increased intraocular pressure ( eyeball pain, blurred vision, sensation of the appearance of a halo or colored spots in front of the eyes).

Overdose

Symptoms: tremor of fingers, palpitations , tachycardia, feeling of heaviness behind the sternum, extrasystole , increased bronchial obstruction. Treatment: the appointment of anxiolytic drugs ( tranquilizers ), selective beta1-blockers .

Shortly before childbirth, admission must be discontinued due to the possibility of weakening of labor by phenoterol. Avoid contact with the eyes. In patients with a history of cystic fibrosis, gastrointestinal motility disorders are possible. The inhalation solution can be used with various inhalation devices. In the presence of a centralized stationary supply of oxygen , the solution is best administered at a rate of 6-8 l / min.

The simultaneous use with xanthine derivatives , cromoglycetic acid and GCS enhances the effect, with beta-blockers - weakens. Xanthine derivatives, corticosteroids and diuretics enhance hypokalemia . Halogenated hydrocarbon drugs for general anesthesia ( halotane , trichlorethylene , enflurane ) increase the risk of side effects from the cardiovascular system . MAO inhibitors , tricyclic antidepressants enhance the beta-adrenostimulating effect.

Release form: in aerosol cans (with the dosing valve) with a capacity of 15 ml containing 300 doses of the combined preparation. Each dose contains 0.5 mg of fenoterol hydrobromide and 0.02 mg of ipratropium bromide.

• Berodual // Medicines / M.D. Mashkovsky . - Reference Mashkovsky on-line .
• Ipratropium bromide + Fenoterol (Ipratropium bromide + Fenoterol): instructions, use and formula (neopr.) . Archived on August 17, 2012.