Berodual

Bronchodilator for symptomatic prevention & treatment of chronic obstructive airway disorders w/ reversible airflow limitation eg, bronchial asthma & chronic bronchitis w/ or w/o emphysema. Consider concomitant anti-inflammatory therapy for patients w/ bronchial asthma & steroid-responsive COPD.

Acute bronchospasm episodes Adult (including elderly) & adolescent >12 yr 1-2.5 mL (20-50 drops). Severe cases 4 mL (80 drops). Acute asthma episodes Childn 6-12 yr 0.5-2 mL (10-40 drops), <6 yr (weighing <22 kg) 0.1 mL (2 drops)/kg. Max: 0.5 mL (10 drops).

Hypersensitivity to fenoterol HBr or atropine-like substances. Hypertrophic obstructive cardiomyopathy & tachyarrhythmia.

Immediate hypersensitivity reactions. Do not take orally. Immediately discontinue use if paradoxical bronchospasm occurs & substitute w/ alternative therapy. Patients predisposed to narrow-angle glaucoma; initiate treatment w/ miotic drops & immediately seek specialist advice if any combination of symptoms (eg, eye pain/discomfort, blurred vision, visual halos or coloured images in association w/ red eyes from conjunctival congestion & corneal oedema) develop. Avoid contact w/ eyes. Carefully assess risk/benefit especially w/ higher doses in insufficiently controlled DM, recent MI, severe organic heart or vascular disorders, hyperthyroidism, phaeochromocytoma, pre-existing urinary outflow tract obstruction (eg, prostatic hyperplasia or bladder-neck obstruction). Patients w/ underlying severe heart disease (eg, ischaemic heart disease, arrhythmia or severe heart failure); seek medical advice if chest pain or other symptoms of worsening heart disease occurs. Potentially serious hypokalaemia. Patients w/ cystic fibrosis may be prone to GI motility disturbances. Advise patients to immediately consult physician in case of acute, rapidly worsening dyspnoea. Prolonged use. Concomitant use w/ other sympathomimetic bronchodilators. May lead to +ve results to fenoterol in tests for non-clinical substance abuse (eg, doping). May cause wheezing & breathing difficulties due to benzalkonium Cl content; increased risk of adverse events in asthma patients. Possible dizziness, tremor, accommodation disorder, mydriasis & blurred vision may affect ability to drive & use machines. Pregnancy (especially 1st trimester) & lactation.

Cough, dry mouth, headache, tremor, pharyngitis, nausea, dizziness, dysphonia, tachycardia, palpitations, vomiting, increased systolic BP & nervousness.

Chronic co-administration w/ other anticholinergics is not recommended. May enhance bronchodilatory effect w/ other β-adrenergics, anticholinergics & xanthine derivatives (eg, theophylline). Potentially serious reduction in bronchodilation w/ β-blockers. Induced hypokalaemia may be increased by concomitant use w/ xanthine derivatives, corticosteroids & diuretics. May increase susceptibility to arrhythmias w/ digoxin; monitor serum K levels. May enhance action by MAOIs, TCAs. May increase susceptibility on CV effects w/ halogenated hydrocarbon anaesth inhalation (eg, halothane, trichloroethylene & enflurane).

Antiasthmatic & COPD Preparations

R03AL01 - fenoterol and ipratropium bromide ; Belongs to the class of combination of adrenergics with anticholinergics, that may also include a corticosteroid. Used in the treatment of obstructive airway diseases.

POM