Berodual MDI is a combination bronchodilator inhaler containing two active ingredients with complementary mechanisms:

• Fenoterol Hydrobromide (50 mcg/puff) — A SABA that stimulates Beta-2 receptors, activating adenylate cyclase to increase cAMP and relax bronchial smooth muscle rapidly
• Ipratropium Bromide (20 mcg/puff) — A SAMA that blocks Acetylcholine at M3 Muscarinic receptors, reducing Vagus nerve-mediated bronchoconstriction and mucus secretion

Both agents act locally in the lungs (10-30% reaches the lungs, rest undergoes first-pass metabolism). Takes effect within 5-15 minutes, lasts 4-6 hours.

Berodual MDI bronchodilator inhaler treats:

• Asthma — Reliever for acute attacks with wheezing, chest tightness, shortness of breath
• COPD — Dual SABA+SAMA is particularly beneficial, GOLD guidelines recommend as initial therapy for group B-D
• Exercise-induced Bronchospasm — Inhale 15-30 min before exercise

Dosage: Adults/children 6+: 2 puffs when needed, repeat after 5 min if needed. Max 8 puffs/day.

Technique:

1. Shake 3-4 times, remove cap
2. Breathe out fully
3. Seal lips, tilt head slightly back
4. Breathe in slowly while pressing once
5. Hold 10 seconds, breathe out slowly
6. Rinse mouth after every use

Wait 1 min between puffs. Use Spacer for children/elderly.

Special populations: Use with caution in elderly and renal impairment patients, especially those with cardiovascular conditions. This is an as-needed reliever — no fixed schedule. If using for the first time or after 3+ days of non-use, prime the inhaler with 1 test spray.

Common: Hand tremor (Fenoterol), dry mouth/throat (Ipratropium), headache, cough

Uncommon: Palpitations, tachycardia, nausea, nervousness

Very rare: Hypokalemia, urinary retention, blurred vision

Stop if: Chest pain, irregular heartbeat, or paradoxical bronchospasm

Monitoring: Assess heart rate periodically, especially in cardiac patients. Monitor potassium levels with high-dose regular use.

Overdose: Severe palpitations, tachycardia, tremor, blood pressure changes — seek medical help immediately.

Driving: May cause dizziness in some patients — exercise caution when driving or operating machinery.

Do not use: Allergy to Fenoterol/Ipratropium/Atropine or other components, Hypertrophic Obstructive Cardiomyopathy, Tachyarrhythmia, children under 6 (limited safety data)

Caution: Cardiovascular disease, hypertension, uncontrolled diabetes, angle-closure glaucoma (Ipratropium may increase intraocular pressure)

Pregnancy/breastfeeding: Consult doctor, especially in first and third trimesters — Fenoterol may inhibit uterine contractions. May be excreted in breast milk, use only when essential.

Liver/kidney: Use with caution, consult doctor to assess suitability.

Berodual MDI vs other inhalers at Intimo Life:

• vs Ventolin Evohaler (Salbutamol 100 mcg): Ventolin is single-agent SABA, faster onset (1-5 min) but one mechanism. Cheaper. Berodual has dual mechanism, broader and longer bronchodilation (4-6 hrs), especially for COPD

Summary: Ventolin for general asthma, Berodual for comprehensive bronchodilation in COPD.

Key interactions:

• Beta-agonists/Theophylline — Potentiate cardiovascular effects
• Beta-blockers — Antagonize bronchodilation
• Diuretics/Corticosteroids — Risk of Hypokalemia
• ICS — Safe together, inhale Berodual first, then ICS after 1-2 min

Berodual MDI acts within 5-15 minutes. Fenoterol within 5 min, Ipratropium builds up over 15-30 min. Lasts 4-6 hours, longer than Salbutamol (Ventolin) at ~4 hours.

Berodual MDI is available at pharmacies or online at Intimo Life. By Boehringer Ingelheim, 200 doses per canister.