The dosage should be adapted to the individual requirements; patient should also be kept under medical observation during treatment. Unless otherwise prescribed, the following dosages are recommended:
Berodual MDI: Adults and Children >6 years: Acute Asthma Episodes: 2 puffs are sufficient for prompt symptom relief in many cases. In more severe cases, if breathing has not noticeably improved after 5 min, 2 further puffs may be taken.
If an attack has not been relieved by 4 puffs, further puffs may be required. In these cases, patients should consult the doctor or the nearest hospital immediately.
Intermittent and Long-Term Treatment: 1-2 puffs for each administration, up to a maximum of 8 puffs/day (average 1-2 puffs 3 times daily).
In children, Berodual metered aerosol should only be used on medical advice and under the supervision of an adult.
Berodual F UDV: The solution is ready for use and requires no dilution.
Adults (Including the Elderly) and Children >12 years:
Acute Asthma Episodes: 1 unit-dose vial is sufficient for prompt symptom relief in most cases, typically the hospital-based treatment of moderate to severe asthma attacks or the home- and hospital-based treatment of patients with moderate to severe COPD. If, in very severe cases, 2 unit-dose vials are required for symptom relief, these should be administered under medical supervision.
Intermittent and Long-Term Treatment: 1 unit-dose vial up to 4 times daily.
Berodual F UDV can be administered using a range of commercially available nebulizing devices. Where wall oxygen is available, the solution is best administered at a flow rate of 6-8 L/min. Because of insufficient information, the general use in children <12 years is not recommended.
Administration: Berodual MDI: The correct administration of the metered aerosol is essential for successful therapy.
Shake the aerosol canister and depress the valve twice before the apparatus is used for the first time.
Before each use, the following rules should be observed: Remove protective cap. Shake the metered aerosol well before each use. Breathe-out deeply. Hold the metered aerosol and close lips over the mouthpiece. The arrow and the base of the container should be pointing upwards. Breathe-in as deeply as possible, pressing the base of the container firmly at the same time, this releases 1 metered dose. Hold breath for a few seconds, then remove the mouthpiece from the mouth and breathe-out. The same action should be repeated for a 2nd inhalation. Replace the protective cap after use.
Special Instructions for the Use of the Inhalation Aid: Before each use, the following rules should be observed:
1. Remove protective cap.
2. Attach the inhalation aid with the appropriate opening to the mouthpiece of the metered aerosol.
3. Cover the other opening with the protective cap. The protective cap of the metered aerosol is to be attached to the inhalation aid in order to prevent premature leakage of the fine cloud of substance.
4. Hold the metered aerosol, with inhalation aid attached, between thumb and forefinger (arrow and container base pointing upwards) and shake well before each use.
5. Press the container base firmly to release a puff from the aerosol into the closed inhalation aid.
6. Remove the protective cap from the inhalation aid and, immediately after a normal exhalation, inhale the substance cloud from the inhalation aid. Breathe-in deeply. Hold breath for a few seconds.
If 2 puffs have been prescribed as a single dose, then the procedure described under points 4-6 must be repeated.
7. Remove the inhalation aid from the metered aerosol and replace the protective cap on the mouthpiece of the metered aerosol.
On Point 6: Inhalation from the inhalation aid must take place immediately after releasing the aerosol puff, otherwise, the released particles of active substance would very quickly settle on the inside surface of the device and thus lose their efficacy. Breath should be held for a few seconds to enable the substance cloud to settle in the bronchi, rather than be immediately exhaled.
If it is used correctly, the inhalation aid facilitates inhalation of the substance, allowing it to penetrate deep into the bronchial system. It thus relieves the user much more quickly of the frightening symptoms of dyspnea.
Berodual F UDV: The unit-dose vials are intended only for inhalation with suitable nebulizing devices and should not be taken orally or administered parenterally.
Prepare the nebulizer for filling, according to the instructions provided by the manufacturer or doctor. Tear 1 unit-dose vial from the strip. Open the unit-dose vial by firmly twisting the top. Squeeze the contents of the unit-dose vial into the nebulizer reservoir. Assemble the nebulizer and use as directed. After use, throw away any solution left in the reservoir and clean the nebulizer, following the manufacturer's instructions.