Treatment should be initiated and administered under medical supervision, e.g. in the hospital setting. Home based treatment can be recommended in exceptional cases (severe symptoms or experienced patients requiring higher doses) when a low dose rapid acting beta-agonist bronchodilator such as BERODUAL metered dose inhaler has been insufficient in providing relief after consultation with an experienced physician.
It can also be recommended in patients who are in need for nebuliser treatment for other reasons e.g. handling issues of MDI or requirement of higher doses in experienced patients.
The treatment with the nebuliser solution in UDVs should always be started with the lowest recommended dose (1 UDV). In very severe cases, two unit dose vials may be required for symptom relief. The dosage should be adapted to the individual requirements and tailored according to the severity of the acute episode. Administration should be stopped when sufficient symptom relief is achieved.
The following dosages are recommended for adults (including elderly patients) and adolescents > 12 years: Acute episodes of bronchospasm: 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.
In very severe cases, two unit dose vials may be required for symptom relief.
These should be administered under medical supervision. Children ≤ 12 years: Because of insufficient information the general use in children ≤ 12 years of age is not recommended.