Metered dose aerosol: The dosage should be adapted to the individual requirements. The following dosages are recommended for adults and children >6 years: Acute asthma episodes: 2 actuations are sufficient for prompt symptom relief in many cases. In more severe cases, if breathing has not noticeably improved after 5 minutes, two further actuations may be taken.
If an attack has not been relieved by 4 actuations, further actuations may be required.
In these cases, patients should be advised to consult the doctor or the nearest hospital immediately.
Intermittent and long-term treatment: (in asthma BERODUAL pressurised inhalation, solution should be used only on an as-needed basis).
1-2 actuations for each administration, up to a maximum of 8 actuations per day (average 1-2 actuations 3 times daily).
In children BERODUAL pressurised inhalation, solution should only be used on medical advice and under the supervision of an adult.
Patients should be instructed in the correct administration of the pressurised inhalation, solution to ensure successful therapy (see Instructions for use under Cautions for Usage).
Nebuliser solution: (1 mL contains 261 mcg ipratropium bromide + 500 mcg fenoterol hydrobromide) (20 drops=1 mL).
Treatment should be initiated and administered under medical supervision, e.g. in the hospital setting. Home based treatment can be recommended in patients when a low dose rapid acting beta-agonist bronchodilator such as Berodual pressurised inhalation, solution 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 pressurised inhalation, solution or requirement of higher doses in experienced patients.
The treatment with the nebuliser solution should always be started with the lowest recommended dose. 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: Adults (including elderly) and adolescents ≥12 years of age: Acute episodes of bronchospasm: Depending on the severity of the acute episode, doses ranging between 261 mcg ipratropium bromide/500 mcg fenoterol hydrobromide (i.e. 1 mL=20 drops) and 652.5 mcg ipratropium bromide/1250 mcg fenoterol hydrobromide (i.e. 2.5 mL=50 drops) may be used. In exceptional particular severe cases, doses up to 1044 mcg ipratropium bromide/2000 mcg fenoterol hydrobromide (i.e. 4 mL=80 drops) may be used.
Children 6-12 years: Acute asthma episodes: Depending on the severity of the acute episode and age doses ranging between 130.5 mcg ipratropium bromide/250 mcg fenoterol hydrobromide (i.e. 0.5 mL=10 drops) and 522 mcg ipratropium bromide/1000 mcg fenoterol hydrobromide (i.e. 2 mL=40 drops) may be used.
Children <6 years (below 22 kg body weight): Because there is limited information in this age group the following dose is recommended to be given under medical supervision only: About 26.1 mcg ipratropium bromide/50 mcg fenoterol hydrobromide (i.e. 0.1 mL=2 drops) per kg body weight up to a maximum of 0.5 mL (=10 drops).