Berodual Composition
Berodual is a fixed-dose combination bronchodilator containing ipratropium bromide (an anticholinergic agent) and fenoterol hydrobromide (a beta-2 adrenergic agonist). 1, 2
Active Ingredients and Dosage Forms
Metered Dose Inhaler (MDI) Formulation
- Each actuation delivers 20 μg ipratropium bromide + 50 μg fenoterol hydrobromide 1, 2, 3
- Standard dosing is typically 2 actuations (40 μg ipratropium + 100 μg fenoterol per dose) administered four times daily 2, 3
Respimat Soft Mist Inhaler (SMI) Formulation
- Available in two strengths: 10 μg ipratropium/25 μg fenoterol or 20 μg ipratropium/50 μg fenoterol per actuation 1, 2
- The Respimat SMI is propellant-free and delivers medication as a fine, slow-moving mist 1
- This formulation allows for 50% dose reduction compared to CFC-MDI while maintaining equivalent therapeutic efficacy 1, 2
Dry Powder Inhaler Formulation
- Delivers 40 μg ipratropium bromide + 100 μg fenoterol per inhalation 4
- Provides therapeutic equivalence to the MDI formulation with similar onset (approximately 10 minutes) and duration of action (up to 6 hours) 4
Mechanism of Action
- Ipratropium bromide blocks muscarinic receptors in the airways, reducing bronchospasm and decreasing mucus production 5
- Fenoterol hydrobromide stimulates beta-2 adrenergic receptors, causing bronchial smooth muscle relaxation 1
- The combination provides superior bronchodilation by targeting different receptor pathways simultaneously, offering additive therapeutic benefit 6, 7
Clinical Advantages of the Fixed Combination
- Achieves equivalent bronchodilator effects with less beta-2 agonist compared to salbutamol monotherapy 3
- Demonstrates better bronchodilating and protective effects compared to either component used alone 7
- The Respimat SMI formulation improves lung deposition and reduces oropharyngeal deposition compared to conventional MDI 1
- In pediatric patients, the Respimat SMI eliminates the need for a spacer device 1