Salbutamol Instructions for use, contraindications, side effects, reviews. Salbutamol - instructions for use Maximum dose of salbutamola for inhalations per day

Aerosol for inhalation dosage.

Pharmacological group

Selective agonists β 2 -adrenoreceptors. PBX code R03A C02.

Indications

Treatment and prevention of bronchospasm with bronchial asthma, chronic obstructive bronchitis and emphysema. Long-term treatment of bronchial asthma patients (as part of comprehensive therapy).

Contraindications

Hypersensitivity to the components of the drug.

Age up to 4 years.

Method of application and dose

The drug is used only inhalation for inhalation of the drug through the mouth.

To relieve the attacks of bronchospasm in adults, the dose is 100 - 200 μg (1-2 doses), which, if necessary, repeated up to 3-4 times a day. The maximum dose is 800 μg (8 doses) per day.

To relieve the bunches of bronchospasm in children aged 4 years, the dose of the drug is 100 μg, if necessary, it increases to 200 μg (2 doses). The maximum dose is 400 μg (4 doses) per day.

To prevent Bronchospasm attacks associated with the influence of allergen or by physical activity, 200 μg of the drug is prescribed to the impact of the provoking factor. For children, the dose is 100 μg once.

For long-term supporting therapy, adults and children over 4 are prescribed 100 - 200 μg (1-2 doses) of the drug up to 4 times a day.

Before applying the aerosol, you must shake the container and press one or twice into the dosing valve.

To apply the drug, follow these steps:

If you are assigned a re-dose, wait 1 min and perform the actions described above, starting from paragraph 2.

For inhalations you can use the spacer.

Note. Rinse the nozzle with running water once a week. Before this carefully remove the aluminum container. Avoid water from entering the container.

Adverse reactions

From the immune system: very rarely - hypersensitivity reactions, including angioedema edema, urticule, bronchospasm, arterial hypotension and collapse.

Metabolic disorders: rarely hypokalemia.

From the nervous system: often - tremor (especially tremor hands), headache.

From the side of the cardiovascular system: tachycardia, very rarely - violation of heart rhythm, including ventricular fibrillation, hydrodynivicular tachycardia and extrasystole; Rarely - peripheral vasodulation.

From the respiratory system: very rarely - paradoxical bronchospasm. In this case, the inhalation of Salbutamola should immediately terminate and immediately assign alternative forms of the drug or other high-speed inhalation broutine.

From the digestive system: irritation of the mucous membranes of the mouth and pharynx.

On the side of the musculoskeletal system: rarely - muscle cramps.

Overdose

Overdose symptoms can manifest itself in excessive stimulation of β-adrenoreceptors and / or by the side effects of varying severity. Overdose can manifest themselves tachycardia, arrhythmia, arterial hypotension or hypertension, sleep impairment, chest pain, hand tremor and all body, excitation, increased fatigue.

Treatment. It is necessary to stop using salbutamol and begin the corresponding symptomatic therapy. An antidote to be given preference in the overdose of salbutamola is a cardioslelective β-blocker. Preparations of this group should be prescribed with care patients with bronchospasm in history. Due to the overdose of Salbutamola, hypocalemia may occur, so it is necessary to be kicolawants in serum levels.

Application during pregnancy or breastfeeding

The drug can be used during pregnancy only in cases where the expected benefit for the mother exceeds the possible risk to the fetus.

Salbutamol stands out to breast milk, so it is not recommended for women who are breastfeeding, except when the expected benefit for the mother exceeds the possible risk for the child.

Children

The drug is used to children under 4 years old.

Features of application

The treatment of asthma should be carried out with a phased program, the patient's condition should be assessed clinically and using functional pulmonary tests. An increase in the frequency of use of inhalation β 2 agonists indicates a deterioration in the control over ASTMA. In this case, the patient's therapy needs to be revised, since the deterioration of the flow of asthma is a vital condition, requires the appointment or increase in the dose of corticosteroids that are already applied. Patients belonging to the risk group are recommended daily picofloumometry. In case, after applying a previously effective dose of salbutamola, relief is not observed at least for 3:00, the patient should consult a doctor for adopting additional measures. It should be properly used inhaler in order to ensure the preparation in bronchi. For young children, it is advisable to apply "Bebimascus" for inhalations.

Salbutamol with caution is prescribed with hyperthyroidism.

Therapy by agonists β 2 -adrenoreceptors can cause hypokalemia. Special caution is recommended for bronchial asthma, since hypokalemia can be intensified while using xanthine derivatives, steroids, diuretics and under the influence of hypoxia. It is recommended to regularly monitor the level of potassium in serum.

The ability to influence the reaction rate when managing motor vehicles or other mechanisms

There are no data on the effect of Salbutamola on the ability to control the car and other mechanisms.

Interaction with other medicines and other types of interactions

The combined use of salbutamola with other sympathomimetics is not recommended, since the risk of developing side effects from the cardiovascular system increases. The simultaneous use of Salbutamola and Mao inhibitors and tricyclic antidepressants are not allowed.

Formula: C13H21NO3, chemical name: (RS) -2-tert-butylamino-1- (4-hydroxy-3-oxymethyl-phenyl) - ethanol.
Pharmacological group: vegetotropic agents / adreminometric agents / beta adrenomimetics; Organotropic agents / means governing the function of the urogenital system and reproduction / tocolitics.
Pharmachologic effect: Tocolic, bronchhalytic.

Pharmacological properties

Salbutamol highly selectively has a stimulating effect on beta2-adrenoreceptors, activates adenylate cyclase located in cells. The bronchological effect of Salbutamola is due to the relaxation of the smooth muscles of the bronchi. Salbutamol acts for a long time, since it is not destroyed in the light Catechol-o-methyltransferase. Salbutamol slows down the contractile activity of myometrium, relaxes the uterus, warns premature childbirth. When inhalation, 10-20% of Salbutamola reaches small bronchi, where it is gradually absorbed into systemic bloodstream, part of the dose is absorbed in the gastrointestinal tract when swallowing. Salbutamol is well absorbed when applying long-acting tablets. The maximum concentration is 30 ng / ml. The duration of salbutamola circulation in the blood (in therapeutic concentration) is 3-9 hours, after the content of the drug gradually decreases. With plasma proteins, Salbutamol binds to 10%.

It stands out with breast milk and passes through the placenta. In the liver, Salbutamol is subjected to biotransformation. The half-life is 3.8 hours. Regardless of the method of administration, it is excreted with bile and urine, mainly unchanged (about 90%) or in the form of glucuronide.

The removal of bronchospasm is rapidly achieved with the inhalation administration of salbutamola. The expansion of the bronchi already occurs on the 4th-5th minute, increases by the 20th minute, becomes the maximum in 40-60 minutes; The duration of the effect is 4-5 hours. The most pronounced result is achieved with inhalation of 2 doses of salbutamol, a further increase in the dose to an increase in bronchial passability does not lead, but the possibility of developing adverse reactions (headache, tremor, dizziness) increases.

Salbutamol positively affects the mucociliary clearance (increases it by 36% in chronic bronchitis), activates the functions of the fiscal epithelium, stimulates the secretion of the mucus. Slows out the release of basophils and fat cells of inflammation mediators (for example, anti-Ig-induced histamine emission), eliminates the antigen-dependent release of the chemotaxis of neutrophils and the suppression of mucocyllular vehicles. Salbutamol warns the appearance of bronchospasm caused by an allergen. It may cause a reduction of the number and desessitization of beta-adrenoreceptors, including lymphocytes. Salbutamol has a number of metabolic effects - reduces the concentration of potassium in plasma, acts on the release of insulin and glycogenolysis, has lipolytic and hyperglycemic (especially in patients with bronchial asthma) effect, increases the likelihood of acidosis.

Indications

Relief and prevention at bronchial asthma bronchospasm; Night asthma (tableted prolonged forms); symptomatic therapy of bronchological syndrome (including chronic bronchitis, emphyms, chronic obstructive pulmonary disease); The threat of premature births (in pregnancy time from 16 to 38 weeks).

Method of using salbutamola and dose

Salbutamol will be used inhalation, intravenously, inside (regardless of meals). Inhalation: stopping the starting attack of suffocation - 100-200 μg (1-2 inhalation); After 5 minutes, repeated inhalation is possible in the absence of effect; Further inhalations are made at intervals of 4-6 hours (no more than 6 inhalations per day); Regular application - 2-4 times / day 1-2 inhalation; Prevention of bronchospasm - use 15-20 minutes to contact with frosty air. Powder for inhalation: One-time dose is 200-400 mg (doses are twice as high due to lower bioavailability). During severe attack, the introduction of an inhalation solution with the use of various nebulizer structures for 5-15 minutes is possible; The initial dose of patients over 18 months is 2.5 mg (if necessary is 5 mg) up to 4 times a day. Inside, patients over 12 years old -3-4 times a day at 2-4 mg, the maximum one-time dose is 8 mg, daily - 32 mg; Children 6-12 years old -3-4 times a day at 2 mg, the maximum dose is 24 mg / day, children 2-6 years old - 3-4 times a day of 1-2 mg (0.1 mg / kg). Prolonged tablets: Patient over 12 years old - every 12 hours of 4-8 mg, the maximum dose is 32 mg / day (every 12 hours 16 mg), children 6-12 years old - every 12 hours 4 mg, the maximum dose is 24 mg / SUT (every 12 hours of 12 mg). As a tocolic agent: intravenously drip - 2.5-5 mg. Divorce in 500 ml of 5% solution of dextrose or 0.9% sodium chloride solution, the rate of administration of salbutamola depends on the portability of the drug and the intensity of the contour. Next is carried out by supporting oral treatment with salbutola in the form of tablets: 4-5 times per day 2-4 mg; The first tablet is accepted 15-30 minutes before the end of the infusion; The duration of treatment is 14 days.

When applying a dosed aerosol, the following instructions must be observed: before each use is to shake the balloon with an aerosol, clearly synchronize the flow of the drug and inhale, to produce the most deep enough, sufficiently long and intensive breath, after the drug inhalation is delayed by 10 seconds. Patients who are hard to perform a breathing maneuver is recommended for inhalation of the drug to apply spacers (special devices), which smooth inaccuracy asynchronous breath and increase the breathing volume. To increase the effectiveness of the patient's treatment, it is necessary to teach the correct use of the inhaler, at the beginning of therapy, use the inhaler under the control of medical personnel. The use of salbutamol when aggravating asthma in high doses leads to an increase in the intensity of the subsequent attack of choking (ricochet syndrome). With a severe seizure of the suffocation, the interval between the inhalations of Salbutamola should be at least 20 minutes. In the absence of minimal effects of inhalation or the development of tachycardia, pronounced tremor, arrhythmias are further uncontrolled the use of the inhaler contraindicated, you need to consult a doctor. The risk of complications increases with a significant duration of therapy, as well as a sharp cancellation of the drug.

Contraindications for use

Hypersensitivity, breastfeeding, pregnancy (for use as bronchodiolics), children's age (up to 4 years - for inhalation powder, up to 2 years - for a dosage aerosol without a spacer and for intake, up to 18 months for a solution for inhalations); Additionally, for administration intravenously as a tocoleic: intrauterine death of the fetus, infection of the generic paths, malformations of the fetus, bleeding with a premature delay of the placenta or the preteposition of the placenta; Threatening miscarriage (in 1 and 2 trimester of pregnancy).

Restrictions on application

Tahiaritimia, coronary heart disease, pronounced arterial hypertension, heart disease, myocarditis, severe heart failure, aortic stenosis, thyrotoxicosis, diabetes mellitus, pheochromocytoma, pronounced renal or / and liver failure.

Application in pregnancy and breastfeeding

The use of salbutamola is contraindicated during pregnancy and during breastfeeding.

Self-action Salbutamola.

Nervous system: Anxiety, tremor (usually brushes), tension, dizziness, increased excitability, sleep disorders, headache, short-term cramps;
circulation system: Tachycardia (including the fetus during pregnancy), heartbeat, arrhythmia, increase or decrease in blood pressure, expansion of peripheral vessels, heart failure, myocardial ischemia, cardiopathy;
digestive system: nausea, irritation or dryness in the oral cavity or sip, vomiting, loss of appetite;
others: Pharyngitis, bronchospasm (caused by hypersensitivity to salbutamol or paradoxical), sweating, difficult to urinate, increasing blood glucose, free fatty acids, dose-dependent hypokalemia, development of mental and physical drug addiction, allergic reactions in the form of edema, erythema, difficulty breathing.

Salbutamola's interaction with other substances

Salbutamol increases the cardiotropy of the thyroid hormones, the activity of stimulants of the central nervous system. Ephedrine and theophylline reinforce the toxic effects of salbutamola. Inhibitors of the synthesis of prostaglandins, corticosteroids, Mao blockers and tricyclic antidepressants increase the possibility of complications from the circulatory system, levodopia and means for inhalation anesthesia - heavy ventricular arrhythmias. Salbutamol reduces the effectiveness of antihypertensive agents, beta-adrenobloclars (including ophthalmic forms), anti-infanal effect of nitrates. Salbutamol increases the risk of intoxicating glycosides when sharing.

Overdose

Under the overdose of salbutamol, the decrease in blood pressure is developing, tachycardia (pulse rate up to 200 strikes per minute), ventricular fluttering, raising heart rate, acidosis, hypoxemia, hyperglycemia, hypokalemia, headache, muscle tremor, excitation, cramps, hallucinations. It is necessary: \u200b\u200bCancel Salbutamola and the conduct of symptomatic treatment; The use of selective beta-adrenobloclars in patients with bronchial asthma due to the danger of the development of severe bronchospastic reaction requires extreme caution.

Trade names of drugs with the active substance Salbutamol

Aloprol. Astalin Ventolin® Ventolin® Light breathing Ventolin® Nebules Volmax® Salamol Salamole Sherry Sky

Salamol Eco Salamol Eco Light Breathing Salmo. Salben® Salbouvent Salbutamol. Salbutamol base

Content

According to WHO (World Health Organization) for 2019, 235 million people on the planet suffered from bronchial asthma. The disease is dangerous than the possibility of asthmatic status: the edema bronchiol, the accumulation of sputum, which lead to suffocation during asynchronous breath. The relief of the attacks of the disease in modern medicine occurs with the help of bronchodilitics and mucolyts in an aerosol or tableted form.

Instructions for the use of salbutamola

This agent refers to the group of selective beta2 adrenomimetics and is not included in the hormonal category. The main purpose is to intensive relieving and preventing the spasmodic attacks of bronchi. Salbutamol does not treat bronchial asthma, but effectively removes symptoms. The medicine is used to reduce risk at premature births. The substance maintains the livelihood of the fetus to 37-38 weeks during generic events.

Composition and form of release

The drug is produced officially in three types, but under other brands it is present in the market in fact in all types of medicines: retard tablets, inhalation solution, syrup, injection solution, etc. The composition and amount of salbutamol sulfate (MNN - Salbutamol) depends on the form factor of the medicine. The type of means is selected depending on the intensity of the attacks, their character and personal characteristics of the patient. What dosages of the active substance salbutamol are present on the pharmacological market:

	Form release	Number of active substance in one dose, mg
	Aerosol (auxiliary substance - ethanol)
	Tablet
	Tablet retard (prolonged action)
	Powder for inhalations
	Oral syrup
	Inhalation solution
	Solution in ampoules
	Injection solution

Pharmacological group Salbutamol

The drug refers to tocolics and beta-adrenoreceptors: clinical and pharmacological groups of anti-inflammatory, musolitic, bronchhalytic, expectorant action. The substance is quickly absorbed into the blood in any form of release, but its plasma concentration is minimal or not detected. Salbutamol is metabolized in the liver and partially in the intestines (in light metabolization does not occur). The semi-elevator and output from the blood takes 2-7 hours in the maximum amount through the urine (approximately 4% comes with bile).

Mechanism of Salbutamola

The active substance will be bought by increasing bronchospasm, increases the life capacity of the lungs. The medicine stimulates the expansion of the coronary arteries of the heart, reduces resistance in the respiratory tract, improves the functionality of the shimmer epithelium of the bronchi. Salbutamol-containing substances reduce potassium concentration in blood plasma. Inhalation and oral forms of drugs begin to act in 5 minutes, the maximum impact quality occurs within 30-90 minutes.

After exposure, the vital volume of the lungs increases, the release of chemotaxis factors, histamine in the extracellular space is blocked. The substance stimulates the normal cleavage of glycogen to glucose (glycogenolysis), secretion of insulin hormone. In some cases, the activity of the substance increases the risk of a lactatacidotic coma against the background of a hyperglycemic and lipolytic effect, the development of extrasystole.

Indications for use

Salbutamol and its derivatives are designed to relocate symptoms of bronchial asthma. Additionally, they are effective in bronchitis and similar diseases. Salbutamol is used for auxiliary with premature childbirth (up to 37-38 weeks). The medicine is effective for asthmatics during acute attacks, but has a smaller impact as prophylactic in comparison with the analogs. The main pathological diseases and conditions under which the use of the substance is recommended:

• prevention of spasmodic processes at bronchial asthma of any forms of leakage;
• stopping attacks choking;
• stabilization and improvement of the patient's condition in reversibility of bronchial obstruction;
• prevention of complications of bronchitis;
• broncho-obstructive syndrome in children;
• relative to the high sudine of the contractile activity of the uterus (pathology is dangerous for a period of up to 37 weeks).

Method of application and dosage

Dosing directly depends on the age of the patient, the type of disease, the form of the drug. In most diagnostic episodes, children 6-12 years old are obtained half an adult dose (for patients with age from 2 to 6 years, the substance is assigned individually). Dosage in tablets, injections, aerosols, etc. It is significantly different, therefore it is strictly forbidden to independently change the forms of the medication, focusing on the former amount of substance.

Sample with salbutomol

The primary use of the substance with which the possible asthmatic is facing is a survey of the FVD (external respiratory functions). Sample is done using Salbutamol, as a result of the decryption of which is made of an accurate diagnosis of the respiratory system. If the patient complains about breathing problems or they are detected during surveys, the doctor sends a patient for testing. Causes for the appointment of Salbutamol sample:

• chronic respiratory diseases - bronchitis, pneumonia, asthma;
• pathology with primary lesions of the vessels of the lungs;
• defects of the location or functioning of the diaphragm;
• neurosis;
• lung emphysema;
• cardiopathy;
• detection of allergens;
• violation of hemostasis;
• provoked shortness of breath;
• future surgical intervention with intubation anesthesia.

Salbutamol for inhalations

The most convenient and common form of drug use is to inhalation of the active substance for the relief and prevention of attacks. This is possible in the form of an aerosol or powder. It is important to remember that the active substance begins to act in about 5 minutes. Many patients who cannot withstand this period often get overdose problems.

Salbutamol aerosol

The aerosol form of the drug has a dosage of 1-2 press (dose) for adults and one children. In the absence of a reaction of the body after 10 minutes, one more use is allowed. After that - a mandatory break for 4-6 hours (!!!). The daily rate of the active substance should not exceed 8 doses. In rare acute cases (weak perception of the drug) for the purpose of the doctor, the dosage may increase.

Powder for inhalations

The powder form is entered from the cyclohaler (disk inhaler). To buy spasms, use one dose (if they occur irregularly). Preventive reception is 3-4 dosages. The amount of drug in one dose 200/400 μg. Daily reception with a normal course of the disease - 0.1-8 mg, but may increase to 1.2-1.6 mg.

Syrup

Salbutamol is recommended in such a form to combine with mulitics (bromgexin, ambroxol) to obtain a qualitative therapeutic effect. The syrup action is aimed at strengthening expectoration. This is due to the expansion of the respiratory tract, and not changes in the consistency of sputum. Adults are prescribed 4-8 mg / day, children 6-12 years old - 2 mg / day, 2-6 years - 1-2 mg / day. It is important to carefully calculate on the basis of the active substance, because the amount of different syrups is different.

Injection

Intravenous administration of the drug is prescribed to women in early childbirth (up to 38 weeks). The mixture is prepared in proportion: 5 mg of SALBUTAMOL solution, 5% dextrose solution, 0.9% sodium solution chloride, water for injection. Relevant dose of the drug - 500 ml. The rate of administration depends on the intensity of the uterus cuts (20-40 Cop / Minute), but should not exceed 120 CAP / min. Next assigns supporting therapy based on tablets. Also, parenteral administration is used to relieve bronchospast syndrome (individual dosage).

Concentrate for infusion solution

Produced for the preparation of injection doses and as a component for salbutamol-containing drugs. In its pure form, as a medicinal product - not applied. The concentrate is used exclusively as a real base of pharmacological production. The contact of the concentrated solution into the body is fraught with heavy poisoning flesh to death.

Salbutamol in tablets and capsules

This form of the drug is assigned to expand the bronchus. Adults and adolescents up to 12 years, the course is 1 tablet 3-4 times a day. The concentration of the drug in pill is 2 or 4 mg. The daily dosage of 4 mg tablets is prescribed during acute forms of diseases. Capsules have a prolonged action due to the special design of the shell at the same concentration of the active substance, although some manufacturers are released in a capsule form standard tablets. The formal duration of the purchased drug effect should be specified.

special instructions

Salbutamol is an aggressive drug of active action, so the cessation of reception, an increase in the dose or number of doses per day is performed under the control of the doctor. Patients with heavy forms of bronchial asthma should be regularly monitored by the period of serum concentration of potassium. The tableted form due to the high concentration of the active substance in some cases gives a pacemulatory effect. Diseases that need to monitor when receiving Salbutamol, and other points to which you want to pay attention to:

• diabetes;
• aortic stenosis;
• thyrotoxicosis;
• glaucoma;
• ischemia;
• myocarditis;
• thyroid diseases;
• heart disease;
• acute heart failure;
• chronic problems of the cardiovascular system;
• the drug is prohibited by the World Anti-Doping Agency (WADA), because it may cause a short-term increase in endurance due to Ephedrine;
• there is a risk of drying hypokalemia against the background of hypoxia.

During pregnancy

The drug is prohibited in 1 and 2 trimester in the threat of miscarriage, bleeding, premature placenta detachment. Not used in 3 trimester in the presence of pronounced toxicosis. Modern medical practice does not have objective data on how Salbutamol affects after introducing into a vein on the fruit. The substance is released along with breast milk, so its use should be correlated with possible harm to the fetus or newborn.

Children

Salbutamol does not apply in patients under 2 years old. Dosage for older children (2-6 years) is prescribed from a landmark 1-2 mg of active substance per day. For patients of the age group of 6-12 years - 2mg / day. Treatment occurs under the permanent control of the pediatrician, because the children's body can be non-standard to respond to the drug (exercise supersensitive or not to perceive it in due measure).

Medicinal interaction

Salbutamol enhances the effectiveness and impact of some stimulants of the CNS (central nervous system). Parallel reception with preparations relating to non-selective β-adrenoblockers (propanol) is not recommended. Theophylline type xanthines when interacting with salbutomol increase the risk of developing tachyritium. Glucocorticosteroids and diuretics are enhanced by hypokalemic syndrome. The drug levels the effect of means for the treatment of angina.

Tricycline antidepressants or Mao inhibitors can lead to a sharp drop in blood pressure. When combining with SalButamol, the effectiveness of nitrates, hypotensive drugs is dramatically reduced. Medication with simultaneous reception with anticholinergic drugs in some cases provokes an increase in intraocular pressure.

Side effects

When compliance with therapeutic dosage, the drug in the form of an aerosol does not cause side symptoms. Rarely manifests the negative manifestations during oral administration. Excess one or daily dose, personal hypervisibility to β2 adrenergic stimulants can be accompanied by tremor fingers and hands, internal tensions, shiver. In parallel, moderate tachycardia, dizziness, expansion of peripheral vessels, vomiting, convulsions, headache, nausea, erythema is developing.

In rare cases, the reaction to Salbutamol is expressed in the gloomy, skin rash. One-time cases of hypotension, bronchospasm, angioedema edema, collapse were recorded. The drug causes active leaning from potassium blood plasma, so patients with predisposition to Caliamia should regularly monitor its level. Cases of hallucination, panic states after receiving salbutamola are extremely rare.

Overdose

The drug even when dosing in rare cases is observed, negative side effects provokes. With overdose, Sulbutovol should immediately terminate the use of this medicine. Symptomatic therapy and reception of cardiolective beta blockers are prescribed. In parallel, the period of serum concentration of potassium is constantly monitored. Common overdose symptoms:

• veretrics;
• acidosis on the background of a lipolytic effect;
• muscle tremor;
• hypoxemia;
• arrhythmia;
• physical weakness;
• change of hypoglycemia on hyperglycemia;
• strengthen side effects.

Contraindications

The drug has a large list of contraindications, in which the use of salbutamol is categorically not desirable. Officially, it will not be possible to purchase it independently, so before a possible purpose, the doctor checks the presence of the following list of pathologies. If there is even one of them, the remedy for another pharmacological basis is selected. Salbutamol does not apply if a history is present:

• increased sensitivity to the components of the drug;
• pathological violation of the heart rate (for example. Paroxysmal tachycardia);
• heart disease;
• myocarditis;
• stenosis of the mouth of aorta;
• coronary artery disease;
• thyrotoxicosis;
• hyperthyroidism;
• decompensated diabetes;
• epilepsy or risk of epiprigances;
• glaucoma;
• renal or liver failure;
• pregnancy.

The drug is not appointed for children up to 2 years and in combination with non-selective beta-adrenoblockers. The use of salbutamola occurs under constant control in patients with hyperthyroidism, feochromocytoma, arterial hypertension, severe chronic heart failure. Separately, there are a number of reasons for the refusal of intravenous introduction of the substance in women:

• intrauterine fetal death;
• infection of generic pathways;
• bleeding associated with the prelationship of the placenta, the integrity of the integrity of the myometrium;
• the threat of spontaneous abortion by 1-2 trimester;
• late heavy toxicosis.

Terms for sale and storage

The medicine is sold exclusively by recipe. Inhaler Salbutamol should be stored outside the access of children protected from direct sunlight exposure. The aerosol must be protected from shocks and drops, not heated, not even the used can, do not freeze. Tableted, liquid, syrupped form are stored as any other medicines.

Analogs

Salbutamola's synonyms are used in case of insufficient effectiveness of a particular basic means, personal intolerance to some of the components or financial accessibility. The list of analogs is present generic, which is structurally a complete copy of Salbutamola at a reduced value. Popular preparations used as replacement:

• Ventoline - Generic (structural analogue, chemical derivative of epinephrine) stops seizures of suffocation, with diseases that are accompanied by obstructive manifestations (bronchitis, bronchial asthma, chronic obstructive pulmonary disease);
• Astalin - treatment and prevention of bronchial spasms, lung enfism;
• Valtorn - urgent ambulance with acute bronchospasm;
• Salamol - the relief and prevention of attacks during the period of exacerbation;
• Salbugexal is a similar action to Salamol.

Salbutamol or Berodual

Often patients with bronchial asthma and similar respiratory diseases are trying to choose between two means that are extremely similar in composition. It should be remembered that the active substances are different and affected by different directions. Salbutamol, in addition to breathing problems, used in gynecology, has practically no side effects, irreplaceable for emergency removal of spasms. Separately, you need to mention a wide range of output forms, which gives a choice for any clinical case.

Berodual (two-component drug) requires less dosage, effective in chronic and acute inflammatory diseases in the field of bronchi. At the same time, the spectrum of contraindications of this means is extensive than that of Salbutamola. The means are multidirectional, with a different therapeutic effect with the general similarity of the compositions. A specific medicine prescribes a doctor based on the history of the disease of the personal perception of the drug. To say it is confident that some reason is more effective, it is impossible.

Price salbutamola

The drug has more than 10 types of release, which gives a wide range of prices. The medicine refers to the average price group, which falls under the state regulation of the cost (vital funds). Salbutamol and its generics are presented in all regions, but accessible as a prescription drug, not in each pharmacy. The average price in Moscow and the region is not radically different from the All-Russian.

Beta adrenomimetics with predominant effect on 2-adrenoreceptors.
Preparation: Salbutamol
The active substance of the drug: Salbutamol
ATH encoding: R03CC02
KFG: Broncholic drug - beta2-adrenomimetics
Registration number: P №015633 / 01
Registration date: 04/28/04
Owner reg. Undoj: Warsaw Pharmaceutical Work Polfa S.A. (Poland)

Release form Salbutamol, Packaging of the drug and composition.

Pills
1 tab.
Salbutamol.
2 mg

15 pcs. - Packaging cell contour (2) - packs.
Pills
1 tab.
Salbutamol.
4 mg

30 pcs. - Flakes (1) - packs.

Description of the active substance.
All the information provided is presented only for familiarization with the drug, the possibility of application you need to consult with the doctor.

Pharmacological action Salbutamol

Beta adrenomimetics with predominant effect on 2-adrenoreceptors (localized, in particular, in bronchi, myometry, blood vessels). Warns and stops bronchospasm; Reduces resistance in the respiratory tract, increases the life capacity of the lungs. Prevents the isolation of histamine, a slowly reacting substance from the fat cells and the factors of chemotaxis neutrophils. Compared to other drugs of this group, there is a less pronounced positive chrono- and inotropic effect on myocardium. Causes the expansion of coronary arteries, practically does not reduce blood pressure. It has a tocolic effect, lowering the tone and the contractile activity of myometrium.

Pharmacokinetics of the drug.

When applying an aerosol, there is a rapid suction of salbutamola in blood; However, its blood plasma concentrations when applied in the recommended doses are very low or no detection limit.

After taking inside, salbutamol is well absorbed from the gastrointestinal tract. Binding of plasma proteins is 10%. Metabolized with the "first passage" through the liver and, possibly, in the intestinal wall; The main metabolite is an inactive sulphate conjugate. Salbutamol is not metabolized in the lungs, thus its final metabolism and elimination after inhalation depends on the method of use, which determines the ratio between the inhaled and unassamed swallowed salbutola.

T1 / 2 from blood plasma is 2-7 hours. Salbutamol is quickly excreted in the form of metabolites and unchanged substances; In small quantities is displayed with the feces.

Indications for use:

Warning and relief of bronchospasm with all the forms of bronchial asthma. Reversible obstruction of the respiratory tract with chronic bronchitis and emphysema of the lungs, the broncho-structure syndrome in children.

Threatening premature birth with the contractile activities of the uterus; childbirth up to 37-38 weeks of pregnancy; Eastic-cervical insufficiency, a decrease in the heart rate, depending on the cuts of the uterus during periods of the cervix and expulsion. In preventive purposes in operations at a pregnant uteride (the imposition of a circular seam in the insufficiency of the internal gloom of the uterus).

Dosage and method of use of the drug.

Inside, as an armored drug with adults and children over 12 years old - 2-4 mg 3-4 times / day, if necessary, the dose can be increased to 8 mg 4 times / day. Children aged 6-12 years - 2 mg 3-4 times / day; Children 2-6 years old - 1-2 mg 3 times / day.

In the inhalation administration, the dose depends on the dosage form used, the frequency of application depends on the testimony and clinical situation.

As a tocolic agent introduced in / in drip at a dose of 1-2 mg.

Self-action Salbutamol:

From the side of the cardiovascular system: the transient expansion of peripheral vessels, moderate tachycardia.

From the CNS: Headache, dizziness, nausea, vomiting.

From the metabolism: hypokalemia.

Allergic reactions: in isolated cases - angioedema edema, allergic reactions in the form of skin rash, urticaria, arterial hypotension, collapse.

Others: tremor hands, inner trembling, tension; Rarely - paradoxical bronchospasm, muscle cramps.

Contraindications for the drug:

Threat of miscarriage in I and II trimesters of pregnancy, premature detachment of placenta, bleeding or toxicosis in the third trimester of pregnancy; Children's age up to 2 years; Increased sensitivity to salbutamol.

Application during pregnancy and lactation.

Salbutamol is contraindicated in the threat of miscarriage in the I and II trimesters of pregnancy, premature details of the placenta, bleeding or toxicosis in the third trimester of pregnancy.

If you need to use salbutamol during pregnancy, the expected benefit of the treatment for the mother and potential risk for the fetus should be correlated. Currently, there is not enough data on the safety of Salbutamola's use in the early period of pregnancy. Salbutamol is distinguished with breast milk, so if necessary, use during the lactation period should also be assessed by the expected beneficial benefit for the mother and the possible risk for the child.

Special instructions for the use of salbutamol.

Caution is used in tachyarhyrahythmias and other violations of cardiac rhythm, arterial hypertension, myocardium, heart defects, aortal stenosis, diabetes mellitus, thyrotoxicosis, glaucoma, acute heart failure (subject to careful control of the doctor).

Increasing the dose or reception frequency of salbutamola should be carried out under the control of the doctor. The interval reduction is possible only in exceptional cases and should be strictly reasonable.

When using salbutamol, there is a risk of hydrocalemia, so during the treatment period in patients with a bronchial asthma of severe flow should control the level of potassium in the blood. The risk of hypokalemia increases with hypoxia.

The interaction of salbutamol with other drugs.

With the simultaneous use of salbutamol with necrotaelective beta-adrenoblockers, mutual suppression of therapeutic effects is possible; With theophylline - risk of tachycardia and arrhythmias, in particular, supraventic extrasistoly increases.

With the simultaneous use of salbutamol and xanthine derivatives, GKS or diuretics, risk of hypokalemia is increasing.

Structure

Active substance: Salbutamola Sulfate 120.5 μg in one dose (equivalent to 100 μg salbutamola).

Auxiliary substances: propellant GR106642X (1,1,1,2-tetrafluoroethane, also known as HFA 134a or Norflouran). Does not contain chlorofluorocarbon phones.

Description

Metal inhaler with an indulged bottom, equipped with a dosing valve containing a suspension of white or almost white. There should be no damage on the inner surface of the inhaler.

Pharmacotherapeutic group

Means for the treatment of obstructive diseases of the respiratory tract. Adrenergic means for inhalation. Selective beta-2-adrenoreceptor agonists.

The codeATH:R03ac02.

Pharmacological properties

Pharmacodynamics

Salbutamol is a selective agonist of beta-2-adrenoreceptor.

After the inhalation use, Salbutamol has a stimulating effect on the Beta-2-adrenoreceptors of the smooth muscles of the bronchi, thus providing quick bright browsection, which manifests itself in a few minutes and is preserved for 4-6 hours.

Pharmacokinetics

Salbutamol.

After the inhalation administration of the drug, its concentration in the blood plasma when taking ordinary doses is minor (10-50 times less than when administering the drug orally or by injection).

The relationship between the level of concentration in the blood and the effectiveness is absent. After pulmonary resorption, the drug is excreted mainly by the kidneys, partly unchanged (less than 2%), partly - in the form of inactive metabolites (phenolic sulfates).

1,1,1,2 - tetrafluoroethan: Obesting gas

After the inhalation administration of the drug, the adsorption of 1,1,1,2-tetrafluoroethane is insignificant and fast, the maximum concentration is achieved less than in 6 minutes.

In animals (mice and rats) there was a minor liver metabolism of the drug with the formation of trifluoroacetic acid and trifluoroacetic aldehyde. Nevertheless, according to the results of kinetic studies conducted among patients receiving 1,1,1,2-tetrafluoroethane in the presence of pathologies, cases of formation of trifluoroacetic acid were not detected.

Indications for use

Symptomatic treatment of bunches of bronchial asthma.

Symptomatic treatment of exacerbations of bronchial asthma or chronic obstructive bronchitis.

Preventing asthma attacks caused by exercise.

Test for the reversibility of bronchial obstruction during the functional studies of the respiratory tract.

Contraindications

Allergic reaction to one of the components of the drug.

The intolerance to this medicinal product (the unexpected appearance of cough or the development of bronchospasm immediately after receiving the drug). In this case, it is necessary to discontinue treatment and assign other therapy or other methods of application.

Application during pregnancy and lactation

Pregnancy

Salbutamol.

In clinical practice, there is a sufficient amount of documented examples of the use of the drug during pregnancy, which makes it possible to conclude about the safe use of Salbutamola during pregnancy.

Consequently, the use of salbutamol during pregnancy by inhalation administration is permissible.

When taking the drug during pregnancy:

A fetal heartbeat may be observed against the mother's tachycardia. In exceptional cases, the stupid heartbeat after birth is noted.

Similarly, in exceptional cases, a postnatal change in the level of glycemia is noted.

In the case of drug intake to childbirth, the vasodilator peripheral effect of beta-2-mimetics should be taken into account.

1,1,1,2 - tetrafluoroethan: Obesting gas

Reproductive function studies conducted on animals did not reveal the harmful effects caused by a reception of 1,1,1,2-tetrafluoroethane, which is contained in this drug.

Nevertheless, the consequences of the reception of 1,1,2-tetrafluoroethane in pregnant women are not installed.

Lactation

Beta-2-mimetics penetrate breast milk.

The fact of penetration of the displacing gas and its metabolites into breast milk during the receipt of the drug is not installed.

Fertility

Information about the influence of Salbutamola on fertility in humans is missing. In preclinical studies of undesirable influence on fertility, animals were not identified.

Method of application and dose

Dosage

Regardless of age:

Treatment of attacks and aggravations of bronchial asthma: when the first symptoms appear to make 1-2 inhalations.

Prevention of asthma attacks caused by exercise: 1-2 inhalations 15-30 minutes before the start of physical activity.

In general, the dose of 1-2 inhalation is sufficient to treat breathing difficulties.

In the case of stability of symptoms, the dose can be repeated in a few minutes.

The duration of the bridal action of salbutamol during inhalation administration ranges from 4 to 6 hours.

In the case of repeated occurrence of symptoms, the drug can be repeated.

Typically, the daily dose of the drug should not exceed 8 inhalations within 24 hours. If this dose is exceeded, the patient should be informed about the need for medical consultation in order to revise the indications for use (see the section "Precautions").

In the case of a severe acute attack of asthma or severe exacerbation of chronic obstructive bronchopneumopathy, the dose of the drug ranges from 2 to 6 inhalations, which should be repeated every 5-10 minutes before the arrival of emergency medical care professionals. In such situations, the use of an inhalation chamber is recommended, since it contributes to the acceleration of the pulmonary diffusion of salbutamola adopted by inhalation. However, repeatedly pressing the dosage inhaler and the release of doses into the inhalation chamber can shorten the total inhaled dose, and the patient must inhale the drug directly (or, if necessary, after each series of two consecutive clicks) from the inhaler after each pressing on the inhaler. In the future, the reception of the drug should be repeated by sequential cycles. A severe acute attack of bronchial asthma requires hospitalization. In this case, treatment is to carry out oxygen therapy and systemic therapy with corticosteroids.

Mode of application

Inhalation administration using a device in the form of a hermetic spray equipped with mouthpiece.

In order to correctly use the device, the doctor is recommended to make sure that the patient uses the inhaler correctly.

In the case of the patient, there is no synchronization of inhalation and pressing the inhaler, the use of an inhalation chamber is shown. Also in such patients it is possible to use other more adapted species of sallbutamol dosage forms.

In children and infants who need to treat a suspension for inhalations salbutamol in the form of an aerosol, it is advisable to use an inhalation chamber equipped with a spacer.

The inhaler is not equipped with a dose counter.

Side effect

Unwanted reactions are listed depending on the anatomy-physiological classification and frequency of occurrence, which is defined as follows: Very often (≥ 1/10), often (≥ 1/100 and

Organ class	Side effects	Frequency
From the immune system	Hypersensitivity reactions, including: angioedema edema, urticule, strong itching, bronchospasm, hypotension, collapse.	Rarely
From the metabolism	Hypokalemia. *	Rarely
From the nervous system	Headache, tremor.	Often
Mental disorders	Conduct disorders: irritability, excitement.	Rarely
From heart	Tachycardia	Often
	Heart palpitations	Infrequently
	Heart arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystole).	Rarely
	Myocardial ischemia (see section "Precautions").	Frequency unknown **
From the vessels	Peripheral vasodulation.	Rarely
From the respiratory system, chest and mediastinal organs	Paradoxical bronchospasm ***	Rarely
From the gastrointestinal tract	Irritation of the mucous membrane of the oral cavity and pharynx.	Infrequently
From the bone-muscular system	Muscular cramps	Infrequently

* Beta-2-mimetics in elevated doses can cause reversible hyperglycemia and hypokalemia during the cessation of treatment.

** The frequency of the myocardium ischemia is not possible, since it was reported in spontaneous reports obtained during post-paying surveillance.

*** As with the use of other drugs for inhalation therapy, there is a possibility of cough and, in rare cases, paradoxical bronchospasm immediately after inhalation. It is recommended to stop taking this medicinal product and use another equivalent bronchottizer of quick action to facilitate bronchospasm. In the future, it is recommended to reconsider treatment to assign alternative therapy if necessary.

Extremely rare cases of lactatacidosis in patients taking salbutamol intravenously either by inhalation administration using a nebulizer in the treatment of severe exacerbation of bronchial asthma were noted.

Digestion (nausea, vomiting) can also be noted.

Informing about possible side effects

The provision of information on suspected adverse reactions identified after registration is of great importance, as it makes it possible to conduct continuous monitoring of the benefit balance and risk of drugs. Report any suspected adverse reactions of health care specialists can through a national system of informing.

Overdose

The symptoms and symptoms of the overdose of salbutamol are transient phenomena expressed in strengthening the pharmacodynamic effect of beta-2-agonists (see Sections "Precautions" and "Sidey").

The consequence of the overdose of Salbutamola may be hypocalemia. Therefore, in the event of an overdose, control of the concentration of potassium in serum is necessary.

Cases of nausea, vomiting and hyperglycemia were noted mainly in children and in cases where an overdose was due to oral administration of salbutamola.

Cases of lactatacidosis were noted when receiving elevated doses of beta-2-agonists of quick action. Consequently, under overdose, it is necessary to control the concentration of lactate in the blood of the blood, as well as the risk of lactatacidosis, in particular, in the case of stability or the deterioration of Tahipne, despite the disappearance of such symptoms of bronchospasm as a whistling breath, which may be associated with the development of metabolic acidosis.

Required actions: observation and symptomatic treatment.

Interaction with other drugs

+ Non-selective beta blockers

+ Halogen preparations for anesthesia (galotan)

When conducting obstetric surgical operations, an increase in the inertia of the uterus with the risk of bleeding was noted; In addition, there is a risk of developing serious ventricular arrhythmias when improving cardiac reactivity.

Combinations requiring compliance with precautions when used

+ Antidiabetic drugs

The reception of beta-2 mimetics is combined with an increase in glycemia, which can be interpreted as a decrease in the effect of antidiabetic therapy, therefore, it may be necessary to change anti-diabetic therapy (see section "Precautions"). Advanced control of blood and urine condition is recommended.

Precautions

special instructions

Inform the patient about the need to immediately appeal for medical assistance in the event that the previously observed facilitation of the state occurs in the development of the attack of bronchial asthma.

Increasing the need for the use of broutine, in particular beta-2-agonists, may be a sign of the exacerbation of bronchial asthma or obstructive bronchopneumopathy. If for several days the patient's need for the consumption of beta-2-mimetic bronchodulators of long and short action by inhalation administration increased significantly, it should be feared (in particular, if the peak values \u200b\u200bof the flow meter decrease and / or become irregular) respiratory decompensation, and asthmatics are opportunities development of asthmatic status. Consequently, the doctor must inform the patient about the need to immediately appeal in a similar case for medical care without intentional exceeding the maximum prescribed doses. In such a situation, it is necessary to revise indications for use.

A sudden and progressive aggravation of the flow of bronchial asthma may be dangerous for life. In such a situation, it is necessary to provide therapy with corticosteroids or an increase in the dosages of existing therapy with corticosteroids. In addition, in adult patients suffering from asthma, inhalation therapy with corticosteroids should be carried out in the case when the use of mimetic beta-2-agonists is more often 1 time per week. In this case, it is necessary to inform the patient that the improvement of its clinical condition should not be a consequence of changes in therapy, in particular, the cessation of inhalation corticosteroids without a medical detention.

As with the use of other drugs for inhalation therapy, immediately after the use of the drug can develop paradoxical bronchospasm, which is manifested in a more pronounced breathing and strengthening wheezing. Bronchospasm requires the treatment of an alternative form of release of the drug or another bronchoditator for inhalation therapy (if available). The use of the drug Salbutamol inhalation should be immediately terminated and, if necessary, assign another high-speed broutine to continue treatment.

Drugs with sympathomimetic effects, to which salbutamol relates, can cause violations of the cardiovascular system. According to the data obtained during the previous period of the use of the drug, as well as in the literature, cases of the development of myocardial ischemia associated with the use of Salbutamola were noted. Patients with a severe cardiopathy of the underlying departments (for example, IBS, arrhythmia or severe heart failure) should be informed about the need to appeal to the attending physician in the event of pain in the chest or other symptoms indicating the exacerbation of heart disease. Attention should be paid to the assessment of such symptoms such as shortness of breath and pain in the chest, which can be a consequence of both heart disease and diseases of the respiratory system.

Precautions when using

In the case of bronchial infection or abundant bronchio breeding, appropriate treatment should be provided, which contributes to the optimal diffusion of the drug in the respiratory tract.

Salbutamol should be appointed with caution to patients receiving significant doses of other sympathomimetic drugs.

Receiving salbutamola in conventional doses by inhaled administration using a device in the form of a hermetic can usually cause adverse reactions in patients suffering from hyperthyroidism, disorders of coronary blood circulation, obstructive cardiomyopathy, ventricular arrhythmia, arterial hypertension, diabetes, unlike salbutamol, the reception of which is carried out With the help of a nebulizer orally or by injection, which should be appointed with caution to such patients.

Therapy of beta-2-mimetics in elevated doses (especially when administered by parenterally or with a nebulizer) can lead to potentially severe hypokalemia, which can cause heart rate violations. In such cases, it is recommended to control the level of potassium in serum, in particular, while using xanthine derivatives, GKS, diuretics, due to hypoxia, as well as in patients with high risk of developing arrhythmia type "Pirouette" (the elongated Qt interval or therapy, capable of lengthening the interval Qt).

Like other beta-2-agonists of adrenoreceptors, Salbutamol can cause an increase in blood glucose. In patients suffering from diabetes, cases of ketoacidosis were noted. The concomitant use of corticosteroids can strengthen this effect.

Extremely rare cases of lactatacidosis associated with the use of increased doses of beta-2-agonists of short-acting, intravenously either by inhalation using a nebulizer, were noted mainly in patients undergoing therapy to relieve Bronchial Asthma exacerbation (see Side Action "). The increase in the content of lactic acid can cause difficulty breathing or compensating hyperventilation, which may be incorrectly interpreted as a sign of unsuccessful treatment of asthma due to an inappropriate increase in the dosage of beta-agonists of short-acting. Consequently, the risk of lactatacidosis should be an object of close observation, especially in severe cases.

Athletes:

Athletes should take into account that this drug contains a active substance that can show positive results when conducting anti-doping control tests.

Impact on the ability to drive a car and / or other mechanisms

There is no data.

Form release

200 doses to an aluminum inhaler equipped with a plastic dosing device with a protective cap. The inhaler and the dosing device in the assembled form along with the application instructions are placed in a cardboard pack.

FROMrocksucidity

2 years. Do not apply after the expiration date indicated on the package.

Storage conditions

At a temperature not higher than 30 ° C, do not freeze, prevent the effects of sun rays. Keep out of the reach of children.

Like most other inhalers in aerosol packages, salbutamol can be less effective at low temperatures. When cooling the canopy, it is recommended to get it from a plastic case and warm your hands for a few minutes. Caller cannot be disassembled, piercing and throwing into the fire, even if it is empty.

Conditions of vacation from pharmacies

On prescription.

Manufacturer

Legal address of the manufacturer:

Glaxo WELLOME PRODUCTION, FRANCE

23 RUE LAVOISIER - ZONE INDUSTRIELLE NO 2, EVREUX, FRANCE /

Glaxo Lelkom Production, France

Industrial Zone 2, Ryu Lavoisier 23, Evro, France.

For more information, contact the address:

Representation LLC "GlaxosmithKline Export Limited" (United Kingdom) in the Republic of Belarus

Minsk, ul. Voronoyansky, 7a, office 400

Tel.: +375 17 213 20 16; Fax + 375 17 213 18 66

Instructions for the use of inhaler

Check inhaler

Before the first use of the inhaler or in the event that the inhaler did not use 5 days and longer, remove the cap from the mouthpiece, slightly squeezing the cap from the sides, shake the inhaler well and click on the aerosol valve to release two inhalation doses into the air to make sure the inhale fee .

Using inhaler

Remove the cap from the mouthpiece, slightly squeezing the cap from the sides.

Inspect the mouthpiece from the inside and outside to make sure it is clean and does not contain extraneous particles.

Shake the inhaler well for uniform mixing the contents and to remove foreign particles.

Keep the inhaler between the index and thumbs in a vertical position, while the thumb should be located on the ground under the mouthpiece.

Make a slow deep exhalation, graze mouthpiece with lips, without squeezing his teeth.

Making a deep breath through the mouth, simultaneously press the upper part of the inhaler to release a single inhalation dose of salbutamola.

Hold the breath for a few seconds, remove the mouthpiece from the mouth, then slowly exhale.

To obtain a second dose, keeping the inhaler in a vertical position, wait about 30 s and then repeat step 3-7.

Tightly close the mouthpiece with a protective cap.

Attention! Performing stage 5, 6 and 7, you can not hurry. It should be inhaled as slowly as possible, immediately before pressing the inhaler valve. In the first few times it is recommended to practice in front of the mirror. If you see "fog", leaving the top of the inhaler or from the corners of the mouth, then you should start all over again from stage 3.

If the doctor gave you other instructions for using the inhaler, then keep them strictly. Contact your doctor if you have difficulty using the inhaler.

Cleaning inhaler

The inhaler must be cleaned at least once a week.

Remove the metal sprinkler from the plastic case and remove the mouthpiece cover.

Thoroughly rinse the plastic housing and the mouthpiece cover under the jet of warm water.

Dry the plastic housing and the mouthpiece cover is completely both outside and inside. Do not overheat.

Place the metal spray cylinder in the plastic case and wear the mouthpiece cover.

Do not immerse the metal balloon in the water.

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