سعر اتروفنت كومب اتش اف ايه 20/50مكجم بخاخ للاستنشاق 2023

Atrovent Comb HFA, one pressurised metered-dose inhaler with 200 puffs (10 ml) (Boehringer Ingelheim): ipratropium bromide 20 mcg + fenoterol hydrobromide 50 mcg per puff, a combined anticholinergic and beta2-agonist bronchodilator.

• Bronchodilator for the prevention and treatment of symptoms in chronic obstructive airway disorders with reversible bronchospasm, such as bronchial asthma and especially chronic bronchitis with or without emphysema; concomitant anti-inflammatory therapy should be considered in asthma and steroid-responsive COPD.Population: Adults and children over 6 yearsBoehringer Ingelheim (boehringerone.com)

• Most frequent in clinical trials: cough, dry mouth, headache, tremor, pharyngitis, nausea, dizziness, dysphonia, tachycardia, palpitations, vomiting, increased systolic blood pressure and nervousness.International label, same formulation · Boehringer Ingelheim (boehringerone.com)
• Other reported reactions include anaphylaxis/hypersensitivity, hypokalaemia, agitation, glaucoma, raised intraocular pressure, accommodation disorder, mydriasis, blurred vision, eye pain, arrhythmia, atrial fibrillation, supraventricular tachycardia, myocardial ischaemia, paradoxical bronchospasm, laryngospasm, pharyngeal oedema, stomatitis, gastrointestinal motility disorder, urticaria, angioedema, hyperhidrosis, muscle spasms, myalgia and urinary retention.International label, same formulation · Boehringer Ingelheim (boehringerone.com)

• Known hypersensitivity to fenoterol hydrobromide, atropine-like substances or any excipient; hypertrophic obstructive cardiomyopathy; tachyarrhythmia.International label, same formulation · Boehringer Ingelheim (boehringerone.com)

• Immediate hypersensitivity reactions (urticaria, angio-oedema, rash, bronchospasm, oropharyngeal oedema, anaphylaxis) may occur. Paradoxical bronchospasm may be life-threatening: stop immediately and use alternative therapy.International label, same formulation · Boehringer Ingelheim (boehringerone.com)
• Use with caution in patients predisposed to narrow-angle glaucoma; spray contact with the eyes has caused mydriasis, raised intraocular pressure, narrow-angle glaucoma and eye pain. Patients must avoid spraying into the eyes; symptoms of acute glaucoma require miotic drops and immediate specialist advice.International label, same formulation · Boehringer Ingelheim (boehringerone.com)
• Use only after careful risk/benefit assessment (especially above recommended doses) in insufficiently controlled diabetes, recent myocardial infarction, severe organic heart or vascular disorders, hyperthyroidism, phaeochromocytoma, or urinary outflow obstruction (e.g. prostatic hyperplasia, bladder-neck obstruction).International label, same formulation · Boehringer Ingelheim (boehringerone.com)

• Other anticholinergic drugsChronic co-administration has not been studied and is not recommended.Boehringer Ingelheim (boehringerone.com)
• Other beta-adrenergics, systemic anticholinergics and xanthine derivatives (e.g. theophylline)May enhance the bronchodilator effect and increase adverse reactions.Boehringer Ingelheim (boehringerone.com)
• Beta-blockersPotentially serious reduction in bronchodilatation.Boehringer Ingelheim (boehringerone.com)

• Preclinical data and human experience show no evidence of adverse effects of fenoterol or ipratropium in pregnancy; the usual precautions for drugs in pregnancy, especially in the first trimester, apply. The inhibitory effect of fenoterol on uterine contraction should be taken into account.International label, same formulation · Boehringer Ingelheim (boehringerone.com)
• Fenoterol hydrobromide is excreted into breast milk in non-clinical studies; it is unknown whether ipratropium is, but it is unlikely to reach the infant to an important extent by aerosol. Use with caution in nursing women.International label, same formulation · Boehringer Ingelheim (boehringerone.com)

• Ipratropium bromide: Quaternary ammonium anticholinergic that antagonises acetylcholine at muscarinic receptors on bronchial smooth muscle, inhibiting vagally mediated bronchoconstriction; bronchodilation results from local drug concentrations in the airways rather than systemic levels.
• Fenoterol hydrobromide: Direct-acting sympathomimetic, selective for beta2-receptors at therapeutic doses; raises intracellular cAMP and relaxes bronchial smooth muscle (Berodual Product Information).