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Pulmodual: Per 2.5 mL of Ipratropium bromide + Salbutamol contains 500 mcg of Ipratropium bromide and 2.5 mg of Salbutamol.
Dosage of Solution for Inhalation: Adult (Including Elderly Patients) and Adolescents over 12 years: One (1) ampoule (2.5 mL) every 6 to 8 hours.
For the Treatment of Acute Attacks: One (1) ampoule (2.5 mL) is sufficient for the prompt relief of symptom; in severe cases two (2) ampoules (5 mL) may be required if an attack has not been relieved by one (1) ampoule (2.5 mL).
Children 2 to 12 years: 3 drops/kg/dose (maximum dose 2.5 mg of salbutamol) every 6 to 8 hours.
Administration: Administer by oral inhalation via nebulization.
Prepare the nebulizer for use.
Remove the ampoule from the labeled strip by twisting and pulling. Hold the ampoule upright and twist off the cap, transfer the contents of the solution into the nebulizer reservoir.
Use the nebulizer according to the instruction provided by the manufacturer.
After use, discard any solution left in the reservoir and thoroughly clean the nebulizer.
Since the Ipratropium bromide + Salbutamol (Pulmodual) solution contains no preservatives, it is important to use the content immediately after opening. A new ampoule should be used for each administration to avoid microbial contamination. Discard partly used, opened or damaged ampoule.
Ipratropium bromide + Salbutamol (Pulmodual) solution for inhalation should not be mixed with other drugs in the same nebulizer.
Pulmodual MDI: Recommended Dose: Salbutamol Sulphate and Ipratropium Bromide Inhalation is for inhalation use only.
Patients should be made aware that Salbutamol Sulphate and Ipratropium Bromide Inhalation must be used daily for optimum benefit, even when asymptomatic.
Two inhalations four times a day. Patients may take additional inhalations as required; however, the total number of inhalations should not exceed 12 in 24 hours.
Mode of Administration: For inhalation use only.
Instruction for Use: Patients should be instructed in the proper use of their Inhalation. During inhalation, the patient should preferably sit or stand. The Inhalation has been designed for use in a vertical position.
Testing the Inhalation: Before using for the first time, patients should remove the mouthpiece cover by gently squeezing the sides of the cover, shake the inhalation well, hold the inhalation between the fingers and thumb with the thumb at the base, below the mouthpiece and release puffs into the air to make sure that it works. The inhalation should be shaken immediately before releasing each puff. If the inhalation has not been used for a week or more remove the mouthpiece cover, the patients should shake the inhalation well and release two puffs into the air.
Use of the Inhalation: 1. Patients should remove the mouthpiece cover by gently squeezing the sides of the cover.
2. Patients should check inside and outside of the Inhalation including the mouthpiece for the presence of loose objects.
3. Patients should shake the Inhalation well to ensure that any loose objects are removed and that the contents of the Inhalation are evenly mixed.
4. Patients should hold the Inhalation upright between fingers and thumb with their thumb on the base, below the mouthpiece.
5. Patients should breathe out as far as it is comfortable and then place the mouthpiece in their mouth between their teeth and close their lips around it. Patients should be instructed not to bite the mouthpiece.
6. Just after starting to breathe in through their mouth, patients should press firmly down on the top of the Inhalation to release Salbutamol Sulphate and Ipratropium Bromide Inhalation, while still breathing in steadily and deeply.
7. While holding their breath, patients should take the Inhalation from their mouth and take their finger from the top of the Inhalation. Patients should continue holding their breath for as long as it is comfortable.
8. To take a second inhalation, patients should keep the Inhalation upright and wait about half a minute before repeating steps 3 to 7.
9. Patients should immediately replace the mouthpiece cover in the correct orientation by firmly pushing and snapping the cap into position. The cover does not require excessive force and it will click into position.
Important: Patients should not rush stages 5, 6 and 7. It is important that patients start to breathe in as slowly as possible just before operating their Inhalation. Patients should practice in front of a mirror for the first few times. If they see "mist" coming from the top of their Inhalation or the sides of their mouth they should start again from stage 2.
Cleaning: The Inhalation should be cleaned at least once a week.
1. Remove the mouthpiece cover.
2. Do not remove the canister from the plastic casing.
3. Wipe the inside and outside of the mouthpiece and the plastic casing with a dry cloth or tissue.
4. Replace the mouthpiece cover in the correct orientation. The cover does not require excessive force and it will click into position.
5. Do not put the metal canister in water.
