Rhea Ipratropium + Salbutamol Dosage/Direction for Use

Ipratropium bromide + salbutamol solution for inhalation in unit dose vials may be administered from a suitable nebulizer or an intermittent positive pressure ventilator.
For nebulization of ipratropium bromide + salbutamol solution for inhalation: Children 2 to 12 years: 3 drops/kg/dose (maximum dose 2500 mcg of salbutamol) every 6 to 8 hours.
Adults (including elderly patients) and adolescents over 12 years of age: One (1) unit dose vial every 6 to 8 hours.
Treatment of acute attacks: One (1) unit dose vial is sufficient for prompt symptom relief in many cases.
In severe cases if an attack has not been relieved by one unit dose vial, the administration of a second unit dose vial may be required. Patients should be advised to consult the physician or the nearest hospital immediately in these cases.
Maintenance treatment: 1 unit dose vial three or four times daily.
Patients should be advised to consult a physician or the nearest hospital immediately in the case of acute or rapidly worsening dyspnoea (difficulty in breathing) if additional inhalations of ipratropium bromide + salbutamol do not produce an adequate improvement.
If higher than recommended doses of ipratropium bromide + salbutamol are required to control symptoms, the patient's therapy plan should be reviewed.
In asthma, concomitant anti-inflammatory therapy should be considered.
Ipratropium bromide + salbutamol has not been studied in patients with hepatic or renal insufficiency. It should be used with caution in those patient populations.
Treatment should be initiated and administered under medical supervision, e.g. in the hospital setting. Home based treatment can be recommended in exceptional cases (severe symptoms or experienced patients requiring higher doses) when a low dose rapid acting beta-agonist bronchodilator has been insufficient in providing relief after consultation with an experienced physician.
The treatment with the solution for inhalation in UDVs should always be started with the lowest recommended dose (1 UDV). In very severe cases two unit dose vials may be required for symptom relief. Administration should be stopped when sufficient symptom relief is achieved.