Windel Plus Nebuliser Solution 1 Ampoule

Side Effects

Common side effects include skeletal muscle tremors, nervousness, and less frequently, tachycardia, dizziness, palpitations, or headaches. Serious hypokalemia may result from prolonged high-dose therapy.

Pharmacology

• Ipratropium Bromide: Rapidly absorbed after inhalation; systemic bioavailability is below 10%. Elimination half-life is 3.6 hours. Does not cross the blood-brain barrier.
• Salbutamol Sulfate: Quickly absorbed after inhalation or oral use; peak plasma concentrations are reached in 3 hours. It has a 4-hour half-life and can cross the blood-brain barrier.

Dosage

• Adults (including elderly): Use one 3 ml ampoule in a nebulizer four times daily, with up to two additional treatments if needed.
• Children: Dosage must be determined by a physician.

Administration

1. Twist off the ampoule top, holding it upright.
2. Squeeze the solution into the nebulizer chamber.
3. If necessary, dilute according to the doctor's instructions.

Interactions

• Concomitant use with beta-mimetics, anticholinergics, or xanthine derivatives may increase side effects.
• Beta-agonist-induced hypokalemia can be exacerbated by diuretics, glucocorticosteroids, and xanthine derivatives.
• Caution with digoxin, as hypokalemia can increase arrhythmia risk.
• Concomitant use of beta-blockers may reduce bronchodilator effects.
• Beta-agonists should be used cautiously with MAO inhibitors or tricyclic antidepressants.

Contraindications

• Not suitable for patients with hypertrophic obstructive tachyarrhythmia or those allergic to atropine or its derivatives.

Overdose Effects

Overdose symptoms (mainly from Salbutamol) include tachycardia, chest pain, hypertension, palpitations, and tremors. Treatment involves sedatives or beta-receptor blockers.

Other side effects include:

• Respiratory: Cough, bronchospasm, local irritation.
• Non-respiratory: Nausea, vomiting, sweating, muscle cramps, arrhythmias.
• Anticholinergic effects: Dry mouth, mydriasis, and urinary retention (rare).

Pregnancy & Lactation

• Pregnancy Category C: Use only if the benefit justifies the risk. Animal studies have shown the teratogenic effects of Salbutamol.
• Caution during breastfeeding: Salbutamol sulfate and Ipratropium bromide may pass into breast milk, though minimal amounts are expected with inhalation.

Precautions & Warnings

• Seek medical attention immediately for acute, rapidly worsening dyspnea.
• Rare immediate hypersensitivity reactions include urticaria, angioedema, rash, and bronchospasm.

Storage Conditions

Store below 30°C, away from light and moisture, and keep out of the reach of children.