NAOS ® - Salbutamol + Ipratropium bromide

NAOS ® is a drug based on Salbutamol sulphate and Ipratropium Bromide

THERAPEUTIC GROUP: Adrenergics for aerosols and other drugs for obstructive respiratory tract syndromes

Indications NAOS ® - Salbutamol + Ipratropium bromide

NAOS ® is indicated in the treatment of bronchial asthma and chronic obstructive bronchopathy with asthmatic component.

Action mechanism NAOS ® - Salbutamol + Ipratropium bromide

NAOS ® is a medicinal specialty, used in the treatment of obstructive diseases of the respiratory tract such as asthma and chronic obstructive bronchopathy with asthmatic component, consisting of two important active ingredients, with different biological activities, however both characterized by the bronchodilator action.
More precisely, Salbutamol is a direct sympathomimetic drug, able to interact with the Beta 2 Adrenergic receptors, expressed by the bronchial smooth muscle, determining, through various molecular mechanisms, a relaxation of the same, while the "Ipratropium bromide, interacting and blocking the receptors muscarinic m2 and M3 expressed by bronchial smooth muscles, causes bronchodilation that persists for a few hours.
These two mechanisms, which intervene in the different phases of bronchoconstriction, guarantee a restoration of the normal patency of the respiratory tract with a clear improvement in the symptoms complained of.
All this is facilitated by the inhaled route of administration, which significantly reduces the risk of clinically relevant side effects

Studies carried out and clinical efficacy

Int J Chron Obstruct Pulmon Dis. 2013; 8: 221-30. doi: 10.2147 / COPD.S31246. Epub 2013 Apr 30.

Efficacy and safety of eco-friendly inhalers: focus on combination ipratropium bromide and albuterol in chronic obstructive pulmonary disease.

Panos RJ.

Study that demonstrates the "efficacy of action" of the combined treatment Ipratropium bromide and Albuterol in the improvement of the clinical conditions of COPD patients, with consequent reduction of morbidity.

Pulm Pharmacol Ther. 2013 Oct; 26: 574-80. doi: 10.1016 / j.pupt.2013.03.009. Epub 2013 Mar 21.

Bronchodilation and safety of supratherapeutic doses of salbutamol oripratropium bromide added to single dose GSK961081 in patients with moderate to severe COPD.

Norris V, Ambery C.

Work that in addition to demonstrating the clinical efficacy of the combined therapy between Sulbutamol and Ipratropium bromide, also highlights its good tolerability, denouncing the onset of hypokalaemia only in 3 patients out of 41 treated.

Ann Allergy Asthma Immunol. 2012 Dec; 109: 454-7. doi: 10.1016 / j.anai.2012.08.003. Epub 2012 Aug 22.

Salbutamol tolerance to bronchoprotection: course of onset.

Stewart SL, Martin AL, Davis BE, Cockcroft DW.

Work that defines the appearance of tolerance to the bronchoprotective effect with B2 agonists, describing the appearance of negative effects on this activity after the regular use of Salbutamol for about 7 doses twice a day. It is therefore important to scrupulously respect medical indications.

Method of use and dosage

Solution to be nebulized and for oral use of 1.875 mg of Salbutamol and 0.375 mg of Ipratropium Bromide per single-dose container.
The definition of the therapeutic scheme is up to the doctor, after having carefully assessed the patient's state of health and the severity of his clinical picture.
The same doctor will have to define the modalities of assumption (oral or aerosol) according to the characteristics of the patient, and thus decide the relative dosages.

Warnings NAOS ® - Salbutamol + Ipratropium bromide

Considering the mechanisms of action of the two drugs and the potential side effects, it would be advisable that the doctor, in addition to defining the therapeutic scheme, periodically supervises the therapy, evaluating the patient's health conditions.
NAOS ® should be used with the utmost caution in patients suffering from cardiovascular disease, glaucoma, hyperthyroidism, pheochromocytoma, diabetes and prostatic hypertrophy.
The patient should also be carefully informed of the potential side effects of this therapy, so that he can recognize them promptly and consult the doctor.
NAOS ® is prohibited in and out of competition.
It is recommended to store the drug out of the reach of children.


Given the biological mechanism of the active ingredients contained in NAOS ® and given the absence of studies able to fully clarify the safety profile of this drug for fetal health, it is necessary to extend the contraindications to use also to pregnancy and subsequent breastfeeding period.


The patient receiving NAOS ® should avoid the simultaneous intake of beta 2 agonist drugs and non-selective beta blockers, as well as diuretics, steroids and xanthine derivatives, potentially responsible for hypokalaemia.

Contraindications NAOS ® - Salbutamol + Ipratropium bromide

The use of NAOS ® is contraindicated in patients with hypersensitivity to the active substance or to one of its excipients, in patients with severe heart disease, glaucoma, prostatic hypertrophy and urinary retention or intestinal obstruction syndrome.

Undesirable Effects - Side Effects

The use of NAOS ® could cause the onset of headache, cough, dry mouth, restlessness, tachycardia, dizziness and nausea.
Fortunately, the incidence of clinically more relevant side effects such as skin rash, hypersensitivity, urticaria, angioedema and cardiac manifestations is rarer.


NAOS ® is a prescription drug.

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