Tables
- TABLE 1
Statements included in the questionnaire for experts and percentage agreement
Statement Agree Disagree Is it safe for all people with bronchiectasis to travel? Most people with bronchiectasis can safely travel for vacation or business
96% 4% It is best to avoid travelling during periods of unstable disease, such as during exacerbations
92% 8% People with bronchiectasis should consult their healthcare providers and plan for travel
85% 15% People with very severe bronchiectasis (e.g. candidate for lung transplantation, frequent hospitalisation) should be advised not to travel abroad
73% 27% Planning travel: are there destinations and conditions that certain people with bronchiectasis should avoid? People with bronchiectasis should try to avoid travelling to places with high levels of air pollution
73% 27% People with bronchiectasis should try to avoid travelling to places with a high prevalence of NTM (e.g. Hawaii, USA)
38% 62% People with bronchiectasis should try to avoid travelling during influenza season
35% 65% People with bronchiectasis should consult their healthcare professional regarding staying at high altitudes
85% 15% Travelling to high-altitude destinations (above 3050 m/10 000 ft) should be avoided in people with bronchiectasis#
32% 68% People with bronchiectasis should preferably travel to destinations with a nearby bronchiectasis centre
31% 69% What travel insurance should people with bronchiectasis acquire? Health insurance with coverage of deterioration of a chronic condition
100% Health insurance with coverage of hospital admission and emergency room visits#
100% Health insurance with coverage of repatriation#
68% 32% What medications and devices should people with bronchiectasis carry with them when travelling? When travelling, it is recommended that people with bronchiectasis should continue taking their regular treatments and make arrangements to take enough medications and equipment for the duration of their travel
100% When travelling, people with bronchiectasis should consult their healthcare professional or respiratory physiotherapist regarding possible alternatives to heavy or large equipment (e.g. nebulisers)
100% People with bronchiectasis who suffer frequent pulmonary exacerbations should consult their specialist regarding carrying antibiotics to be used in case of a pulmonary exacerbation when travelling
100% Medications taken for travel should be properly stored according to manufacturer's recommendations (particularly storage temperature, light exposure)
100% Electricity requirements (e.g. for a nebuliser) and cleaning instructions should be known prior to travelling and proper adaptations, including checking batteries, should be planned
100% How can people with bronchiectasis maintain regular treatments when in transport? It is advised that airway clearance and inhalations are performed while waiting at airports before and after flights. This is best planned ahead and checked with the airport for the best place to do this
77% 23% While it is not advised to take cough suppressants for bronchiectasis, it may be considered for long flights where a cough may be disturbing to other passengers
35% 65% Do people with bronchiectasis need to prepare and carry certain documents? It is advised that patients with bronchiectasis carry documentation from the last clinic/hospitalisation visit, translated into English and preferably also into the language of the country of destination
81% 19% A document for travel may be prepared and should include: patient's health status, allergies, chronic bacterial infections, regular medications and devices used regularly, recommended medications during exacerbation
100% It is advised that patients with bronchiectasis carry a translation of a disability card# (such as a European Union disability parking card) if eligible and where available
84% 16% When travelling in a guided tour, it is advised that people with bronchiectasis should notify the travel company of their condition
69% 31% What are oxygen requirements on the flight and at the travel destination? Oxygen requirements during commercial flights should be predicted before flight
100% In people with an FEV1 <55% pred or oxygen saturation <93% at ambient air, a hypoxia inhalation test should be performed
77% 23% In people with FEV1 <1.5 L, a hypoxia inhalation test should be performed#
44% 56% When planning travel to destinations between 2000 and 3050 m, considerations as for commercial flights should be made
92% 8% How else can people with bronchiectasis be prepared to travel? It is recommended that people with bronchiectasis seek advice for travellers and follow recommended immunisations for the destination
100% Recommended medications while travelling (such as for the prevention of malaria) should be checked for interactions with regular treatments and with treatments during exacerbations
100% It is recommended that people with bronchiectasis should be stable prior to travelling, if symptoms typical for an exacerbation develop shortly before travelling, treatment should be started and travel postponed if possible
96% 4% People with severe bronchiectasis and chronic Pseudomonas sp. infection may be advised to receive treatment with an intravenous antibiotic course shortly before travelling to prevent an exacerbation while away
50% 50% What kind of activities may people with bronchiectasis engage in while on holiday and what precautions are recommended? It is recommended that people with bronchiectasis should use sun protection while using medications that increase photosensitivity (e.g. ciprofloxacin, doxycycline)
100% It is recommended that people with bronchiectasis take measures to avoid dehydration while in a hot climate
100% It is advised that people with bronchiectasis maintain general measures of hygiene to prevent cross-infection: hand hygiene, wearing face masks in crowded places
88% 12% It is recommended that all people with bronchiectasis refrain from SCUBA diving
35% 65% It may be safe for people with bronchiectasis to SCUBA dive if they are asymptomatic (no sputum or shortness of breath at the time of diving) and lung function is normal (FEV1 and peak expiratory flow should both be >80% pred, FEV1/forced vital capacity >75%)
85% 15% It is recommended that people with bronchiectasis should be aware of their own limitations to strenuous activities and limit their participation in such activities accordingly. This refers to sports including hiking, swimming and snorkelling, but also less strenuous activities such as short walks uphill and climbing stairs
96% 4% Where should people with bronchiectasis get help if they get sick while away? Prior to travel, people with bronchiectasis should be advised on increasing airway clearance if suffering an exacerbation while away
96% 4% Prior to travel, people with bronchiectasis should be advised when to take antibiotics, including a recommendation for an oral antibiotic, dose and duration
100% People with bronchiectasis should be advised when and where to seek medical care at their destination
88% 12% NTM: nontuberculous mycobacteria; FEV1: forced expiratory volume in 1 s; SCUBA: self-contained underwater breathing apparatus; % pred: % predicted. #: 25 out of 26 responded; all other items had 26 responses.
- TABLE 2
Examples of equations for predicting hypoxaemia
PaO2 Alt=0.410×PaO2Ground+17.652 PaO2 Alt=0.519×PaO2Ground+11.855×(FEV1 L)−1.760 PaO2 Alt=0.453×PaO2Ground+0.386×(FEV1 % pred)+2.44 PaO2 Alt=22.8−(2.74×altitude in 1000s of feet)+0.68×PaO2Ground PaO2 Alt: predicted arterial oxygen tension at altitude (in millimetres of mercury); PaO2Ground: measured arterial oxygen tension at sea level (in millimetres of mercury); FEV1: forced expiratory volume in 1 s; % pred: % predicted. Information from [10].
- TABLE 3
Storage conditions for common medications for bronchiectasis
Drug name Common trade names in Europe Storage conditions Comments Oral antibiotics and antifungals Azithromycin Cap. azithromycin 250 mg
Cap. Azenil 250 mg
Cap. azithromycin Inovamed 250 mg
Cap. Zithromax 250 mg
Tab. Zeto 250 mg
Tab. azithromycin 250 mgCap., tab.: store in the original package in order to protect from light; store below 25°C Skin photosensitivity: uncommon (≤1%)
Alcohol: no special recommendationAzenil 200 mg/5 mL powder for oral susp.
Azithromycin 200 mg/5 mL powder for oral susp.
Azithromycin Teva 200 mg/5 mL powder for oral susp.
Zithromax 200 mg/5 mL powder for oral susp.Powder for susp.: store below 25°C
Reconstituted susp.: store at room temperature, below 25°C
After reconstitution of the powder, use the susp. within 5 days; shake immediately prior to useErythromycin Tab. erythromycin 250 mg
Tab. Erythro Teva 250 mg; 500 mg
Tab. Erythrocin 250 mg; 500 mg
Tab. Erythroped A 500 mgTab.: store in a dry place, below 25°C Alcohol: may decrease the absorption of erythromycin or enhance effects of alcohol (ethanol); the combination should be avoided Erythromycin SF granules for oral susp. 125 mg/5 mL; 250 mg/5 mL; 500 mg/5 mL
Erythromycin ethyl succinate granules for oral susp. 125 mg/5 mL; 250 mg/5 mL; 500 mg/5 mL
Erythroped SF 250 mg/5 mL; 500 mg/5 mL
Primacine granules for oral susp. 250 mg/5 mLGranules for susp.: store below 25°C
Reconstituted susp.: store in a refrigerator (2–8°C); do not freeze
After reconstitution, use the suspension within 14 days; shake immediately prior to useRoxithromycin Tab. Rulid 150 mg; 300 mg
Tab. Roxo 150 mgTab.: store below 25°C Alcohol: no special recommendation Clarithromycin Tab. Karin 250 mg, 500 mg
Tab. Klacid SR 500 mg
Tab. clarithromycin 250 mg, 500 mg
Tab. Klaricid XL 500 mg
Prolonged release tab. Mycifor XL 500 mg
Caplets Klaridex 250 mgTab., caplets: store in the original package in order to protect from light and moisture; store below 25°C (some manufacturers permit excursions up to 30°C) Alcohol: no special recommendation Sachet Klaricid adult 250 mg Sachet: store in a dry place, below 30°C
Mix the contents of the sachet with a small amount of water before taking to make the granules easier to swallowKlacid paediatric granules for susp. 125 mg/5 mL
Susp. Clarithromycin 125 mg/5 mL; 250 mg/5 mL
Oral susp. clarithromycin 125 mg/5 mL; 250 mg/5 mL
Klaricid paediatric susp. 125 mg/5 mL; 250 mg/5 mLGranules for susp.: store below 30°C
Reconstituted susp.: store at room temperature, below 25°C (up to 30°C according to manufacturer) and use within 14 days from reconstitution; do not refrigerate or freeze the reconstituted suspension; shake immediately prior to useAmoxicillin Cap. amoxicillin 250 mg; 500 mg
Cap. Amoxil 250 mg; 500 mg
Cap. Moxyvit 250 mg
Cap. Moxyvit forte 500 mg
Cap. Moxypen forte 500 mgCap.: store in a dry place, below 25°C Alcohol: no special recommendation Amoxicillin powder for oral susp. 125 mg/5 mL; 250 mg/5 mL
Amoxicillin powder for oral susp. SF 125 mg/5 mL; 250 mg/5 mL
Moxyvit forte powder for oral susp. 250 mg/5 mL
Moxypen forte powder for susp. 250 mg/5 mLPowder for susp.: store in a dry place, below 25°C
Reconstituted susp.: according to manufacturer instructions, store in a refrigerator (2–8°C) or at room temperature (below 25°C) and use within 7–14 days#; shake immediately prior to useAmoxicillin–clavulanic acid Tab. Amoxiclav Teva 875 mg
Tab. Augmentin 250 mg; 500 mg; 875 mg
Tab. co-amoxiclav 250 mg; 500 mg
Tab. Maclivan 500 mgTab.: store in the original package in order to protect from moisture; store below 25°C
Augmentin tab. supplied in an aluminium pouch should be used within 30 days of opening the pouchAlcohol: no special recommendation Augmentin powder for oral susp. 250 mg/5 mL; 400 mg/5 mL
Augmentin ES Augmentin powder for oral susp. 600 mg/5 mL
Co-amoxiclav powder for oral suspension 125 mg/5 mL; 250 mg/5 mL; 400 mg/5 mL
Maclivan powder for oral suspension 250 mg/5 mL; 400 mg/5 mLPowder for susp.: store in the original package in order to protect from moisture; store below 25°C
Reconstituted susp.: according to manufacturer instructions, store in a refrigerator (2–8°C) and use within 7–10 days#Doxycycline Cap. Doxy 100 mg
Cap. doxycycline 50 mg; 100 mg
Cap. Vibramycin Hyclate 100 mg
Tab. Doxylin 100 mg
Vibramycin-D 100 mg Dispersible tabs
Vibra-Tabs 100 mgCap., tab.: store in the original package in order to protect from light and moisture; store below 25°C# Skin photosensitivity: sunlight or ultraviolet light exposure increases the risk of photosensitivity; use skin protection and avoid prolonged exposure to sunlight and ultraviolet light; avoid use of tanning equipment.
Discontinue the treatment at first sign of skin erythema
Alcohol: ingestion may shorten the half-life of doxycycline and reduce its serum concentration; the combination should be avoidedDoxycycline powder for susp. 25 mg/5 mL
Vibramycin monohydrate powder for susp. 25 mg·mL−1Powder for susp.: store in the original package in order to protect from light and moisture; store below 25°C#
Reconstituted susp.: store in the original package in order to protect from light and moisture; store below 25°C (up to 30°C according to manufacturer); use within 14 days from reconstitution; shake immediately prior to useVibramycin calcium syrup 50 mg·mL−1 Syrup: store in the original package in order to protect from light and moisture; store below 30°C Minocycline Cap. minocycline 50 mg; 100 mg
Cap. Minoclin 100 mg
Tab. minocycline 50 mg; 100 mgCap., tab.: store in the original package in order to protect from light; store below 25°C Skin photosensitivity: may cause photosensitivity; use skin protection and avoid prolonged exposure to sunlight and ultraviolet light; avoid use of tanning equipment
Discontinue the treatment if skin erythema occurs
Alcohol: no special recommendationCefuroxime Tab. Zinnat 125 mg; 250 mg; 500 mg
Tab. Cefuroxime 250 mgTab. store in the original package in order to protect from moisture; store below 30°C Alcohol: no special recommendation Zinnat powder for oral susp. 125 mg/5 mL; 250 mg/5 mL Powder for suspension: store in the original package, below 30°C
Reconstituted susp.: store in a refrigerator (2–8°C); do not freeze
After reconstitution, use the susp. within 10 days; shake the bottle vigorously before the medication is takenCephalexin Cap. Cefovit 250 mg; forte 500 mg
Cap., tab. Cefalexin 250 mg; 500 mg
Tab. Keflex 250 mg; 500 mgCap.: store in a dry place, below 25°C Alcohol: no special recommendation Cefovit powder for oral susp. 125 mg/5 mL;
Cefovit forte 250 mg/5 mL
Cefalexin granules for oral susp. 125 mg/5 mL; 250 mg/5 mL
Keflex granules for oral susp. 125 mg/5 mL; 250 mg/5 mLPowder/granules for susp.: store in a dry place, below 25°C
Reconstituted susp.: according to manufacturer instructions, store in a refrigerator (2–8°C) and use within 10–14 days#; shake well before each useSMX-TMP Caplets Diseptyl forte 800 mg/160 mg
Tab. co-trimoxazole 400 mg/80 mg
Tab. co-trimoxazole forte 800 mg/160 mg
Tab. Septrin 400 mg/80 mg
Tab. Septrin forte 800 mg/160 mgCap., tab.: store in the original package, below 25°C Skin photosensitivity: as been reported with SMX-TMP; use with caution; use skin protection and avoid prolonged exposure to sunlight and ultraviolet light; avoid use of tanning equipment
Discontinue the treatment if skin erythema occurs
Alcohol: a disulfiram-like reaction (flushing, sweating, palpitations and drowsiness) may occur if alcohol (0.5–1 L of an alcoholic drink e.g. beer) is ingestedSusp. Diseptyl 200 mg/40 mg in 5 mL
Co-trimoxazole paediatric susp. 200 mg/40 mg in 5 mL
Co-trimoxazole adult susp. 400 mg/80 mg in 5 mL
Septrin paediatric susp. 200 mg/40 mg in 5 mL
Septrin adult susp. 400 mg/80 mg in 5 mLSusp. Store in a dark and dry place, below 25°C
Use within 10 days of opening#.Ciprofloxacin Tab. Ciprodex 250 mg; 500 mg; 750 mg
Tab. ciprofloxacin Teva 250 mg; 500 mg; 750 mg
Ciprofloxacin 100 mg; 250 mg; 500 mg; 750 mg film-coated tab.
Tab. Ciproxin 500 mgTab. store in the original package, below 25°C Skin photosensitivity: ciprofloxacin has been shown to cause photosensitivity reactions; use skin protection and avoid prolonged exposure to sunlight and ultraviolet light; avoid use of tanning equipment
Discontinue the treatment if skin erythema occurs
Caffeine: ciprofloxacin has been shown to interfere with the metabolism of caffeine leading to increased caffeine concentrations; patients consuming regular large quantities of caffeinated beverages may need to restrict caffeine intake if excessive cardiac or central nervous system stimulation occurs; the effect of this interaction is greater in femalesCiproxin 250 mg/5 mL, granules and solvent for oral susp. Ciproxin: store the granules and solvent below 25°C; protect the solvent from freezing; avoid inverted storage
The ready-to-use oral susp. (utilising the individual components) is stable only for 14 days when either stored in a refrigerator (2–8°C) or at temperatures up to 30°C; protect the reconstituted susp. from freezingMoxifloxacin Tab. Megaxin 400 mg
Tab., film-coated Moxicloxacin 400 mg
Tab. Avelox 400 mgTab.: store in the original package in order to protect from moisture; store below 25°C Skin photosensitivity: quinolones have been shown to cause photosensitivity reactions in patients; use skin protection and avoid prolonged exposure to sunlight and ultraviolet light; avoid use of tanning equipment
Discontinue the treatment if skin erythema occursFluconazole Cap. Flucanol 50 mg; 100 mg; 150 mg; 200 mg
Cap. fluconazole Teva 150 mg
Cap. Trican 50 mg, 100 mg, 150 mg, 200 mg
Cap. fluconazole/Azocan 50 mg, 150 mg, 200 mgCap.: store in a dry place below 25°C# Alcohol: no special recommendation Fluconazole powder for oral susp. (Genus Pharmaceuticals) 50 mg/5 mL
Diflucan powder for oral suspension 10 mg/mL; 40 mg/mLPowder for susp.: store in a dry place, below 25°C
Reconstituted susp. store in a refrigerator (2–8°C) or at temperatures up to 30°C use within 14–28 days#; protect the reconstituted susp. from freezing; shake well before administrationItraconazole Cap. Itranol 100 mg
Cap. itraconazole 100 mgCap.: store in the original package in order to protect from moisture; store below 25°C Skin photosensitivity: uncommon (≤2%); case reports have been described
Use skin protection and avoid prolonged exposure to sunlight and ultraviolet light; avoid use of tanning equipment
Discontinue the treatment if skin erythema occurs
Alcohol: no special recommendationCap. Sporanox Sporanox cap.: up to 30°C Sporanox oral solution 10 mg·mL−1 Powder for susp.: store below 25°C; use within 30 days of opening Itraconazole 10 mg·mL−1 oral solution Expectorants and cough suppressants Acetylcysteine Reolin effervescent tablets 200 mg
Siran 200 mg effervescent tabletsEffervescent tablets: store in the original package in order to protect from moisture; store below 25°C; close the tube immediately after taking out the tablet
After dissolving the tablet, it must be used immediately
Reolin: use within 2 years after the first opening or until the expiry date
Siran: use within 4 weeks after the first openingAlcohol: no special recommendation Sachet acetylcysteine 200 mg powder for oral solution Powder for oral solution: store in the original package in order to protect from moisture
Reconstituted solution: the product must be used immediatelyGuaifenesin Resyl syrup 100 mg/5 mL (contains 6% alcohol by volume)
Benylin syrup for children's chesty coughs 50 mg/5 mL
Benylin syrup Mucus Cough Max honey and lemon flavour 100 mg/5 mL (contains 4.7% alcohol by volume)
Oral solution Benylin Mucus Cough Max menthol flavour 100 mg/5 mL (contains 4.7% alcohol by volume)
Boots chesty cough relief 100 mg/5 mL oral solution
Boots chesty cough syrup 6 years plus (contains alcohol)
Boots mucus cough relief 100 mg/5 mL oral solution
Covonia chesty cough SF syrup
Robitussin chesty cough medicine 100 mg/5mL−1 oral solution (contains 2.7% v/v alcohol)
Lemsip cough for chesty cough 50 mg/5 mL oral solutionSyrup: store in the original package, below 25°C
Resyl: store below 30°C; use within 6 months of opening
Benylin honey and lemon flavour: use within 6 months of opening
Oral solution: store below 25°C
Benylin menthol flavour: store in the original container to protect from light and use within 4 weeks of openingAlcohol: some products contain alcohol; therefore, these formulations can emphasise the effect of sedatives (including alcohol) and myorelaxants
Avoid concurrent use or use caution when motor skills are requiredOther oral medications Prednisone Tab. prednisone 1 mg; 5 mg; 20 mg
Modified-release tab. Lodotra 1 mg; 2 mg; 5 mgTab.: store in a dark and dry place, below 25°C
Tab. prednisone 1 mg: use within 2 months of opening (but not after the expiry date)
Lodotra: store below 25°C and use within 14 weeks of opening (but not after the expiry date)Alcohol: no special recommendation Prednisolone Tab. Pevanti 2.5 mg; 5 mg; 10 mg; 20 mg; 25 mg
Tab. prednisolone 1 mg, 2.5 mg; 5 mg; 10 mg; 20 mg; 25 mg; 30 mg
Tab. prednisolone gastro-resistant 1 mg; 2.5 mg; 5 mg
Soluble tab. prednisolone 5 mgTab. (also gastro-resistant and soluble tab.): store in the original package in order to protect from light and moisture, below 25°C
Pevanti: use within 6 months of opening (but not after the expiry date)Alcohol: some products contain alcohol; avoid concurrent use of ethanol with these formulations or use caution when motor skills are required Danalone syrup 15 mg/5 mL (contains alcohol) Syrup: store below 25°C but not in the refrigerator; close firmly, and prevent penetration of air and moisture Prednisolone Dompe 1 mg·mL−1 oral solution (single-dose containers)
Prednisolone 10 mg·mL−1 oral solutionDompe: before opening, store in the original package; store below 30°C
Once opened, the container must be discarded once the dose is removed
Prednisolone 10 mg·mL−1: keep the container in the outer carton in order to protect from light
Before opening, store in a refrigerator (2–8°C)
Once opened, store below 25°C and use within 3 monthsProton pump inhibitors Omeprazole Caplets Omepradex 10 mg; 20 mg; 40 mg
Caplets Omepradex-Z 20 mgCaplets: store in the original package, below 25°C Skin photosensitivity: has been described but is rare (≤0.1%)
Alcohol: no special recommendationCap. Losec 20 mg (Israel)
Cap. Omepra 10 mg; 20 mg; 40 mg
Cap. Omeprix 20 mg
Cap. Losec 10 mg; 20 mg; 40 mg (Europe)
Cap. Mepradec gastro-resistant 10, 20 mg
Cap. Omeprazole gastro-resistant 10 mg; 20 mg; 40 mg
Cap. Prenome 10 mg; 20 mg; 40 mg
Cap. Omeprazole 10 mg; 20 mg; 40 mg
Tab. Omeprazole Gastro-resistant 10 mg; 20 mg; 40 mg
Pyrocalm Control 20 mg gastro-resistant tabletsCap., tab.: store below 25°C
Store in the original package in order to protect from moisture, below 25–30°C and use within 3 months of opening of the bottle#Esomeprazole Tab. esomeprazole Inovamed 20 mg; 40 mg
Tab. Nexium 20 mg; 40 mg
Tab. esomeprazole gastro-resistant 20 mg; 40 mg
Cap. Emozul gastro-resistant 20 mg, 40 mg
Cap. esomeprazole gastro-resistant 20 mg; 40 mg
Ventra gastro-resistant capsules 20 mg; 40 mgTab., cap.: store in the original package in order to protect from moisture
Store below 25–30°C# and use within 3–6 months after first opening of the bottle#Skin photosensitivity: has been described in the literature but is rare (≤0.1%)
Alcohol: no special recommendationSachet Nexium 10 mg gastro-resistant granules for oral susp. Granules for oral susp.: use within 30 min after reconstitution Lansoprazole Cap. lansoprazole 15 mg; 30 mg
Cap. Lanton 15 mg; 30 mg
Cap. lansoprazole gastro-resistant 15 mg; 30 mg
Orodispersible tab. lansoprazole 15 mg; 30 mg
Zoton Fas-Tab 15 mg; 30 mgCap., tab.: store in the original package in order to protect from light and moisture; store below 25°C
Use within 2 months to 100 days after first opening of the bottle#Skin photosensitivity: has been described in the literature but is rare (≤0.1%)
Alcohol: no special recommendationPantoprazole Tab. Contrololc 20 mg; 40 mg
Pantoloc Control 20 mg gastro-resistant tablets
Tab. Pantoprazole gastro-resistant 20 mg; 40 mgTab. store in the original package in order to protect from moisture; store below 25°C
Use within 6 months after first opening of the bottle#Skin photosensitivity: has been described in the literature (but the frequency cannot be estimated from the available data); use with caution
Alcohol: no special recommendationH2 blockers Famotidine Tab. famotidine Teva 20 mg; 40 mg
Tab. Famo 20 mg; 40 mg
Tab. Gastro 10 mg; 20 mg; 40 mg
Tab. Pepcid 20 mg; 40 mgTab. store in the original package in order to protect from light and moisture; store below 25°C Alcohol: no special recommendation Pepcid powder for oral susp. 40 mg/5 mL Powder for susp.: store in the original package at 25°C; excursions permitted to 15–30°C
Reconstituted susp.: after reconstitution, use the suspension within 30 days; protect from freezingRanitidine Tab. Zaridex 150 mg; 300 mg
Tab. Ranitidine film-coated 150 mg; 300 mg
Tab. Zantac 75 mg; 150 mg; 300 mgTab.: store in the original package, below 25°C Alcohol: co-ingestion of alcohol (1.5–2 drinks) while on ranitidine may result in higher blood alcohol concentrations, although the clinical significance is uncertain
In addition, some products contain alcohol; avoid concurrent use of ethanol with these formulations or use caution when motor skills are requiredZantac syrup 150 mg/10 mL (contains ∼7.5% w/v alcohol) Syrup: store below 25°C and use within 28 days of opening Ranitidine 150 mg/10 mL oral solution (contains ∼8% w/v alcohol)
Ranitidine 30 mg·mL−1 oral solution (contains ∼7.5% w/v alcohol)Oral solution: store in original carton/bottle in order to protect from light; store below 25°C Antacids Aluminium hydroxide, magnesium hydroxide and dimethicone/simethicone Maalox Plus chewable tablets (200 mg magnesium hydroxide, 200 mg hydrated aluminium oxide and 25 mg dimethicone in a tablet) Tab.: store in the original package, below 25°C Alcohol: no special recommendation Maalox Plus oral susp. (225 mg aluminium hydroxide, 200 mg magnesium hydroxide and 25 mg simethicone in 5 mL) Oral susp.: store below 25°C and use within 28 days of opening; shake well before administration Calcium carbonate Chewable tab. Tums
Chewable tab. N-Zarevet
Chewable tab.Chewable tab.: store in the original package, below 25°C
N-Zarevet: use within 12 months after first opening of the bottleAlcohol: no special recommendation Calcium carbonate and magnesium carbonate Chewable tab. Rennie
Chewable tab. RolaidsChewable tab.: store in the original package, below 25°C Alcohol: no special recommendation Rolaids mint liquid (550 mg calcium carbonate and 110 mg magnesium hydroxide in 5 mL) Liquid: do not freeze Calcium carbonate, sodium bicarbonate and sodium alginate Chewable tab. Gaviscon Chewable tab.: store in the original package in order to protect from moisture; below 25–30°C# Alcohol: no special recommendation Gaviscon peppermint liquid Liquid: store in the original package, below 25–30°C (according to manufacturer instructions) and use within 6 months of opening Gaviscon liquid sachets mint flavour (500 mg sodium alginate, 267 mg sodium bicarbonate and 160 mg calcium carbonate per 10-mL dose) Liquid sachet: store in the original package, below 25°C; discard any unused contents Bronchodilators: inhalers and solution Salbutamol MDI Ventolin inhaler CFC-Free 100 µg per dose
Salbutrim CFC-free inhaler 100 µg per doseVentolin, Salbutrim: store below 30°C; protect from frost and direct sunlight
If the inhaler gets very cold, take the metal container out of the plastic case and warm it in your hands for a few minutes; do not use anything else to warm it upAlcohol: no special recommendation Easyhaler Salbutamol 100 µg per dose, 200 µg per dose
Salamol Easi-Breathe 100 µg per doseEasyhaler: store in a dry place, at a temperature below 25°C; use within 6 months after first opening of foil pouch Salbulin MDPI Novolizer Salbulin: store below 30°C; use within 6 months after first opening the container Ipratropium MDI MDI Atrovent 20 µg per dose MDI: store below 25°C (Europe) or 30°C (Israel); protect from frost and direct sunlight; do not expose to temperature >50°C Alcohol: no special recommendation Salbutamol (solution) Ventolin respirator solution 5 mg·mL−1 (0.5% w/v) Ventolin respirator solution: store below 25–30°C#; protect from light; discard any contents remaining 1 month after opening the bottle
A fresh solution should be prepared before each usageAlcohol: no special recommendation Ventolin Nebules 2.5 mg/2.5 mL (0.1% w/v), 5 mg/2.5 mL (0.2% w/v)
Ampules Salbutamol 2.5 mg/2.5 mL nebuliser solution; 5 mg/2.5 mLVentolin Nebules, Ampules Salbutamol: store below 25–30°C#; protect from light after removal from the foil overwrap pouch
Use nebules 3 months after removal from the foil pouch; use immediately after first opening of the ampule and discard any unused contentsIpratropium (solution) Aerovent respirator solution 0.25 mg·mL−1 Respirator solution: store below 25°C; do not freeze
Discard any contents remaining 1 month after opening the bottle
A fresh solution should be prepared before each usageAlcohol: no special recommendation Atrovent 250 UDVs, 1 mL; Atrovent UDVs, 2 mL–0.25 mg·mL−1 vials
Ampules ipratropium bromide 250 µg/1 mL nebuliser solution; 500 µg/2 mL nebuliser solutionAtrovent 250 UDVs, Atrovent UDVs, Ampules Ipratropium bromide: keep the vials in the outer carton; store below 25°C
Use immediately after first opening of the ampule and discard any unused contentsOther inhaled medications Isotonic saline (sodium chloride 0.9% w/v) Ampules sodium chloride 0.9% Fresenius 5 mL; 10 mL; 20 mL per ampule
Saline nebuliser solution Arrow 2.5 mL per ampule
Saline Steripoules 2.5 mLAmpules: store below 25°C; do not refrigerate or freeze
Saline nebuliser solution
Strips of 10 ampules are overwrapped in an aluminium foil pack; ampules removed from the foil overwrap should be used within 90 daysAlcohol: no special recommendation Hypertonic saline (sodium chloride 3%, 6%, 7% w/v) INH Solution MucoClear (sodium chloride) 3%, 4 mL per ampule
INH Solution MucoClear (sodium chloride) 6%, 4 mL per ampuleMucoClear: store below 25°C; do not refrigerate or freeze Alcohol: no special recommendation INH Solution PulmoSal 7%, (pH+) 4 mL per vial Pulmosal: store at room temperature, 15–30°C; avoid excessive heat and protect from freezing Inhaled antimicrobials CMS Vial Coliracin 1 000 000 units per vial
Vial CMS 1 000 000 IU powder for solution for injection
Vial Colomycin 1 000 000 IU, 2 million IU
Promixin, 1 000 000 IU powder for nebuliser solutionVial: store below 25°C; protect from light
Use immediately after reconstitution with 0.9% sodium chloride; solutions may be used within 24 h when stored in a refrigerator (2–8°C)Alcohol: no special recommendation Colobreathe 1 662 500 IU inhalation powder, hard capsules (∼125 mg CMS) Colobreathe: store in the original package until immediately before use in order to protect from moisture; store below 25°C Tobramycin Vial tobramycin 40 mg·mL−1 solution for injection Vial for injection: store in the outer carton in order to protect from light; store below 25°C
Use immediately after reconstitution with 0.9% sodium chloride
Solutions may be used within 24 h when stored in a refrigerator (2–8°C)
A fresh solution should be prepared before each usageAlcohol: no special recommendation Vial Nebcin injection 40 mg·mL−1 Ready-to-use nebuliser solution: store in the original package in order to protect from light and moisture; store in a refrigerator (2–8°C); do not freeze Bramitob 300 mg/4 mL nebuliser solution, single-dose container The contents of the whole ampule should be used directly after opening; opened ampules should never be stored for re-use TOBI Podhaler 28 mg per capsule inhalation powder, hard capsules TOBI pouch, Tymbrineb foil pouch, Tobramycin pouch (intact or opened); may be stored at room temperature (up to 25°C) for up to 28 days TOBI 300 mg/5 mL nebuliser solution, single-use ampule Bramitob bags (intact or opened) may be stored at room temperature (up to 25°C) for up to 3 months
Vantobra pouch (intact or opened) may be stored at room temperature (up to 25°C) for up to 4 weeksTOBI Podhaler 28 mg per capsule inhalation powder Capsules for inhalation: TOBI Podhaler capsules must always be stored in the blister to protect from moisture and only removed immediately before use; store below 30°C
Podhaler device: store the inhaler in its tightly closed case when not in use; each Podhaler device and its case are used for 7 days and then discarded and replacedGentamicin Ampule gentamicin B. Braun 1 mg·mL−1; 3 mg·mL−1 solution for infusion
Ampule gentamicin 10 mg·mL−1 solution
Ampule Genticin 40 mg·mL−1 injectable
Ampule Cidomycin 80 mg/2 mL solution for injectionAmpules for injection: store in the outer carton in order to protect from light; store below 25°C; use immediately after reconstitution with 0.9% sodium chloride; a fresh solution should be prepared before each usage Alcohol: no special recommendation Cap: capsules; tab: tablets: susp.: suspension; SF: sugar free; SR: sustained release; SMX: sulfamethoxazole; TMP: trimethoprim; MDI: metered-dose inhaler; CFC: chlorofluorocarbon; CMS: colistimethate sodium.#: see leaflet, as different instructions for different manufacturers [23].