Atrodil can be taken together with Beto 50 ZK and Xarelto. These drugs do not interact with each other. Also, the implanted pacemaker is not a contraindication to taking this drug. Atrodil has a local effect and is absorbed into the systemic circulation only in about 2%, so there is no risk of interaction with other drugs. According to the manufacturer of Atrodil: "Due to the slight absorption of ipratropium bromide from the gastrointestinal tract, the bioavailability of the swallowed part of the product is only about 2% of the dose. This dose portion has no significant effect on plasma concentrations of the active substance. The part of the dose entering the lungs enters the bloodstream very quickly (within a few minutes) and is almost completely bioavailable." You can therefore safely take the drug, as prescribed by your doctor. Here you can check the availability of this medicine and make a reservation at the pharmacy of your choice: https://www.gdziepolek.pl/produkty/7971/atrodil-aerozol/apteki