Dilution of drugs before nebulization - is it necessary?

According to the manufacturer's instructions, the recommended dose of the medicinal product should be diluted with 0.9% sodium chloride solution to a volume of 3 - 4 ml, sprayed with a nebuliser and inhaled until the solution is used up.

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There is no information on whether skipping a dilution step affects the efficacy or side effects, so follow official advice.

It can be assumed that the recommended dilution is intended to, m.in, achieve an appropriate nebulisation time, which may affect the effectiveness of nebulisation.

Dilution may also be important due to the risk of adverse reactions associated with the effects of the particles on the skin of the face and eye area during nebulisation, which may cause significant adverse reactions (e.g. glaucoma attacks with ipratropium bromide). By diluting the solution, you can reduce the likelihood of side effects resulting from topical effects on the skin and eye area, e.g. especially if the mask does not fit tightly to the face.

I encourage you to read the following articles:
https://www.gdziepolek.pl/artykuly/czym-sie-rozni-nebulizator-od-inhalatora https://www.gdziepolek.pl/artykuly/jaki-inhalator-wybrac