ipratropium bromide inhaler, Atrovent, Atrovent HFA

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: ipratropium bromide inhaler

BRAND NAME: Atrovent, Atrovent HFA

DRUG CLASS AND MECHANISM: Ipratropium bromide is a bronchodilator that dilates (enlarges) airways (bronchi) in the lungs. It is used in treating, symptoms of asthma, colds, allergies, and chronic obstructive pulmonary disease (COPD) due to emphysema or chronic bronchitis. Ipratropium blocks the effect of acetylcholine on airways (bronchi) and nasal passages. Acetylcholine is a chemical that nerves use to communicate with muscle cells. In asthma and chronic obstructive pulmonary disease, cholinergic nerves going to the lungs cause narrowing of the airways by stimulating muscles surrounding the airways to contract. The "anti-cholinergic" effect of ipratropium blocks the effect of cholinergic nerves, causing the muscles to relax and airways to dilate. Mucus glands in the nose also are controlled by nerves that use acetylcholine to communicate. By blocking acetylcholine, ipratropium helps relieve symptoms of allergies and the common cold by preventing secretion of mucus by mucus glands in the nose. When inhaled, ipratropium travels directly to airways, and very little is absorbed into the body. The FDA approved ipratropium in October 1995.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Nasal Inhaler: 0.03 or 0.06%. Oral Inhaler (aerosol): 0.021 mg/spray

STORAGE: Ipratropium should be kept at room temperature, 15-30 C (59-86 F). Excessive humidity should be avoided.

PRESCRIBED FOR: Intranasal ipratropium is used for treating allergic or nonallergic rhinitis and rhinitis due to the common cold. Oral ipratropium is used for treating acute asthma flares and bronchospasms resulting from chronic obstructive pulmonary disease (chronic bronchitis or emphysema).

DOSING:

• The recommended dose for allergies is 2 sprays (0.03%) in each nostril 2 or 3 times daily.
• The dose for treating symptoms of the common cold is 2 sprays (0.06%) in each nostril 3 to 4 times daily.
• The dose for treating asthma is 8 inhalations every 20 minutes as needed for up to 3 hours.
• The dose for treating bronchospasms associated with COPD is 2 puffs 4 times daily and additional puffs if needed but not to exceed 12 puffs per day.

DRUG INTERACTIONS: Use with other anticholinergic drugs (for example, atropine) may increase the occurrence of side effects.

PREGNANCY: Studies of ipratropium in animals have not demonstrated negative effects on the fetus. There have been no studies in humans.

NURSING MOTHERS: It is not known if ipratropium is secreted in breast milk. Other medications in the same class of drugs are secreted into breast milk. It is not known whether the small amounts that may appear in the milk are of any consequence to the infant.

SIDE EFFECTS: The most common side effects associated with ipratropium are dry mouth, cough, headache, nausea, dizziness, and difficulty breathing. Ipratropium can cause bronchospasms that can be life-threatening. It can also cause rash, itching, or serious allergic reactions involving closure of the airways. Because of its anticholinergic effect it may worsen symptoms of benign prostatic hyperplasia and narrow-angle glaucoma.

Reference: FDA Prescribing Information

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