ipratropium bromide inhaler (Atrovent)

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.

Atrovent HFA, Atrovent

GENERIC AVAILABLE: Yes

Yes

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.

• 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.

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

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

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.

What preparations of ipratropium bromide inhaler are available?

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

How should I keep ipratropium bromide inhaler stored?

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