What is Ipratropium?

Ipratropium oral inhalation solution (brand name Atrovent®) is a medication that comes in liquid form, to be inhaled through a nebulizer or an inhaler. It is also available as Ipratropium Nasal, which is sprayed in the nose.

Why is Ipratropium Bromide prescribed?

Ipratropium is a bronchodilator, and is used to prevent breathing difficulties and wheezing in patients who have COPD (chronic obstructive pulmonary disease), which may manifest itself as either chronic bronchitis or emphysema. It can also be used to treat asthma. In the nasal form, it is used to treat runny nose from seasonal allergies.

It works by causing the muscles around the airways to relax, thus opening up the passages to enable more air to flow. It is not intended for use in acute attacks, as it takes longer to take effect. For acute attacks there are other medications available, which can be used in conjunction with Ipratropium.

What is the dosage for Ipratropium?

Ipratropium comes in individual vials that are then used in a nebulizer, either with other drugs such as albuterol, or on its own. Treatments last 5-15 minutes and should be administered 3 or 4 times a day, 6 to 8 hours apart, or as directed by your doctor. A health professional should show you how to use the nebulizer equipment for the first time. In order to use the nebulizer, you will need to follow these steps:

• Twist off the cap of the vial and pour the solution into the reservoir of the machine.
• Next, connect the mask or mouthpiece to the reservoir, and then connect the nebulizer to the compressor.
• Put on the mask or insert the mouthpiece and turn on the compressor.
• Breathe in the vapors for 5 to 15 minutes.
• Once your treatment is complete, clean the nebulizer carefully.

If you are using the aerosol inhaler, the medication is provided in canisters that provide a total of 200 puffs of Ipratropium; keep track of how many times you have used each canister and discard after 200 uses even if there seems to be medicine left in the container. In aerosol form, Ipratropium should be used four times a day, or as directed by your doctor. Never use more than the prescribed amount, and at most 12 puffs a day. Keep away from flames, as the canister is combustible.

Avoid getting Ipratropium in your eyes. If you use the nebulizer, it is best to use a mouthpiece rather than a face mask to inhale the medicine. If you do use the face mask, close your eyes while the treatment lasts. When using the inhaler, close your eyes before using.

Contraindications/Precautions

Do not use Ipratropium if you have had any kind of allergic reaction to it in the past, or to other similar medications such as belladonna or atropine.

Also be sure to let your doctor know of any other allergies you may have, whether you are currently pregnant or plan to become pregnant, or if you are breastfeeding.

You should also talk to your physician about any vitamins or herbal supplements you may be taking, and let him or her know if you have had any of the following:

• Narrow angle glaucoma
• Trouble urinating
• Prostate problems

If you plan to have any type of surgery, including dental surgery, let your doctor or dentist know you are taking Ipratropium. Limit alcoholic beverages, and do not use heavy machinery or drive unless you are sure you are not becoming dizzy or developing vision problems from taking this drug.

Interactions

Ipratropium may interact with the following drugs. Please let your physician know if you are taking any of these drugs before starting Ipratropium .

• Antihistamines (such as diphenhydramine, brand name Benedryl®)
• Certain anti-spasmodic drugs, e.g., dicyclomine
• Medications that treat Parkinson’s Disease
• Muscle relaxants
• Pramlintide
• Phenothiazines (psychiatric drugs)
• Tricyclic antidepressants (amitriptyline, etc.)

This may not be a complete list; be sure your doctor is aware of all medications you are taking.

Side Effects

The following side effects are most common with this drug. Call your doctor if they become acute or persistent.

• Dizziness
• Constipation
• Nausea/heartburn
• Dry mouth
• Pain or difficulty urinating
• Frequent urination
• Backache

Call your physician right away if you have any of the following serious side effects.

• Allergic symptoms such as swelling of the throat, tongue, lips, eyes or face; rash/hives, itching, or trouble breathing.
• Hoarseness
• Tachycardia (fast heartbeat)
• Problems with swallowing
• Difficulty breathing
• Chest pain
• Eye pain or vision changes

References:

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a695021.html

http://www.emedicinehealth.com/drug-ipratropium_nasal/article_em.htm

http://www.medicinenet.com/ipratropium-inhalation_solution/article.htm