Indications
Ipratropium inhaler (Ipratropium Bromide) is a bronchodilator, a medicine that opens the airways. It is used to relieve and prevent breathlessness, wheezing and chest tightness in chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is sometimes used with Salbutamol for asthma, and is often supplied in a combined inhaler with Salbutamol.
How It Works
Ipratropium is an anticholinergic (antimuscarinic) medicine. It blocks the effect of acetylcholine, a chemical messenger that makes the muscles around the airways tighten and increases mucus. By blocking it, Ipratropium relaxes the airway muscles and widens the airways, making breathing easier. It starts working within about 15 minutes and its effect lasts around 4 to 6 hours.
Dosage and Administration
For adults, the usual dose with the metered dose inhaler is 1 to 2 puffs (20 to 40 micrograms) three or four times a day, or as prescribed; do not exceed the daily amount your doctor advises. Shake the inhaler, breathe out fully, place the mouthpiece in your mouth, press once while breathing in slowly and deeply, then hold your breath for about 10 seconds. A spacer device can make it easier to use. It is not a rescue inhaler for sudden severe attacks; use your quick relief inhaler and seek help as advised.
Interactions
- Other anticholinergic medicines, such as Tiotropium, some antihistamines, tricyclic antidepressants and medicines for overactive bladder, may add to side effects such as dry mouth, constipation and urine retention.
- Beta agonists such as Salbutamol and Theophylline may add to the bronchodilator effect, which is often intended.
Contraindications
- Allergy to Ipratropium, Atropine or similar medicines, or to any ingredient of the inhaler.
Side Effects
Common side effects include dry mouth, throat irritation, cough, headache, dizziness and an unpleasant taste. Less often there may be constipation, difficulty passing urine, fast heartbeat or blurred vision. If the spray gets into the eyes it can cause eye pain, blurred vision or worsen glaucoma.
Get urgent medical help if breathing suddenly becomes worse or you start wheezing right after using the inhaler, if you have eye pain with blurred vision and seeing halos around lights, if you cannot pass urine, or if you have signs of a serious allergic reaction such as swelling of the face or throat.
Pregnancy and Lactation
There is limited information on use during pregnancy; use only if your doctor decides the benefit outweighs any risk. Only very small amounts reach the blood, so it is unlikely to affect a breastfed baby, but discuss with your doctor.
Precautions and Warnings
- Avoid spraying into the eyes, especially if you have or are at risk of narrow angle glaucoma.
- Use with care if you have an enlarged prostate or difficulty passing urine.
- Tell your doctor if your usual dose works less well or you need it more often, as this may mean your condition is getting worse.
- Rinse your mouth after use if it feels dry.
Overdose
Overdose by inhalation is unlikely to cause serious problems. Too much may cause dry mouth, fast heartbeat, blurred vision or difficulty passing urine. Seek medical advice if symptoms are troublesome.
Therapeutic Class
Bronchodilator; short acting inhaled anticholinergic (antimuscarinic).
Storage
Store below 30°C, away from direct sunlight and out of the reach of children. Do not freeze. The canister is pressurised: do not puncture or burn it, even when empty.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.