Indications
Ipratropium solution for inhalation is a bronchodilator (airway-opening medicine) given through a nebuliser. It is used to relieve and prevent wheezing and breathlessness caused by narrowed airways in chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, and, together with a short-acting reliever such as Salbutamol, in acute asthma attacks. It is prescription only.
How It Works
Ipratropium is an anticholinergic (antimuscarinic) medicine. It blocks the action of acetylcholine, a natural chemical that makes the muscles around the airways tighten and increases mucus production. By blocking it, Ipratropium relaxes these muscles, widening the airways so that air flows more easily. Its effect starts within about 15 minutes and lasts several hours.
Dosage and Administration
Use as prescribed. The solution is placed in a nebuliser chamber, diluted with sterile Normal Saline if instructed, and breathed in through a mouthpiece or mask until the mist stops, usually over 5 to 15 minutes. For adults with COPD it is commonly used three or four times a day. In acute asthma, doses are given as decided by the doctor. A mouthpiece is preferred to a mask in people with glaucoma risk, to keep mist away from the eyes. Use each vial once and discard any remainder.
Interactions
Other anticholinergic medicines, such as Tiotropium, some antihistamines, tricyclic antidepressants and medicines for overactive bladder, can add to side effects like dry mouth, constipation and urine retention. It is often used safely with Salbutamol; together they may increase the risk of acute glaucoma if the mist gets into the eyes.
Contraindications
- Allergy to Ipratropium, Atropine or similar medicines.
Side Effects
Common effects include dry mouth, throat irritation, cough, headache, dizziness and a bitter taste. Less common effects include constipation, difficulty passing urine, fast heartbeat, blurred vision and eye pain if mist reaches the eyes.
Get urgent medical help if breathing suddenly gets worse straight after use (paradoxical bronchospasm), for eye pain with blurred vision, haloes around lights and red eyes (possible acute glaucoma), inability to pass urine, or an allergic reaction with swelling of the face or throat.
Pregnancy and Lactation
Use in pregnancy only if the doctor decides it is needed; little is absorbed into the body after inhalation. It is not known if it passes into breast milk in significant amounts; it is generally considered acceptable during breastfeeding when prescribed.
Precautions and Warnings
- Protect the eyes from the mist, especially if you have narrow-angle glaucoma.
- Use with care if you have an enlarged prostate or bladder outflow problems.
- It is not the first choice reliever on its own for sudden asthma attacks; follow your action plan.
- Clean the nebuliser as instructed to prevent infection.
Overdose
Overdose may cause dry mouth, blurred vision, fast heartbeat and difficulty passing urine. Contact a doctor if too much has been used.
Therapeutic Class
Inhaled bronchodilator; short-acting antimuscarinic.
Storage
Store below 30°C, protected from light, in the original packing and out of the reach of children. Do not freeze. Use vials soon after opening.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.