Rynaspray

Indications

• Inhaler and nebuliser forms: to open the airways in chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, and to relieve wheezing in asthma, often together with Salbutamol.
• Nasal spray: to reduce a runny nose caused by allergies or colds, as prescribed.

How It Works

Ipratropium is an anticholinergic medicine. It blocks the nerve signals that tighten the muscles around the airways and increase mucus, so the airways relax and breathing becomes easier. In the nose it reduces watery discharge.

Dosage and Administration

• Metered-dose inhaler (adults): usually 1 or 2 puffs (20 to 40 mcg) 3 or 4 times a day.
• Nebuliser solution (adults): usually 250 to 500 mcg 3 or 4 times a day, given through a nebuliser machine. In a severe attack the doctor may give it more often.
• Inhalation capsules: inhaled through the device supplied, as prescribed. Do not swallow the capsules.
• Nasal spray and all doses for children: as prescribed.

Use a mouthpiece, or a well-fitting mask, with the nebuliser so the mist does not get into the eyes.

Interactions

Other anticholinergic inhalers such as Tiotropium, Glycopyrronium or Umeclidinium add to its effect and side effects; they are not normally used together. Medicines with anticholinergic effects (some antihistamines, antidepressants and bladder medicines) can increase dry mouth, constipation and difficulty passing urine. It is commonly and safely used with Salbutamol.

Contraindications

Allergy to ipratropium, Atropine or similar medicines, or to any ingredient of the product.

Side Effects

Common: dry mouth, throat irritation, cough, headache, dizziness and constipation. Less common: fast heartbeat, blurred vision and difficulty passing urine.

Get urgent medical help if breathing or wheezing gets worse straight after using it, if you have eye pain with red eyes, blurred vision or seeing coloured rings around lights, if you cannot pass urine, or if the face, lips or throat swell.

Pregnancy and Lactation

It can be used in pregnancy when the doctor considers it needed, since treating breathing problems well is important for mother and baby. It is unlikely to harm a breastfed baby, but use it only on the doctor's advice.

Precautions and Warnings

Take care if you have glaucoma (raised eye pressure), an enlarged prostate or difficulty passing urine. Keep the spray and mist away from the eyes. It is not the first choice for quick relief of a sudden asthma attack on its own; use the reliever your doctor has given you. See a doctor if your breathing is not improving or you need it more often than before.

Overdose

Serious effects are unlikely. Too much may cause dry mouth, blurred vision and a fast heartbeat. Contact a doctor if symptoms are troublesome.

Therapeutic Class

Bronchodilator (anticholinergic, short-acting muscarinic antagonist).

Storage

Store below 30°C, away from light and out of the reach of children. Do not freeze. Do not puncture or heat the inhaler canister. Keep nebuliser vials in their pack and throw away any solution left in an opened vial.