Ipratropium

Indications
Nasal
Seasonal allergic rhinitis
Adult: As metered-dose nasal spray (0.06%): 42 mcg into each nostril bid/tid, up to 84 mcg into each nostril 3-4 times daily for up to 4 days when rhinorrhoea is associated with common cold or up to 3 wk in seasonal allergic cases.
Child: As metered-dose nasal spray: ≥6 yr: 42 mcg into each nostril bid/tid.
Nasal
Rhinorrhoea associated with rhinitis
Adult: As metered-dose nasal spray (0.06%): 42 mcg into each nostril bid/tid, up to 84 mcg into each nostril 3-4 times daily for up to 4 days when rhinorrhoea is associated with common cold or up to 3 wk in seasonal allergic cases.
Child: As metered-dose nasal spray: ≥6 yr: 42 mcg into each nostril bid/tid.
Inhalation
Chronic obstructive pulmonary disease
Adult: As metered-dose aerosol: 20 or 40 mcg 3 or 4 times daily. Max: 12 inhalations daily. As dry powder: 40 mcg 3 or 4 times daily. Max: 320 mcg daily. As nebulised solution: 500 mcg (1 unit dose vial) 3-4 times daily.
Child: As metered-dose aerosol: <6 yr: 20 mcg tid; 6-12 yr: 20 or 40 mcg tid. As nebulised solution: <6 yr: 125-250 mcg; 6-12 yr: 250 mcg at intervals of at least 6 hr up to 1 mg daily.
Warnings / Precautions
Bladder neck obstruction, narrow-angle glaucoma or patients susceptible to glaucoma, prostatic hyperplasia. Protect patient's eyes from nebulised drug. Renal and hepatic impairment. Pregnancy, lactation, children, elderly.
Adverse Reactions
Dry mouth, urinary retention, buccal ulceration, paralytic ileus, headache, nausea, constipation, paradoxical bronchospasm, immediate hypersensitivity reactions (urticaria, angioedema), acute angle-closure glaucoma, nasal dryness and epistaxis (nasal spray).
Potentially Fatal: Anaphylactic reactions, atrial fibrillation, supraventricular tachycardia.
Drug Interactions
Increased toxicity with other anticholinergic drugs.
See Below for More ipratropium bromide Drug Interactions
Mechanism of Actions
Ipratropium bromide blocks the action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation.
Absorption: Poorly absorbed from the GIT.
Distribution: Minimally protein-bound.
Excretion: Via urine and faeces (as unchanged drug and metabolites).
Storage Conditions
Inhalation: Aerosol: Store at 25°C (77°F). Do not expose above 49°C (120°F). Solution: Store at 15-30°C (59-86°F). Nasal: Store tightly closed at 25°C (77°F).
ATC Classification
R01AX03 - ipratropium bromide ; Belongs to the class of other nasal preparations for topical use.
R03BB01 - ipratropium bromide ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, anticholinergics.
Storage
Inhalation: Aerosol: Store at 25°C (77°F). Do not expose above 49°C (120°F). Solution: Store at 15-30°C (59-86°F). Nasal: Store tightly closed at 25°C (77°F).
Available As
  • Ipratropium 20 mcg
  • Ipratropium Bromide 20 mcg
  • Ipratropium Bromide 250 mcg
  • Ipratropium 40 mcg
  • Ipratropium Bromide 40 mcg
  • Ipratropium Bromide 42 mcg
  • Ipratropium Bromide 500 mcg
  • Ipratropium 500 mg
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