Trade Names:Atrovent HFA- Aerosol Each actuation delivers 17 mcg
Trade Names:Ipratropium Bromide- Solution for Inhalation 0.02% (500 mcg/vial)- Nasal Spray 0.03%. Each spray delivers 21 mcg- Nasal Spray 0.06%. Each spray delivers 42 mcgApo-Ipravent (Canada)Gen-Ipratropium (Canada)ratio-Ipratropium (Canada)ratio-Ipratropium UDV (Canada)
Antagonizes action of acetylcholine on bronchial smooth muscle in lungs, causing bronchodilation.
Mean bioavailability is 7% (inhalation). Ipratropium is not readily absorbed.
0 to 9% is protein bound.
The t ½ is approximately 2 h (inhalation or IV). Following IV administration, approximately half of the dose is excreted unchanged in the urine.
Pharmacokinetics not studied.Hepatic Function Impairment
Pharmacokinetics not studied.
Maintenance treatment of bronchospasm associated with COPD, including chronic bronchitis and emphysema, used alone or in combination with other bronchodilators (inhalation); symptomatic relief of rhinorrhea associated with allergic and nonallergic rhinitis and symptomatic relief of rhinorrhea associated with the common cold (intranasal).
Hypersensitivity to atropine or any anticholinergic derivatives or to soya lecithin or related food products.
Aerosol/Inhalation 2 inhalations 4 times daily. Do not exceed 12 inhalations in 24 h. Solution 500 mcg (1 unit dose vial) administered 3 to 4 times a day by oral nebulization, with doses 6 to 8 h apart. The solution can be mixed in the nebulizer with albuterol if used within 1 h.
Spray 0.03 formulation: 2 sprays (42 mcg) per nostril 2 or 3 times daily (optimum dose varies). 0.06 formulation: 2 sprays (84 mcg) per nostril 3 or 4 times daily (optimum dose varies).
Store at 77°F; excursions permitted between 59° and 86°F. Do not puncture. Do not use or store near heat or open flame.Nasal spray
Store upright between 59° and 86°F. Avoid freezing.Solution
Store at room temperature. Protect from light. Store unused vials in the foil pouch.
There is some potential for additive anticholinergic effects when administered with other anticholinergic agents.
None well documented.
Palpitations; hypertension; aggravated hypertension; hypotension, tachycardia, superventricular tachycardia and/or atrial fibrillation (postmarketing).
Cough; exacerbation of symptoms; bronchitis dyspnea, upper respiratory tract infection, bronchospasm (including paradoxical bronchospasm).
Nervousness; dizziness; headache.
Acute eye pain; blurred vision; local irritation; mydriasis; epistaxis, nasal dryness, nasal congestion, nasal burning, conjunctivitis, hoarseness, increased intraocular pressure, pharyngitis, rhinitis, sinusitis (0.06% nasal spray formulation only).
Nausea; dry mouth; GI distress; constipation; taste perversion; dyspepsia.
Allergic-type reactions (rash; pruritus; angioedema of the tongue, lips, and face; urticaria; laryngospasm; anaphylacitc reactions), arthritis, back pain, influenza-like symptoms, rash, urinary retention, UTI.
Category B .
Safety and efficacy in children younger than 12 yr of age not established for solution; younger than 6 yr of age for 0.03% nasal spray; younger than 5 yr of age for 0.06% nasal spray; safety and efficacy not established (HFA inhaler).
May occur immediately.
Use drug with caution in patients with narrow-angle glaucoma, prostatic hypertrophy, prostatic hyperplasia, or bladder neck obstruction due to increased risk for precipitation or worsening of underlying disease.
Not indicated for initial treatment of acute episodes of bronchospasm in which rapid response is required. For relief of bronchospasms in acute exacerbations of COPD, drugs with faster onset may be preferable as initial therapy. The combination of ipratropium and beta agonists in the relief of bronchospasms associated with COPD has not been demonstrated to be more efficacious than either drug alone.
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