The dosage should be adapted to the individual requirements of the patients who should be kept under medical supervision during treatment. It is advisable not to exceed the recommended daily dose during either acute or maintenance treatment.
If therapy does not produce a significant improvement or if the patient's condition gets worse, medical advice must be sought in order to determine a new plan of treatment. The patients should be instructed that in the case of acute or rapidly worsening dyspnoea a physician should be consulted immediately.
The following doses are recommended: Metered Dose Inhaler: Maintenance treatment: Adults and children > 6 years of age: 2 metered doses (puffs) 4 times daily.
Since a requirement for increasing doses suggests that additional therapeutic modalities may be needed, a total daily dose of 12 puffs should generally not be exceeded.
For acute exacerbations of chronic obstructive pulmonary disease treatment with ATROVENT solution for inhalation may be indicated.
Because of insufficient information in children ATROVENT metered dose inhaler should only be used on medical advice and under the supervision of an adult.
Solution for inhalation: 20 drops = about 1 mL.
1 drop = 0.0125 mg ipratropium bromide anhydrous.
Adults (including elderly) and adolescents > 14 years of age: 0.4 - 2.0 mL (8 - 40 drops = 0.1 - 0.5 mg ipratropium bromide anhydrous) 3 - 4 times daily.
Children 6 - 14 years of age: 0.4 - 1.0 mL (8 - 20 drops = 0.1 - 0.25 mg ipratropium bromide anhydrous) 3 - 4 times daily.
Children < 6 years of age: Because there is limited information in this age group the following dose recommendation should be given under medical supervision: 0.4 - 1.0 mL (8 - 20 drops = 0.1 - 0.25 mg ipratropium bromide anhydrous) 3 - 4 times daily.