Ipratropium bromide


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Inhalation COPD; Asthma As metered-dose aerosol: 20-40 mcg 3-4 times/day; single doses of up to 80 mcg may be required in some patients. As soln for nebulisation: 250-500 mcg 3-4 times/day. Nasal Rhinorrhoea associated w/ rhinitis As metered-dose nasal spray: 42 mcg into each nostril 2-3 times/day, up to 84 mcg into each nostril 3-4 times/day for up to 4 days when rhinorrhoea is associated w/ common cold or up to 3 wk when associated w/ seasonal allergic rhinitis.
Dosage Details
Inhalation/Respiratory
Asthma, Chronic obstructive pulmonary disease
Adult: As metered-dose aerosol: 20-40 mcg 3-4 times daily; single doses of up to 80 mcg may be required in some patients. As soln for nebulisation: 250-500 mcg 3-4 times daily.
Child: As metered-dose aerosol: <6 yr 20 mcg tid; 6-12 yr 20-40 mcg tid. As soln for nebulisation: <6 yr For acute asthma: 125-250 mcg, given no more often than 6 hrly up to a total dose of 1 mg. 6-12 yr For acute and chronic asthma: 250 mcg, repeated as necessary up to a total dose of 1 mg.

Nasal
Rhinorrhoea associated with rhinitis
Adult: As metered-dose nasal spray: 42 mcg into each nostril 2-3 times daily, up to 84 mcg into each nostril 3-4 times daily for up to 4 days when rhinorrhoea is associated w/ common cold or up to 3 wk when associated w/ seasonal allergic rhinitis.
Child: As metered-dose nasal spray: ≥12 yr 42 mcg into each nostril 2-3 times daily.
Contraindications
Hypersensitivity to ipratropium, atropine, or its derivatives.
Special Precautions
Patient w/ prostatic hyperplasia/bladder neck obstruction, myasthenia gravis, narrow-angle glaucoma, cystic fibrosis. Pregnancy and lactation.
Adverse Reactions
Dry mouth, constipation, tachycardia, palpitations, arrhythmias, nausea and vomiting, dyspepsia, headaches, dizziness, ocular complications (e.g. mydriasis, narrow-angle glaucoma). Rarely, urinary retention, hypersensitivity reactions (e.g. urticaria, angioedema, rash); nasal dryness, irritation and epistaxis.
Potentially Fatal: Paradoxical bronchospasm, anaphylaxis.
Inhalation/Respiratory/Nasal: B
Patient Counseling Information
This drug may cause dizziness, accommodation disorder, mydriasis and blurred vision, if affected, do not drive or operate machinery.
Drug Interactions
Additive bronchodilatory effect w/ β-adrenergic drugs and xanthine preparations.
Action
Description: Ipratropium bromide causes bronchodilation by blocking the action of acetylcholine at parasympathetic site in bronchial smooth muscle. It also inhibits serous and seromucous gland secretions by nasal application.
Onset: Bronchodilation: W/in 15 min.
Duration: 2-5 hr (oral inhalation).
Pharmacokinetics:
Absorption: 10-30% of a dose is deposited in the lungs while only a small amount reaches systemic circulation. Poorly absorbed from the GI tract. Bioavailability: 2% (oral inhalation); 7-28% (nasal).
Distribution: Plasma protein binding: ≤9% (oral inhalation); <20% (nasal).
Metabolism: Metabolised via ester hydrolysis (41%) and conjugation (36%).
Excretion: Via urine and faeces. Elimination half-life: 2 hr (oral inhalation); 1.6 hr (nasal).
Chemical Structure

Chemical Structure Image
Ipratropium bromide

Source: National Center for Biotechnology Information. PubChem Database. Ipratropium bromide, CID=657308, https://pubchem.ncbi.nlm.nih.gov/compound/Ipratropium-bromide (accessed on Jan. 21, 2020)

Storage
Aerosol/nasal spray: Store at 25°C. Protect from light or heat. Soln for nebulisation: Store between 15-30°C. Protect from light.
ATC Classification
R03BB01 - ipratropium bromide ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, anticholinergics.
R01AX03 - ipratropium bromide ; Belongs to the class of other nasal preparations for topical use.
References
Anon. Ipratropium (Nasal). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/07/2015.

Anon. Ipratropium (Oral Inhalation). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/07/2015.

Buckingham R (ed). Ipratropium Bromide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/07/2015.

Ipratropium Bromide Solution (Mylan Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/07/2015.

Disclaimer: This information is independently developed by MIMS based on Ipratropium bromide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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