Atrovent

Ipratropium is a prescription medication used to treat chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

This medication belongs to a group of drugs called anticholinergics (or antimuscarinics) which work by opening up the air passages in the lungs to allow air to flow more easily, relieving symptoms such as coughing, wheezing and shortness of breath. 

Ipratropium comes in a metered-dose inhaler (called an "MDI"). It is usually taken as 2 inhalations four times a day. Ipratropium is also available as a nebulizer solution.

Common side effects include headache, cough, dry mouth, and dizziness. Do not drive or operate heavy machinery until you know how it affects you.

Ipratropium is a prescription medication used to treat chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.

This medication may be prescribed for other uses in some cases including asthma. Ask your doctor or pharmacist for more information.

Contraindications

• Known hypersensitivity to the drug or any other component of the formulation, or to atropine or its derivatives.1 4 329

• Known hypersensitivity to soya lecithin or related food products, including soybeans and peanuts.1 277 320

Warnings/Precautions

Warnings

Delayed onset of action; not indicated for initial treatment.1 4 Generally should not be used alone for the management of acute bronchospasm, when a rapid response is required.1 4 164 225

Sensitivity Reactions

Immediate hypersensitivity reactions, including rash, angioedema of the tongue, lips, and face, urticaria, bronchospasm, oropharyngeal edema, and anaphylactic reaction.1 4 196 213 277 285 320 329

Possible paradoxical bronchospasm.1 4 190 191 196 270 271 272 273 320

General Precautions

Contact a clinician immediately if a previously effective dosage regimen fails to provide the usual relief (e.g., need to increase the dose or frequency of administration of the drug).1 Do not increase the dose or frequency of inhalation without consultation with a clinician.1

Possible temporary blurred vision,1 2 4 10 328 349 mydriasis,1 225 250 275 ocular pain,4 328 329 349 conjunctival or corneal congestion associated with visual halos or colored images,1 or precipitation or worsening of angle-closure glaucoma4 173 329 337 349 following inadvertent contact of ipratropium with the eyes.4 190 191 328 349

Minimize ocular exposure by using a mouthpiece rather than a face mask during administration via a nebulizer.4 190 191 329 During oral inhalation of aerosol, close eyes.1 2 Inhalation aerosol should not be administered using the open-mouth technique in these patients with angle-closure glaucoma.173 190 191 Use with caution in patients with angle-closure glaucoma.1 4

Possible urinary retention/difficulty,1 4 251 252 320 329 urinary tract infection,4 320 329 or dysuria.4 320

Use with caution in patients with bladder neck obstruction or prostatic hypertrophy.1 4 190 191 225 329

Possible adverse cardiovascular effects (e.g., tachycardia, palpitations, aggravated hypotension or hypertension).1 4 329

When used in fixed combination with other agents, consider the cautions, precautions, and contraindications associated with the concomitant agents.

Specific Populations

Category B.1

Use with caution.1 2 4 329

Safety and efficacy of oral inhalation not established in children <12 years of age.1 4 320 329

Use with caution.4 329

Use with caution.4 329

Common Adverse Effects

Bronchitis, upper respiratory tract infection,320 cough,1 2 4 87 120 285 and dryness of the mouth,1 2 14 16 60 90 120 127 throat,1 75 90 or tongue87 with ipratropium aerosol. Adverse effects resulting in discontinuance of nebulized ipratropium most frequently include bronchitis, dyspnea, and bronchospasm.4 329

• Importance of providing patients with a copy of the manufacturer’s patient information.1 4

• Importance of using proper administration technique.1 4

• Importance of advising patients that oral inhalation is not intended for occasional use.1 4 Use consistently throughout the course of therapy for maximum effectiveness.1 4

• Importance of contacting a clinician if symptoms of COPD are not relieved by usually effective doses or if they worsen.1 Do not increase the dosage or frequency of administration without consultation with a clinician.1

• Importance of advising patients to close their eyes during oral inhalation of aerosol1 2 to avoid inadvertent contact of the drug with the eyes and subsequent adverse effects.1 10

• Importance of contacting a clinician immediately if ocular symptoms develop.1

• Importance of advising patients that blurring of vision, precipitation or aggravation of narrow angle glaucoma, mydriasis, visual halos, colored images in association with conjunctival or corneal congestion, or eye pain or discomfort may result from contact of the inhalation solution with the eyes.1

• Importance of informing clinicians if ocular adverse effects develop.1

• Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.1

• Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.320

• Importance of informing patients of other important precautionary information. (See Cautions.)

• If you have an allergy to ipratropium or any other part of Atrovent (ipratropium (nasal)).
• If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

This medicine may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Nose irritation.
• Nosebleed.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Avoid getting this medication in your eyes. If this happens, rinse with water.

Atrovent may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Applies to ipratropium: inhalation aerosol liquid, inhalation aerosol powder, inhalation solution

Along with its needed effects, ipratropium (the active ingredient contained in Atrovent) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ipratropium:

• Bladder pain
• bloody or cloudy urine
• cough producing mucus
• difficult, burning, or painful urination
• difficulty with breathing
• frequent urge to urinate
• lower back or side pain
• shortness of breath
• tightness in the chest
• wheezing

• Body aches or pain
• chills
• cough
• ear congestion
• fever
• headache
• loss of voice
• runny nose
• sneezing
• sore throat
• unusual tiredness or weakness

• Constipation (continuing) or lower abdominal pain or bloating
• fainting
• fast, pounding, or irregular heartbeat or pulse
• severe eye pain
• skin rash or hives
• swelling of the face, lips, or eyelids

• Blindness
• blurred vision
• confusion
• decrease in the frequency of urination
• decrease in the urine volume
• decreased vision
• difficulty in passing urine (dribbling)
• difficulty with swallowing
• dizziness
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• hives or welts
• itching
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• nausea or vomiting
• noisy breathing
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• redness of the skin
• redness of the white part of the eyes or inside of the eyelids
• sweating
• tearing

Some side effects of ipratropium may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Back pain
• dryness of the mouth
• unpleasant taste

• Acid or sour stomach
• belching
• burning eyes
• diarrhea
• general feeling of discomfort or illness
• heartburn
• indigestion
• joint pain
• loss of appetite
• muscle aches and pains
• nervousness
• pain or tenderness around the eyes and cheekbones
• shivering
• stomach discomfort, upset, or pain
• trembling
• trouble sleeping

Atrovent is used to treat a runny nose caused by allergic rhinitis, non-allergic perennial rhinitis, and the common cold.

Atrovent doesn’t work to relieve nasal congestion or sneezing.

Atrovent comes in the form of a nasal spray. Your doctor or nurse will show you how to use this product.

Atrovent is a brand name for the drug ipratropium. It’s also available as a generic drug.

The more common side effects of this drug include headache, upper respiratory tract infection (such as the common cold), nosebleeds, nasal dryness, nasal irritation, and pharyngitis (sore throat).

• Not for fast relief of symptoms See Details

• Don’t spray it into your eyes See Details

What is Atrovent?

This drug is a prescription drug. It’s available as a nasal spray, pressurized inhalation solution known as a metered dose inhaler (MDI), and inhalation solution given through a nebulizer machine. 

This drug is a brand name for the drug called ipratropium. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Why it's used

This nasal spray is used to treat a runny nose caused by allergic rhinitis, non-allergic perennial rhinitis, and the common cold.

This drug doesn’t relieve nasal congestion or sneezing.

How it works

This drug belongs to a class of drugs called anticholinergics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. 

More Details