Ipratropium Bromide information from DrugsUpdate  

Pharmacodynamics

Pharmacokinetics

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).

Ipratropium Bromide Indications / Ipratropium Bromide Uses

Information Not Available

Ipratropium Bromide Adverse Reactions / Ipratropium Bromide Side Effects

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.

Precautions

Hypersensitivity
May occur immediately.

Special Risk Patients
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.

Acute bronchospasm
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.

Paradoxical bronchospasm
May occur.

Special Precautions

Information Not Available

Other Drug Interactions

Increased toxicity with other anticholinergic drugs

Other Interactions

Information Not Available

Dosage

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 weeks in seasonal allergic cases.
Child: As metered-dose nasal spray: ≥6 years: 42 mcg into each nostril bid/tid.

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 weeks in seasonal allergic cases.
Child: As metered-dose nasal spray: ≥6 years: 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 years: 20 mcg tid; 6-12 years: 20 or 40 mcg tid. As nebulised solution: <6 years: 125-250 mcg; 6-12 years: 250 mcg at intervals of at least 6 hours up to 1 mg daily.

Food(before/after)

Information Not Available

Ipratropium Bromide and Pregnancy

Caution when used during pregnancy

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Ipratropium Bromide and Lactation

Caution when used during lactation

Ipratropium Bromide and Children

Safety and efficacy in children younger than 12 years of age not established for solution; younger than 6 years of age for 0.03% nasal spray; younger than 5 years of age for 0.06% nasal spray; safety and efficacy not established (HFA inhaler).

Ipratropium Bromide and Geriatic

Information Not Available

Ipratropium Bromide and Other Contraindications

Information Not Available

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).

Lab interference

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).