ipratropium bromide
Ipratropium bromide is an inhaled medication used to help people with chronic obstructive pulmonary disease (COPD). It's an inhaled anticholinergic that works by opening up your airways so you can breathe easier. The medication is administered through a nebulizer machine and inhaled through the mouth 3 to 4 times a day. Common side effects include headache and cough.
What is Ipratropium bromide?
What is Ipratropium bromide used for?
Maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults
How Ipratropium bromide works
Ipratropium bromide is a short-acting muscarinic antagonist (SAMA), a type of anticholinergic medication. It works by blocking a chemical called acetylcholine from causing your airways to contract. By blocking acetylcholine, ipratropium bromide relaxes the muscles in your airways to make it easier to breathe.
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What are the side effects of Ipratropium bromide?
Common Side Effects
- Bronchitis (15%)
- Upper respiratory tract infections (13%)
- Shortness of breath (10%)
- Headache (6%)
- Cough (5%)
Other Side Effects
- Pain
- Sore throat
- Flu-like symptoms
- Nausea
- Back pain
- Chest pain
- Runny nose
- Dry mouth
- Constipation
- Arthritis
Serious Side Effects
- Serious allergic reaction: hives, swelling of your face, lips, or tongue, difficulty breathing
- Sudden narrowing of your airways: difficulty breathing, wheezing, chest pain or tightness, cough
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine 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:
For the 0.03% nasal spray
More common
Body aches or pain
chills
difficulty with breathing
ear congestion
headache
loss of voice
unusual tiredness or weakness
Less common
Blurred vision
burning, dry, or itching eyes
discharge or excessive tearing
itching, redness, tearing, or other sign of eye irritation not present before use of this medicine or becoming worse during use
nasal dryness
nosebleeds
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
Incidence not known
Difficulty with swallowing
dizziness
fast heartbeat
hives or welts
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
redness of the skin
skin rash
tightness in the chest
Some side effects 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:
For the 0.03% nasal spray
Less common or rare
Bad, unusual, or unpleasant (after) taste
change in taste
dry mouth or throat
increased nasal congestion or runny nose
nasal itching, burning, or irritation
For the 0.06% nasal spray
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Ipratropium bromide
Pros
Works well as a maintenance treatment for COPD
Doesn't really affect your heart rate
Can mix with albuterol if ipratropium bromide doesn't fully control your symptoms
Available as a lower-cost generic
Cons
Takes about 5 to 15 minutes to receive the whole dose
Need to use with a nebulizer machine, which isn't ideal for someone who's on the go
Might need to be used multiple times per day because effects don't last long
Not a rescue medication
Pharmacist tips for Ipratropium bromide
Ipratropium bromide isn't meant to be used as a rescue medication for treating sudden difficulty breathing. Always have your rescue medication, like albuterol (Ventolin) or levalbuterol (Xopenex), with you just in case you have sudden trouble breathing.
Understand how to use ipratropium bromide with a nebulizer machine. Ask your provider or pharmacist if you have any questions about using the medication.
You don't need to shake the ipratropium bromide vial before using it. You also don't need to rinse your mouth or spit after using ipratropium bromide.
Sit in a comfortable, upright position during your ipratropium bromide breathing treatment. Using the mouthpiece or face mask, breathe as calmly, deeply, and evenly as possible until there's no more mist in the nebulizer.
Clean your nebulizer after each time you use it. This helps prevent infections that can happen if you use a nebulizer machine that isn't cleaned well.
Call your provider if your breathing worsens or you find yourself using your rescue inhaler more while using ipratropium bromide. These could be signs you need a change in your COPD medications.
Keep the vials of ipratropium bromide in the original foil pouch and store at room temperature. After opening the pouch, keep any unused vials in the foil pouch to protect them from light.
Frequently asked questions about Ipratropium bromide
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What are the risks and warnings for Ipratropium bromide?
Ipratropium bromide can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reactions
Risk factors: History of allergy to other medications or foods
Severe allergic reactions to ipratropium bromide are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using ipratropium bromide.
Narrowing of your airways (bronchospasm)
Though rare, ipratropium bromide can sometimes cause a muscle spasm in your lungs (bronchospasm). This can lead to difficulty breathing, wheezing, cough, and chest discomfort. If you become short of breath after using ipratropium bromide, get medical attention right away.
Risk of eye and vision problems
Risk factors: History of glaucoma
Though not common, using ipratropium bromide can raise the pressure in the eyes. This is especially a concern for people with glaucoma. Talk to your eye provider before using ipratropium bromide if you have glaucoma or other eye problems. Try not to get ipratropium bromide in your eyes because this could cause eye pain, discomfort, blurry vision, and other vision changes.
Trouble urinating
Risk factors: Enlarged prostate | Bladder-neck obstruction (blockage)
Ipratropium bromide should be used carefully in people who have prostate problems, because it can worsen this condition and lead to difficulty urinating. Contact your provider if you notice difficulty urinating while using this medication.
Ipratropium bromide dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2.5ml of 0.02% | 25 vials | $13.07 | $0.52 |
Typical dosing for Ipratropium bromide
The typical dose is 1 vial inhaled through the mouth by nebulization 3 to 4 times a day. Doses should be spaced 6 to 8 hours apart.
Interactions between Ipratropium bromide and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Clozapine
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Methacholine
- Quetiapine
- Revefenacin
- Scopolamine
- Secretin Human
- Tiotropium
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Betel Nut
Ipratropium bromide contraindications
Severe allergy to an anticholinergic medication
What are alternatives to Ipratropium bromide?
Maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults
Chronic obstructive pulmonary disease (COPD)
Asthma in people age 6 years and older - Spiriva Respimat only
Maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults
What is the latest news about Ipratropium bromide?
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References
Best studies we foundCampbell, S. (1999). For COPD a combination of ipratropium bromide and albuterol sulfate is more effective than albuterol base. Archives of Internal Medicine.
Everard, M. L., et al. (2005). Anticholinergic drugs for wheeze in children under the age of two years. The Cochrane Database of Systematic Reviews.
Khorfan, F. M., et al. (2011). Effects of nebulized bronchodilator therapy on heart rate and arrhythmias in critically ill adult patients. CHEST Journal.
Mann, K. V., et al. (1988). Use of ipratropium bromide in obstructive lung disease. Clinical Pharmacy.
Ritedose Pharmaceuticals, LLC. (2023). Ipratropium bromide solution [package insert]. DailyMed.
Sam, C., et al. (2023). Physiology, acetylcholine. StatPearls.
Sockrider, M. (2020). Nebulizer breathing treatments at home. American Thoracic Society.
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