Ipratropium bromide is a medication used to help open the airways and make breathing easier for people with conditions that cause airway narrowing. It belongs to a class of drugs called anticholinergics, which work by relaxing the muscles in the lungs and reducing mucus production. This medicine helps relieve symptoms such as wheezing, coughing, and shortness of breath.
It works by blocking muscarinic receptors, mainly the M3 receptors in the airways. By doing this, ipratropium bromide prevents the tightening of airway muscles and allows more air to move in and out of the lungs. The effects usually start within minutes and last for about four to six hours.
Ipratropium bromide is commonly prescribed for chronic obstructive pulmonary disease (COPD), chronic bronchitis, and asthma. It comes in several forms, including inhalers, nebulizer solutions, and nasal sprays, making it suitable for both short-term relief and long-term management.
Indications for use
Ipratropium bromide is used for the treatment and maintenance of respiratory conditions that cause airway obstruction. The main indications include:
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Management of chronic obstructive pulmonary disease (COPD)
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Relief of symptoms in chronic bronchitis and emphysema
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Adjunct treatment for acute asthma attacks
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Reduction of nasal discharge in allergic or nonallergic rhinitis (nasal spray form)
It is often used together with beta2-agonists, such as albuterol, to achieve greater bronchodilation in people who do not respond adequately to a single medication.
How to take it
Ipratropium bromide should always be used as directed by a healthcare provider. It can be taken using different forms, including a nebulizer, inhaler, or nasal spray. The correct method of use depends on the specific formulation prescribed.
1. Inhalation solution (nebulizer)
For adults and children 12 years or older, the usual dose is500 mcg (0.5 mg) every 6 to 8 hours using a nebulizer.
For children under 12, the recommended dose is 125 to 250 mcg three or four times per day.
In cases of acute asthma, doses may be repeated every 20 minutes for up to three doses under medical supervision. The total daily dose should not exceed 2 mg unless advised by a doctor.
To use, each vial (500 mcg/2.5 mL) should be placed in the nebulizer chamber and inhaled through the mouthpiece or face mask until the solution is fully used.
2. Inhaler
Shake the inhaler well before use. After exhaling fully, place the mouthpiece in the mouth, press down on the inhaler to release one puff, and inhale slowly and deeply. Hold your breath for about 10 seconds before exhaling. The mouthpiece should be cleaned weekly to prevent buildup and blockage.
3. Nasal spray
For nasal congestion, two sprays should be applied into each nostril two to three times per day. The spray should be primed before the first use and again if it has not been used for several days. Spray the medication while breathing gently through the nose.
Possible side effects
Common side effects of ipratropium bromide include:
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Dry mouth or throat irritation
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Cough
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Headache
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Dizziness
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Nausea
Less common side effects may include blurred vision, urinary retention, or constipation due to its anticholinergic effect. In rare cases, ipratropium bromide may cause paradoxical bronchospasm, which is a sudden worsening of breathing after inhalation. People with glaucoma should be careful to avoid getting the medication in their eyes, as it can worsen the condition.
Overall, side effects are generally mild because very little of the medication is absorbed into the bloodstream when inhaled properly.
Contraindications
Ipratropium bromide should not be used by people who are allergic to ipratropium, atropine, or other anticholinergic drugs.
Caution is advised for people with:
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Narrow-angle glaucoma
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Enlarged prostate (benign prostatic hypertrophy)
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Bladder neck obstruction
It should also be used carefully in older adults and in those who are pregnant or breastfeeding, always under medical supervision.
Use in children
Ipratropium bromide is approved for use in children, mainly as an add-on treatment for severe asthma or bronchospasm. Studies have shown that it is effective and well-tolerated when given in appropriate doses. When used in children, a nebulizer or inhaler spacer device should be used correctly to ensure safe and effective delivery.