► Atrovent (ipratropium (ipratropium bromide)) - Practical Medicine

Atrovent (ipratropium (ipratropium bromide)) - inhaler fluid from a nebulizer

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Atrovent inhalation fluid from a nebulizer; 250 μg / ml; 20 ml Boehringer Ingelheim International 14.92 0.00

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:ipratropium (ipratropium bromide)

The drug is available on prescription

What is Atrovent ?

An inhalation drug that prevents spastic bronchial and bronchodilatory states facilitating the free flow of air in the airways. The drug is used in diseases with bronchospasm. The effect occurs after a few minutes and lasts an average of up to 6 hours.

What does Atrovent contain and how does it work?

The active substance is ipratropium bromide. It is a substance belonging to a group of medicines called parasympatolytics or cholinolytics. It works anti-spastically, it dilates the bronchi and prevents their cramps. The mechanism of action of ipratropium is to inhibit the activation of cholinergic receptors (specifically muscarinic receptors type M3) of the smooth muscle cells of the bronchi located in the membrane. These receptors are stimulated by acetylcholine released after activation of the vagus nerve and cause contraction of the bronchial smooth muscles. Inhibition of their activation leads to bronchodilation. Improves the ventilation of the lungs, and the patient feels the reduction or complete resolution of dyspnea caused by the contraction of the muscles of the respiratory tract.

When to use Atrovent?

The preparation is indicated as a bronchodilator in the maintenance treatment of bronchospasm:
• in chronic obstructive pulmonary disease (COPD)
• in bronchial asthma.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the product if you are allergic (you are hypersensitive) to any of the ingredients or to atropine and atropine-like substances.

When should you take special care with Atrovent?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups. Therefore, before using the preparation you should consult a doctor if you suspect or have been diagnosed with you:
• prostatic hyperplasia
• narrowing of the bladder neck
• predisposition to glaucoma with a closing angle of perception.
Cystic fibrosis patients may be more susceptible to gastrointestinal motility disorders.
Protect eyes from contact with the preparation. The aerosol from the nebulizer should be used through the mouthpiece. If this is not possible, use a nebuliser mask that is close to the face. People with a predisposition to glaucoma should take special care and very carefully protect their eyes during inhalation. The preparation after entering the eye may cause dilation of the pupils, increase in intraocular pressure, glaucoma with a closed angle of perception, eye pain.If symptoms such as eye pain, discomfort, blurred vision, visual halo, altered vision of colors coexisting with eye redness occur, immediately consult a physician. These symptoms may indicate an acute glaucoma with a closed angle of perception, and it may be necessary to use appropriate medications.
Rarely, the preparation may cause immediate hypersensitivity reactions such as urticaria, angioneurotic edema , rash, bronchospasm, swelling of the mucous membrane of the mouth and throat, and anaphylactic shock.
If the dyspnoea that occurs is a violent attack and its symptoms are rapidly increasing, you should seek medical help immediately. If the treatment does not bring significant improvement or the symptoms become worse, please consult your doctor. Your doctor will assess your condition and verify your further treatment.
Additional information about the other ingredients of the preparation:
- the preparation contains benzalkonium chloride as a preservative and sodium edetate as a stabilizer; these substances may cause bronchospasm.
Important information about the use of the preparation.
The delivered dose depends on properly conducted inhalation. That is why it is very important to master the inhalation technique corr ectly. Inhalation of the drug allows its rapid access directly to the airways, or the place of its operation. Inhalation fluid from the nebulizer is supplied in a bottle of amber glass (20 ml) with a dropper. 20 drops of the formulation is 1 ml corresponding to 0.25 mg ipratropium bromide.
• To always buy your prescription in time and buy a new one before you use up the previous one.
• Always carry a inhaler with a fast-acting bronchodilator.
- Keep the nebulizer clean (clean the nebuliser in accordance with the manufacturer's instructions).

Does this preparation affect the ability to drive vehicles?
There are no studies on the effect of the preparation on the ability to drive and use machines.

Dosage of Atrovent

Use the product as directed by your doctor. Do not exceed the recommended doses, because it will not increase the effectiveness of the drug and may harm your health and life. Administration of the preparation in a daily dose of more than 2 mg (8 ml, ie 160 drops) in adults and children over 14 years of age and 1 mg (4 ml, ie 80 drops) in children under the age of 14 should take place under the supervision of a doctor. If you have any doubts regarding the use of the preparation, consult a physician. Unless your doctor tells you otherwise, the usual doses are:
Adults and adolescents over 14 years old.
2 ml (40 drops) 3 to 4 times a day.
Children from 6 to 14 years old.
Due to the limited amount of information on the use of the preparation in this age group, inhalations in accordance with the recommended dosage below should be under the supervision of a physician.
1 ml (20 drops) 3-4 times a day.
Children before the age of 6.
Due to the limited amount of information on the use of the preparation in this age group, inhalations in accordance with the recommended dosage below should be under the supervision of a physician.
0.4-1 ml (8-20 drops) 3-4 times a day.

Can Atrovent be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
The safety of the preparation during pregnancy has not been established. Only a doctor can assess the risk-benefit ratio in your case.
It is not known if the product is excreted in human milk. Before using the product during breastfeeding, consult a doctor.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter. Interactions of ipratropium bromide and beta-adrenergic receptor drugs (eg sympathomimetics (link) such as fenoterol, formoterol, salmeterol) and xanthine-derived drugs (eg theophylline) may increase the bronchodilator effect.Co-administration with nebuliser of ipratropium bromide and beta-agonists (e.g., fenoterol) may increase the risk of acute glaucoma in patients with closed-angle glaucoma.

What side effects can occur?

Like all medicines, Atrovent can also cause side effects, although it will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
After the use of the preparation may occur: headache and dizziness, disturbances of eye accommodation, glaucoma with a closed angle of perception, acceleration of heart function, constipation, diarrhea, vomiting, skin hypersensitivity reactions (rash, pruritus, urticaria, Quincke's edema). The rare but serious side effects include: anaphylactic type hypersensitivity reactions (angioneurotic edema of the lips, tongue, throat that may impede breathing and / or swallowing, shortness of breath, bronchospasm, hypotension, shock). If you notice the appearance of anaphylactic reaction symptoms, you should seek medical help immediately. This preparation, like other inhalation medicines, may cause respiratory irritation, cough, dry mouth, and (rarely) bronchospasm. After getting into the eye, the preparation may cause dilation of the pupils, increase in intraocular pressure, glaucoma with a closing angle of perception, and eye pain. If symptoms such as eye pain, discomfort, blurred vision, visual halo, changes in color vision coexisting with red eyes occur, immediately consult a physician. These symptoms may be indicative of the occurrence of acute glaucoma with a septic angle of filtration, which may require treatment with dropping eye drops. In rare cases urinary retention may occur (especially in people with urinary outflow obstruction) and, especially when high doses are used, cardiac arrhythmias may occur, including atrial fibrillation, sUPRA ventricular tachycardia and accessory spasms.

Other preparations on the Polish market containing ipratropium (ipratropium bromide)

Atrodil (inhalation spray, solution)
Atrovent N (inhalation spray, solution)