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Ipratropium bromide, sold under the trade name Atrovent among others, is a type of anticholinergic medication which is applied by different routes: inhaler, nebulizer, or nasal spray, for different reasons. Rxlist.com: Search Atrovent Rx.com: Ipratropium
The inhalant bronchodilator. It is used to treat the symptoms of chronic obstructive pulmonary disease (COPD) and asthma. It is used by inhaler or nebulizer. Onset of action is typically within 15 to 30 minutes and lasts for three to five hours.
The nasal spray prevents the glands in the nose from producing large amounts of fluid. Mayo Clinic: Ipratropium (Nasal Route) Cleveland Clinic: Ipratropium Nasal Spray It is used to treat rhinorrhea (runny nose) caused by allergic rhinitis, nonallergic rhinitis, and the common cold. Rxlist.com: Atrovent Nasal Spray It is used by metered-dose manual pump spray. Onset of action is within an hour.
Common side effects of inhalant use include dry mouth, cough, bronchitis, and Dyspnea. RxList.com: Atrovent HFA Potentially serious side effects include urinary retention, worsening spasms of the airways, and a anaphylaxis. It appears to be safe in pregnancy and breastfeeding. Ipratropium is a short-acting muscarinic antagonist, (2026). 9780702080609 ISBN 9780702080609 which works by causing to relax.
Common side effects of nasal spray may include headache, dry nose, dry mouth or throat, nasal or throat irritation, Nosebleed, bad taste in mouth, nausea, dizziness, or constipation. Potentially serious side effects are unusual, but include severe allergic reaction, eye pain or change in vision, or urinary retention. It is considered safe during pregnancy. Ipratropium nasal is not expected to harm an unborn baby . Drugs.com: Ipratropium nasal
Ipratropium bromide was patented in 1966, and approved for medical use in 1974. It is on the World Health Organization's List of Essential Medicines, the most important medicines needed in a health system. Ipratropium is available as a generic medication. In 2023, it was the 268th most commonly prescribed medication in the United States, with more than 900,000 prescriptions.
It is also used to treat and prevent minor and moderate bronchial asthma, especially asthma that is accompanied by cardiovascular system diseases, as it has been shown to produce fewer cardiovascular side effects.
Combination with beta-adrenergic agonists increases the dilating effect on the bronchi, as when ipratropium is combined with salbutamol (albuterol — USAN) under the trade names Combivent (a non-aerosol metered-dose inhaler or MDI) and Duoneb (nebulizer) for the management of COPD and asthma, and with fenoterol (trade names Duovent and Berodual N) for the management of asthma.
Ipratropium as a nasal solution sprayed into the nostrils can reduce rhinorrhea (runny nose) but will not help nasal congestion. It is supplied in a metered-dose manual pump spray.
Conditions such as narrow-angle glaucoma, prostatic hyperplasia, or bladder neck obstruction are not necessarily contraindicators, but should be taken into account, particularly if the patient is receiving an anticholinergic by another route.
Urinary retention has been reported in patients receiving doses by nebulizer. As a result, caution may be warranted, especially by those with prostatic hypertrophy.
Common side effects of nasal spray are experienced at a rate of 1-6% (versus the control group of 0-3%), and may include headache, dry nose, dry mouth or throat, nasal or throat irritation, Nosebleed, bad taste in mouth, nausea, dizziness, or constipation. Drugs.com: Ipratropium nasal Potentially serious side effects from nasal spray are rare, but include severe allergic reaction, eye pain or change in vision, or difficulty urinating.
Accidental contact with the eye should be avoided.
Ipratropium nasal spray may interact with certain medications for depression, anxiety, or other mental health conditions, certain medications for Parkinson's disease such as Benzatropine and trihexyphenidyl, atropine, certain Antihistamine for allergy, cough, and Common cold, certain medications for bladder problems such as oxybutynin and tolterodine, certain medications for stomach problems such as dicyclomine and hyoscyamine, and certain medications for motion sickness such as scopolamine.
Ipratropium exhibits broncholytic action by reducing cholinergic influence on the bronchial musculature. It blocks muscarinic acetylcholine receptors, without specificity for subtypes, and therefore promotes the degradation of cyclic guanosine monophosphate (cGMP), resulting in a decreased intracellular concentration of cGMP. Most likely due to actions of cGMP on intracellular calcium, this results in decreased contractility of smooth muscle in the lung, inhibiting bronchoconstriction and mucus secretion. It is a nonselective muscarinic antagonist, and does not diffuse into the blood, which prevents systemic side effects. Ipratropium is a derivative of atropine but is a quaternary amine and therefore does not cross the blood–brain barrier, which prevents central side effects. Ipratropium should never be used in place of salbutamol (albuterol) as a rescue medication.
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