ipratropium (Nasal route)

Pronunciation

ip-ra-TROE-pee-um

Commonly used brand name(s)

In the U.S.

  • Atrovent

Available Dosage Forms:

  • Spray

Therapeutic Class: Nasal Agent

Pharmacologic Class: Anticholinergic

Uses For ipratropium

Ipratropium nasal spray is used to relieve runny nose (rhinorrhea).

The 0.03% nasal solution is used to relieve a runny nose caused by allergic and nonallergic perennial rhinitis. However, it does not relieve nasal congestion, sneezing, or postnasal drip caused by allergic or nonallergic perennial rhinitis.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

The 0.06% nasal solution is used for 4 days to relieve a runny nose caused by the common cold. However, it does not relieve nasal congestion or sneezing caused by the common cold.

When ipratropium is sprayed into your nose, it works by preventing the glands in your nose from producing large amounts of fluid.

ipratropium is available only with your doctor's prescription.

Before Using ipratropium

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ipratropium, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ipratropium or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ipratropium nasal spray in children younger than 6 years of age. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of ipratropium nasal spray in geriatric patients.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ipratropium, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ipratropium 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

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of ipratropium. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bladder neck blockage or
  • Enlarged prostate or
  • Glaucoma, narrow-angle—Use with caution. May make these conditions worse.
  • Kidney disease or
  • Liver disease—Use with caution. ipratropium has not been studied in patients with these conditions.

Proper Use of ipratropium

Use ipratropium only as directed by your doctor . Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of side effects.

ipratropium comes with patient directions. Read and follow the instructions carefully. Ask your doctor if you have any questions.

ipratropium is only used in the nose. Do not get it in your eyes. If it does get in the eyes, rinse them with water right away and call your doctor.

Some patients using ipratropium may feel better right away. For others, it may take 1 or 2 weeks before the medicine helps. Keep using the medicine on a regular schedule as your doctor ordered.

To use the nasal spray:

  • Remove the clear plastic dust cap and the green safety clip from the nasal spray pump. The safety clip prevents the accidental discharge of the spray when you are not using it.
  • When you use the spray pump for the first time, you must prime the bottle. Pump the bottle 7 times or until a fine spray comes out.
  • Gently blow your nose before using the spray. Insert the tip of the bottle into your nostril.
  • Close the opposite nostril with a finger and lean your head slightly forward.
  • Spray into your nostril and sniff deeply through your nose. Then breathe out through your mouth.
  • Take the spray pump out of your nostril. Lean your head backward for a few seconds.
  • If a second dose is needed in the same nostril, lean the head slightly forward and repeat the same steps.
  • Spray the opposite nostril using the same steps.
  • Replace the clear plastic dust cap and the green safety clip.
  • If the spray pump gets clogged, hold the tip of the bottle under warm running water for about 1 minute. Dry the pump and prime it again.
  • If you do not use the bottle for more than 24 hours, prime it again by releasing two sprays.
  • If you do not use the bottle for more than 7 days, clean the spray tip and prime it again by releasing seven sprays.
  • Keep track of the number of sprays you use. Throw the bottle away after you use 345 sprays (0.03% nasal spray) even if some liquid remains in the bottle.
  • You should not take extra doses of the nasal spray without checking first with your doctor.

Dosing

The dose of ipratropium will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ipratropium. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For the 0.03% nasal spray:
    • For runny nose caused by allergic and nonallergic perennial rhinitis:
      • Adults, teenagers, and children 6 years of age and older—2 sprays in each nostril two or three times a day.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
  • For the 0.06% nasal spray:
    • For runny nose associated with the common cold:
      • Adults, teenagers, and children 5 years of age and older—2 sprays in each nostril three or four times a day. Do not use the medicine for more than 4 days.
      • Children younger than 5 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of ipratropium, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using ipratropium

It is very important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it.

If you or your child feel that your symptoms do not improve within a few weeks or if they become worse, check with your doctor.

ipratropium may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Stop using ipratropium and call your doctor right away if you or your child have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using ipratropium.

Check with your doctor right away if blurred vision, difficulty in reading, eye pain or discomfort, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

ipratropium may cause dizziness or trouble in seeing clearly. Make sure you know how you react to ipratropium before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to see well.

If you have dryness of the nose or have unexplained nosebleeds, call your doctor right away.

Ipratropium nasal spray may cause dryness of the mouth or throat. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

ipratropium Side Effects

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 sprayMore common
  • Body aches or pain
  • chills
  • cough
  • difficulty with breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • runny nose
  • sneezing
  • sore throat
  • 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 ipratropium or becoming worse during use
  • nasal dryness
  • nosebleeds
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
Rare
  • Pain or cramping in the abdomen or stomach
  • painful or difficult urination
Incidence not known
  • Difficulty with swallowing
  • dizziness
  • fast heartbeat
  • hives or welts
  • itching
  • 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
For the 0.06% nasal spray used for 4 daysLess common
  • Nasal dryness
  • nosebleeds
Rare
  • Blurred vision
  • dizziness
  • eye redness or pain
  • fast, slow, or irregular heartbeat
  • pain or cramping in the abdomen or stomach
  • painful or difficult urination
  • ringing or buzzing in the ears
  • sore throat

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 sprayLess 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
  • nausea
For the 0.06% nasal sprayLess common or rare
  • Dry mouth or throat
  • increased nasal congestion

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.

See also: Side effects (in more detail)

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