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Atrovent Disease Interactions

There are 3 disease interactions with Atrovent (ipratropium).

Moderate

Inhaled anticholinergic agents (applies to Atrovent) anticholinergic effects

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Urinary Retention, Glaucoma (Narrow Angle)

Aclidinium, ipratropium, umeclidinium, and tiotropium are anticholinergic agents. Although systemic effects are uncommon due to the poor absorption of quaternary ammonium compounds from gastrointestinal and nasal mucosa, worsening of urinary retention or angle-closure glaucoma has been reported. Increased intraocular pressure and precipitation or exacerbation of angle-closure glaucoma may also occur due to inadvertent contact of the eye with aerosolized or nebulized drug. Accordingly, therapy with quaternary ammonium compounds should be administered cautiously in patients with urinary retention/obstruction or angle-closure glaucoma. Measures should be taken whenever possible to minimize ocular exposure to these drugs, such as keeping eyes closed during oral inhalation or use of a mouthpiece rather than face mask during nebulization. Patients should be advised to contact their physician if they experience urinary difficulty (especially in patients with prostatic hyperplasia or bladder neck obstruction); or signs and symptoms of angle-closure glaucoma (e.g., eye pain or discomfort; blurred vision; visual halos; colored images in association with red eyes from conjunctival congestion or corneal edema).

References

  1. Gross NJ "Ipratropium bromide." N Engl J Med 319 (1988): 486-94
  2. Milford CA, Mugliston TA, Lund VJ, Mackay IS "Long-term safety and efficacy study of intranasal ipratropium bromide." J Laryngol Otol 104 (1990): 123-5
  3. Lozewicz S "Bladder outflow obstruction induced by ipratropium bromide." Postgrad Med J 65 (1989): 260-1
  4. Pras E, Stienlauf S, Pinkhas J, Sidi Y "Urinary retention associated with ipratropium bromide." DICP 25 (1991): 939-40
  5. Massey KL, Gotz VP "Ipratropium bromide." Drug Intell Clin Pharm 19 (1985): 5-12
  6. Pakes GE, Brogden RN, Heel RC, Speight TM, Avery GS "Ipratropium bromide: a review of its pharmacological properties and therapeutic efficacy in asthma and chronic bronchitis." Drugs 20 (1980): 237-66
  7. "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim PROD (2002):
  8. "Product Information. Atrovent Nasal (ipratropium nasal)." Boehringer-Ingelheim
  9. "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
  10. "Product Information. Tudorza Pressair (aclidinium)." Forest Pharmaceuticals (2012):
  11. "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):
View all 11 references
Moderate

Inhaled anticholinergic agents (applies to Atrovent) tachycardia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Arrhythmias

Cases of supraventricular tachycardia and atrial fibrillation have been reported with the use of inhaled anticholinergic agents in patients with COPD/Asthma. Care and monitoring of cardiac function is recommended when prescribing these agents to patients at risk.

References

  1. "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim PROD (2002):
  2. "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
Moderate

Ipratropium (applies to Atrovent) renal/liver

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease, Renal Dysfunction

Ipratropium has not been studied in patients with hepatic or renal insufficiency. Therapy with this agent should be used with caution in these patients.

References

  1. "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim PROD (2002):

Atrovent drug interactions

There are 102 drug interactions with Atrovent (ipratropium).

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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