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Atrovent HFA (ipratropium) Disease Interactions

There are 3 disease interactions with Atrovent HFA (ipratropium):

Moderate

Inhaled anticholinergic agents (Includes Atrovent HFA) ↔ anticholinergic effects

Moderate Potential Hazard, Moderate plausibility. Applies to: Urinary Retention, Glaucoma (Narrow Angle)

Aclidinium, ipratropium, 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 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. Massey KL, Gotz VP "Ipratropium bromide." Drug Intell Clin Pharm 19 (1985): 5-12
  2. Gross NJ "Ipratropium bromide." N Engl J Med 319 (1988): 486-94
  3. 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
  4. 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
  5. "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim, Ridgefield, CT.
  6. Pras E, Stienlauf S, Pinkhas J, Sidi Y "Urinary retention associated with ipratropium bromide." DICP 25 (1991): 939-40
  7. "Product Information. Atrovent nasal spray (ipratropium nasal)." Boehringer-Ingelheim, Ridgefield, CT.
  8. Lozewicz S "Bladder outflow obstruction induced by ipratropium bromide." Postgrad Med J 65 (1989): 260-1
  9. "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim, Ridgefield, CT.
View all 9 references
Moderate

Inhaled anticholinergic agents (Includes Atrovent HFA) ↔ tachycardia

Moderate Potential Hazard, Moderate plausibility. Applies to: 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.

Moderate

Ipratropium (Includes Atrovent HFA) ↔ renal/liver

Moderate Potential Hazard, Moderate plausibility. Applies to: 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.

Atrovent HFA (ipratropium) drug interactions

There are 368 drug interactions with Atrovent HFA (ipratropium)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

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

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