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Atrovent HFA Side Effects

Generic name: ipratropium

Medically reviewed by Last updated on Jan 11, 2023.

Note: This document contains side effect information about ipratropium. Some dosage forms listed on this page may not apply to the brand name Atrovent HFA.

Applies to ipratropium: inhalation solution.

Serious side effects of Atrovent HFA

Along with its needed effects, ipratropium (the active ingredient contained in Atrovent HFA) 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 while taking ipratropium:

More common

  • Bladder pain
  • bloody or cloudy urine
  • cough producing mucus
  • difficult, burning, or painful urination
  • difficulty with breathing
  • frequent urge to urinate
  • lower back or side pain
  • shortness of breath
  • tightness in the chest
  • wheezing

Less common

  • Body aches or pain
  • chills
  • cough
  • ear congestion
  • fever
  • headache
  • loss of voice
  • runny nose
  • sneezing
  • sore throat
  • unusual tiredness or weakness


  • Constipation (continuing) or lower abdominal pain or bloating
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • severe eye pain
  • skin rash or hives
  • swelling of the face, lips, or eyelids

Incidence not known

  • Blindness
  • blurred vision
  • confusion
  • decrease in the frequency of urination
  • decrease in the urine volume
  • decreased vision
  • difficulty in passing urine (dribbling)
  • difficulty with swallowing
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • hives or welts
  • itching
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • nausea or vomiting
  • noisy breathing
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • redness of the skin
  • redness of the white part of the eyes or inside of the eyelids
  • sweating
  • tearing

Other side effects of Atrovent HFA

Some side effects of ipratropium 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:

More common

  • Back pain
  • dryness of the mouth
  • unpleasant taste

Less common or rare

  • Acid or sour stomach
  • belching
  • burning eyes
  • diarrhea
  • general feeling of discomfort or illness
  • heartburn
  • indigestion
  • joint pain
  • loss of appetite
  • muscle aches and pains
  • nervousness
  • pain or tenderness around the eyes and cheekbones
  • shivering
  • stomach discomfort, upset, or pain
  • trembling
  • trouble sleeping

For Healthcare Professionals

Applies to ipratropium: compounding powder, inhalation aerosol, inhalation solution.


The most common adverse reactions were bronchitis, COPD exacerbation, dyspnea, headache, throat irritation, cough, dry mouth, gastro-intestinal motility disorders (including constipation, diarrhea and vomiting), nausea, and dizziness.[Ref]


Very common (10% or more): Bronchitis (up to 14.6%), upper respiratory tract infection (up to 13.2%)

Common (1% to 10%): Chest pain, cough, dyspnea, bronchospasm, sputum increased, pharyngitis, rhinitis, sinusitis, throat irritation

Uncommon (0.1% to 1%): Paradoxical bronchospasm, laryngospasm, pharyngeal edema, dry throat[Ref]


Common (1% to 10%): Mouth dryness, nausea, gastrointestinal motility disorder, dyspepsia

Uncommon (0.1% to 1%): Constipation, diarrhea, taste perversion, vomiting, stomatitis

Frequency not reported: Mouth edema[Ref]


Common (1% to 10%): Urinary tract infection

Uncommon (0.1% to 1%): Urinary retention[Ref]


Common (1% to 10%): Back pain

Uncommon (0.1% to 1%): Arthritis[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness

Uncommon (0.1% to 1%): Tremor, nervousness[Ref]


Common (1% to 10%): Influenza-like symptoms, pain[Ref]


Uncommon (0.1% to 1%): Hypertension, palpitations, supraventricular tachycardia

Rare (less than 0.1%): Atrial fibrillation, rate increased

Frequency not reported: Hypotension, palpitation, tachycardia[Ref]


Uncommon (0.1% to 1%): Rash, pruritus

Rare (less than 0.1%): Urticaria[Ref]


Uncommon (0.1% to 1%): Hypersensitivity, anaphylactic reactions, angioedema of tongue, lips, face

Frequency not reported: Urticaria (including giant urticaria), laryngospasm[Ref]


Uncommon (0.1% to 1%): Blurred vision, mydriasis, intraocular pressure increased, glaucoma, eye pain, halo vision, conjunctival hyperemia, corneal edema

Rare (less than 0.1%): Accommodation disorder

Frequency not reported: Precipitation or worsening of narrow-angle glaucoma, acute eye pain[Ref]


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10. Levin DC, Little KS, Laughlin KR, Galbraith JM, Gustman PM, Murphy D, Kram JA, Hardie G, Reuter C, Ostransky D, Mcfarland K. Addition of anticholinergic solution prolongs bronchodilator effect of beta(2) agonists in patients with chronic obstructive pulmonary disease. Am J Med. 1996;100 Suppl:s40-8.

11. Lozewicz S. Bladder outflow obstruction induced by ipratropium bromide. Postgrad Med J. 1989;65:260-1.

12. Pras E, Stienlauf S, Pinkhas J, Sidi Y. Urinary retention associated with ipratropium bromide. DICP. 1991;25:939-40.

13. Verheijen-Breemhaar L, Bogaard JM, Hilvering C. Comparison of the bronchodilatory action and side-effects of ipratropium bromide and thiazinamium methyl sulphate: a long-term, double-blind, crossover trial in patients with chronic bronchitis. Pharmatherapeutica. 1982;3:180-7.

14. Braun SR, Levy SF. Comparison of ipratropium bromide and albuterol in chronic obstructive pulmonary disease: a three-center study. Am J Med. 1991;91:s28-32.

15. O'Driscoll BR. Supraventricular tachycardia caused by nebulised ipratropium bromide. Thorax. 1989;44:312.

16. Cabana MD, Johnson H, Lee CKK, Helfaer M. Transient anisocoria secondary to nebulized ipratropium bromide. Clin Pediat. 1998;37:445-7.

17. Kizer KM, Bess DT, Bedford NK. Blurred vision from ipratropium bromide. Am J Health Syst Pharm. 1999;56:914.

Further information

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

Some side effects may not be reported. You may report them to the FDA.