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Atrovent Nasal Side Effects

Generic Name: ipratropium nasal

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

For the Consumer

Applies to ipratropium nasal: nasal spray

Along with its needed effects, ipratropium nasal (the active ingredient contained in Atrovent Nasal) 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 nasal:

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 this medicine or becoming worse during use
  • nasal dryness
  • nosebleeds
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • 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
  • 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 of ipratropium nasal 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

For Healthcare Professionals

Applies to ipratropium nasal: nasal spray


Ipratropium has been generally well-tolerated, and void of systemic effects when administered intranasally.[Ref]


Local side effects have included blood-tinged mucus (17%), nasal dryness (10%), epistaxis (7%), and nasal irritation (2%).[Ref]

Nervous system

Nervous system side effects have included headache is reported in approximately 9% of the patients treated with the nasal spray. Dizziness has occurred infrequently.[Ref]


Hypersensitivity side effects have included reports of allergic-type reactions including skin rash, angioedema of the throat, tongue, lips,and face, generalized urticaria, laryngospasm, and anaphylactic reactions.[Ref]


Ocular side effects have included blurred vision and conjunctivitis after the medication came in contact with the eyes.[Ref]


Genitourinary side effects have not been usually observed with the low doses given by nasal spray. Urinary retention has been reported occasionally in patients receiving larger doses by nebulizer. Caution may be warranted when using ipratropium in men with prostatic hypertrophy.[Ref]


Respiratory side effects have included pharyngitis and upper respiratory tract infection has been reported in 8% and 9% of patients, respectively.[Ref]


Cardiovascular side effects have included rare reports of tachycardia and palpitations.[Ref]


Gastrointestinal side effects have included nausea and diarrhea.[Ref]


Dermatologic side effects have included rare reports of skin rash.[Ref]


1. Gross NJ "Ipratropium bromide." N Engl J Med 319 (1988): 486-94

2. Massey KL, Gotz VP "Ipratropium bromide." Drug Intell Clin Pharm 19 (1985): 5-12

3. "Product Information. Atrovent nasal spray (ipratropium nasal)." Boehringer-Ingelheim, Ridgefield, CT.

4. Dockhorn R, Grossman J, Posner M, Zinny M, Tinkleman D "A double-blind, placebo-controlled study of the safety and efficacy of ipratropium bromide nasal spray versus placebo in patients with the common cold." J Allergy Clin Immunol 90 (1992): 1076-82

5. Hayden FG, Diamond L, Wood PB, Korts DC, Wecker MT "Effectiveness and safety of intranasal ipratropium bromide in common colds: a randomized, double-blind, placebo-controlled trial." Ann Intern Med 125 (1996): 89-97

6. 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

7. Lozewicz S "Bladder outflow obstruction induced by ipratropium bromide." Postgrad Med J 65 (1989): 260-1

8. O'Driscoll BR "Supraventricular tachycardia caused by nebulised ipratropium bromide." Thorax 44 (1989): 312

Some side effects of Atrovent Nasal may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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