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IPRATROPIUM BROMIDE

Brand Name(s) : Atrovent, Respontin, Rinatec
Warnings
Uses
Side Effects
Precautions
Interactions
Overdose

IPRATROPIUM BROMIDE WARNINGS

Ipratropium bromide should be used with caution in:

  • Men with an enlarged prostate gland (prostatic hyperplasia)
  • People with difficulty urinating
  • People with increased eye pressure (narrow angle glaucoma) or at risk of developing it
  • People with cystic fibrosis
  • People taking beta adrenergic drugs for breathing problems such as salbutamol, terbutaline
  • People taking xanthines for breathing problems such as theophylline or aminophylline

It should not be used in:

  • Hypersensitivity (allergy) to ipratropium bromide, atropine or any of its derivatives or to any other component of the product.

Also see list of precautions and interactions

STORAGE

Atrovent Inhaler CFC-Free
Do not store above 25°C. Keep away from direct sunlight and heat.

Atrovent UDVs
Store below 25°C. Keep vials in the outer carton in order to protect from light.

Respontin Nebules

  • Keep Respontin Nebules out of the light and in the foil pack. When you open a foil pack:
    -Note the date
    -Add 4 weeks to the date. This is the new 'discard after' date.
    -There is a space on the foil pack lid to write the 'discard after date'.
    -Do not use any unused Respontin Nebules from that foil pack after the discard after date.
  • If the foil pack has not been opened, do not use the Nebules after the expiry date shown on the carton and Nebules label. The date refers it the last day of that month.
  • Store below 25°C (77°F).

Rinatec nasal spray
Use this spray within 6 months of first priming. Do not store above 25°C.

IPRATROPIUM BROMIDE USES

What is it used for?

  • Ipratropium bromide is used to treat people with breathing difficulties due to lung conditions such as asthma or chronic obstructive airways disease (COPD). It is also used to treat rhinitis (inflammation of the nose).
  • It is an anticholinergic bronchodilator.
  • It is used to widen the airways in the lung making it easier to breathe. Ipratropium bromide is taken using an inhaler device to treat people with breathing difficulties so that the medicine is delivered directly to the lungs where it is needed. It is known as a reliever medicine, but does not provide immediate relief of breathing difficulties.
  • Ipratropium bromide is taken using a nasal spray to relieve the symptoms of allergic and non-allergic rhinitis as it reduces secretions from the nose. Allergic rhinitis is a condition with inflammation of the nose arising from an allergy, such as pollen in hayfever or house dust mites or animal fur leading to cold-like symptoms, such as sneezing, itchiness and blocked or runny nose. Non-allergic rhinitis has similar symptoms and arises from oversensitive blood vessels in the nose.
  • In general this drug is used to treat asthma, COPD and rhinitis.
  • Benefits of being on this drug to treat breathing difficulties can include significant improvements in lung function and relief from symptoms such as chest tightness, wheezing and cough. It helps to control the symptoms of rhinitis, particularly runny nose.

Listed below are the typical uses of ipratropium bromide.

  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Allergic rhinitis
  • Non-allergic rhinitis

On occasion your doctor may prescribe this medicine to treat a condition not on the above list.

HOW TO USE/TAKE

Ipratropium bromide is available as a metered dose inhaler and is also available as nebules, which are used with a machine called a nebuliser. This converts the medicine inside the nebules into a fine spray which can then be inhaled through a face mask. Ipratropium bromide is also available as a nasal spray. It can be taken with or without food.

How often do I take it?

  • Inhaler and nebules
  • Take this medication by inhalation usually 1 to 2 doses, three or four times daily. It is important to take ipratropium bromide properly and to keep the inhaler mouthpiece clean.
  • Advice on how to take ipratropium bromide can be found in the Patient Information Leaflet. Particular care must be taken to ensure that ipratropium bromide does not get into your eyes.

Nasal spray
The usual starting dose is 2 sprays into each nostril, two or three times daily.

Use this medication regularly in order to get the most benefit from it.

Remember to use it at the same time each day - unless specifically told otherwise by your doctor.

It may take up to 1 to 2 hours before the full benefit of this drug takes effect.

Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • When taking ipratropium bromide, you may feel dizzy or have difficulty in focusing or blurred vision. If this is the case, you should not drive or operate machinery.
  • Avoid getting any of this product in your eyes. If you accidentally get in your eyes and have pain, stinging, dilated pupils or other eye symptoms, talk to your doctor for advice. If you are affected do not drive or operate machinery.
  • Avoid driving or using machinery whilst using your inhaler or nebuliser.
  • Consult your doctor or pharmacist for more details.

When can I stop?

  • It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.

IPRATROPIUM BROMIDE SIDE EFFECTS

  • Headache
  • Dizziness
  • Vomiting
  • Dry mouth
  • Constipation (problem with gastrointestinal motility)
  • Diarrhoea (problem with gastrointestinal motility)
  • Throat irritation
  • Cough
  • Unexpected chest tightness
  • Skin rash
  • Itchiness
  • Fast heart rate
  • Itchy skin rash
  • Palpitations (fast and irregular heart beats)
  • Abnormal heart rhythm such as atrial fibrillation
  • Eye problems such as eye pain, raised eye pressure and wide pupils
  • Throat tightness
  • Nausea
  • Difficulty urinating
  • Bad taste in mouth
  • Serious allergic reactions such as swelling of tongue, face and lips or anaphylaxis (very severe allergic reaction).

If any of these persist or you consider them severe then inform your doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms:

  • An increase in wheezing or other breathing difficulties immediately after using your inhaler or nebuliser. Stop using and seek immediate medical advice.
  • Increase in heart rate, fast and irregular heart beat (palpitations) or abnormal heart rhythm.
  • Less relief from your symptoms than usual or the relief is not lasting for as long. Your condition may be getting worse and you may need other medicines.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website

IPRATROPIUM BROMIDE PRECAUTIONS

Before taking ipratropium bromide, tell your doctor or pharmacist if you are allergic to it; or to atropine or similar medicines; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have:

  • Hypersensitivity (allergy) to ipratropium bromide, atropine or any of its derivatives or to any other component of the product.

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following

  • Enlarged prostate gland (prostatic hyperplasia)
  • Difficulty urinating
  • An eye condition known as narrow angle glaucoma (increased eye pressure) or you are at risk of developing it
  • Cystic fibrosis

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • Alcohol intake is not known to affect ipratropium bromide.

The elderly: ipratropium bromide can be used in the elderly.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

The safety of ipratropium bromide has not been established during pregnancy. Ask your doctor or pharmacist if you have any doubts or questions about this.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

It is not known whether ipratropium bromide passes into breast milk. The manufacturer therefore states that it should not be taken if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

IPRATROPIUM BROMIDE INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

  • None known.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

  • Other medicines used to treat breathing problems
  • Beta adrenergic drugs such as
    - Salbutamol
    - Terbutaline
  • Xanthines such as
    -Aminophylline
    -Theophylline

This information does not contain all possible interactions. Therefore, before using ipratropium bromide, tell your doctor or pharmacist of all the products you use.

IPRATROPIUM BROMIDE OVERDOSE

No serious symptoms are to be expected in case of overdoes. Dry mouth, visual disturbances and fast and irregular heart beats may occur as signs of overdose.

If you take more of this medicine than you should, talk to a doctor or go to hospital straight away. Take the medicine pack with you.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of ipratropium bromide or intentional overdose is suspected, contact your local hospital, GP or if in England call 111 or NHS Direct. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited or TicTac Communications Ltd. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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