Ipratropium

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Atrovent, Ipraxa, Itrop; Belgium: Atronasa, Atrovent, Nevu-trop; Bulgaria: Atrovent; Cyprus: Atrovent, Ipratropium; Czech Republic: Atrovent; Denmark: Atrovent, Ipratropiumbromid; Estonia: Atrovent; Finland: Atrovent, Ipratropiumbromid, Ipraxa; France: Atrovent, Ipratropium; Germany: Atrovent; Ipratropium, Itrop; Greece: Atrovent, Zyrolen; Hungary: Atrovent, Berodual N, Tropilyt; Ireland: Atrovent, Ipratropium, Ipravent, Rinatec; Italy: Atem, Rinovagos; Lithuania: Atrovent; Luxembourg: Atronase, Atrovent; Malta: Atrovent, Ipratropium; Netherlands: Atrovent, Ipratropiumbromide, Ipraxa; Poland: Atrovent, Itrop, Ipratropium; Portugal: Atrovent, Ipraxa; Romania: Atrovent, Ipravent, Ipraxa; Slovakia: Atrovent; Slovenia: Ipraxa; Spain: Atrovent, Ipratropio; Sweden: Atrovent, Ipratropiumbromid, Ipraxa; UK: Atrovent, Respontin, Rinatec.

North America

Canada: Atrovent, Ipratropium, Ipravent, Novo-Ipramide; USA: Atrovent, Ipratropium.

Latin America

Argentina: Aerotrop, Akitropio, Atrovent, Iprabon; Brazil: Alvent, Ares, Atrovent, Iprabon, Ipraneo, Ipratrópio; Mexico: Atrovent.

Asia

Japan: Atrovent.

Drug combinations

Ipratropium and Albuterol

Ipratropium and Fenoterol

Ipratropium and Xylometazoline

Chemistry

Ipratropium Bromide: C~20~H~30~BrNO~3~ H~2~O. Mw: 430.38. (1) 8-Azoniabicyclo[3.2.1]octane, 3-(3-hydroxy-1-oxo-2-phenylpropoxy)-8-methyl-8-(1-methylethyl)-, bromide, monohydrate(endo,syn)-, (±)-; (2)(8r)-3α-Hydroxy-8-isopropyl-1αH,5αH-tropanium bromide (±)-tropate monohydrate. CAS-66985-17-9; CAS-22254-24-6 (anhydrous)(1977).

Pharmacologic Category

Anticholinergic Agents; Antimuscarinics/Antispasmodics. (ATC-Code: R01AX03; R03BB01).

Mechanism of action

Blocks action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation. Local application to nasal mucosa inhibits serous and seromucous gland secretions.

Therapeutic use

Anticholinergic bronchodilator used in bronchospasm associated with chronic obstructive pulmonary disease, bronchitis, and emphysema (oral inhalation). Symptomatic relief of rhinorrhea associated with common cold and allergic and nonallergic rhinitis (nasal spray).

Pregnancy and lactiation implications

Teratogenic effects not observed in animal studies. There are no adequate, controlled studies to date using orally inhaled ipratropium in pregnant women, and drug should be used during pregnancy only when clearly needed. It is recommended that orally inhaled ipratropium be used with caution in nursing women.

Unlabeled use

Adjunct to short-acting β-adrenergic agonist therapy in moderate-to-severe exacerbations of acute asthma in emergency room (oral inhalation).

Contraindications

Hypersensitivity to ipratropium, atropine (and its derivatives), or any component of the formulation.

Warnings and precautions

Rarely, paradoxical bronchospasm might occur with use of inhaled bronchodilating agents. Immediate hypersensitivity reactions (angioedema, bronchospasm, rash, urticaria) reported. Use with caution in narrow-angle glaucoma, myasthenia gravis, prostatic hyperplasia or bladder neck obstruction. Inhalation/nebulizer should only be used in acute exacerbations of asthma in conjunction with short-acting β-adrenergic agonists for acute episodes.

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