Ipratropium (Atrovent®)

Ipratropium is an inhaled bronchodilator frequently prescribed for the treatment of chronic obstructive pulmonary disease (COPD).

When taken regularly, ipratropium may reduce the frequency and severity of COPD symptoms. Although it may help control symptoms, it is not a cure for COPD or related lung disorders.

Atrovent® is the brand name of ipratropium. Some respiratory medications, such as Combivent® and DuoNeb®, combine ipratropium with other broncodilators.

How does ipratropium work?

Some of the coughing, wheezing, and shortness-of-breath symptoms associated with COPD are caused by the constriction (tightening) of smooth muscles around the lungs, a condition called bronchoconstriction. Ipratropium works by blocking certain chemicals that cause those muscles to constrict, which relaxes and opens the air passages to the lungs and make breathing easier.

Ipratropium does not act as quickly as other bronchodilators, such as albuterol. Your doctor may recommend that you use a fast-acting bronchodilator instead of ipratropium to control worsening COPD symptoms.

How is ipratropium taken?

Take ipratropium exactly as directed by your doctor. Do not take more or less of it, or take it more often than prescribed by your doctor.

Ipratropium comes as a solution to inhale by mouth using a nebulizer or in a metered dose inhaler (MDI).

Follow these steps when taking ipratropium via an inhaler (MDI):

  1. Be sure that the canister is fully and firmly inserted in the mouthpiece.
  2. Remove the protective cap from the end of the mouthpiece. (If the cap was not in place, check the mouthpiece for dirt or other objects that may obstruct the flow of medicine)
  3. Shake the inhaler well.
  4. Prime the inhaler if necessary. If you are using the inhaler for the first time, have not used the inhaler in more than 14 days, or have dropped the inhaler, you will need to prime it. To prime the inhaler, shake it well and then press down on the canister 4 times to release 4 sprays into the air, away from your face. Be careful not to get the medicine in your eyes.
  5. Hold the canister with the canister upright and the mouthpiece on the bottom.
  6. Prepare to inhale albuterol by exhaling (breathing out) as completely as possible.
  7. Place the open end of the mouthpiece into your mouth.
  8. Close your lips tightly around the mouthpiece.
  9. Breathe in slowly and deeply through the mouthpiece. At the same time, press down once on the canister to release the medicine.
  10. Hold your breath for 10 seconds then breathe out slowly .
  11. If you were told to use 2 puffs, wait 1 minute between puffs.
  12. Replace the protective cap on the inhaler.

If a metered dose inhaler is used, keep track of the number of inhalations. When using the inhaler, discard the canister after using the labeled number of inhalations on the package, even if it feels as though there is medication left in the canister. Follow the instructions for cleaning the mouthpiece.

Follow these steps when taking ipratropium via a nebulizer:

  1. Remove one vial of ipratropium solution from the foil pouch. Leave the rest of the vials in the pouch until you are ready to use them.
  2. Look at the liquid in the vial. It should be clear and colorless. Do not use the vial if the liquid is cloudy or discolored.
  3. Twist off the top of the vial and squeeze all of the liquid into the nebulizer reservoir. If you are using your nebulizer to inhale other medications, ask your doctor or pharmacist if you can place the other medications in the reservoir along with ipratropium.
  4. Connect the nebulizer reservoir to the mouthpiece or face mask.
  5. Place the mouthpiece in your mouth or put on the face mask. Sit in an upright, comfortable position and turn on the compressor.
  6. Breathe in calmly, deeply, and evenly for about 5-15 minutes until mist stops forming in the nebulizer chamber.
  7. Clean your inhaler or nebulizer regularly.
  8. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your nebulizer.

What are the possible side effects from ipratropium?

Read the medication guide that you receive with the medication for a complete list of possible side effects. You may also learn more about ipratropium from the National Institutes of Health (NIH). Speak with your doctor if you are concerned about possible side effects that you may be experiencing.

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Last updated: 1/8/2019