Ipratropium: Difference between revisions
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== References == | == References == | ||
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[[Category:Antimuscarinics]] | |||
[[Category:Short-acting muscarinic antagonists]] | |||
[[Category:Bronchodilators]] | |||
Latest revision as of 10:43, 23 May 2026
Ipratropium bromide
Atrovent (inhaler, intranasal); also generic
Experience
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Summary
Common uses
COPD exacerbation (with albuterol)0, Severe asthma exacerbation (adjunct to albuterol)0, Vasomotor rhinitis / rhinorrhea (intranasal)0
Pharmacy
Starting dose
Nebulized 500 mcg q6-8h (or with albuterol as DuoNeb); MDI 17 mcg/puff, 2 puffs QID; nasal 0.03% or 0.06% spray BID-TID
Preparations
Atrovent HFA 17 mcg/actuation MDI; 500 mcg/2.5 mL nebulizer solution; 0.03% and 0.06% intranasal sprays; with albuterol as DuoNeb / Combivent Respimat
US FDA Max
12 puffs MDI/d typical; nebulized 2000 mcg/d
Pharmacology
Routes
Inhaled (MDI, nebulized), intranasal
Onset
Bronchodilation 15-30 minutes
Duration
4-6 hours
Half-life
~2 hours (plasma; minimal relevance — local-action drug)[1]
Bioavailability
Inhaled lung deposition with minimal systemic absorption (the basis of the favorable safety profile vs systemic antimuscarinics)[1]
Pregnancy
Limited data; generally considered acceptable when needed.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Ipratropium is a quaternary ammonium derivative of atropine that non-selectively antagonizes airway muscarinic receptors (M1, M2, M3), blocking acetylcholine-mediated bronchoconstriction; the charged quaternary structure prevents BBB crossing, eliminating CNS antimuscarinic effects.0 Slower onset than β2-agonists; primary role is as add-on to albuterol in COPD/asthma exacerbations, where the combination shows greater bronchodilation than either alone. Inhaled antimuscarinic systemic absorption is minor but can produce dry mouth, tachycardia, and (rarely) urinary retention[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Atrovent HFA (ipratropium bromide), Boehringer Ingelheim, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021527s019lbl.pdf