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Medicines > classes: [[:Category:Bronchodilators|Bronchodilator]] & routes : Inhaled (DPI or Intranasal

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generic:
Ipratropium bromide (1) · Tiotropium (1)
brand:
Atrovent (inhaler, intranasal); also generic (1) · Spiriva, Spiriva Respimat (1)
classes: (Click arrow to add another value)
mechanism:
None (2)
uses:
'"`UNIQ--vote-000009BE-QINU`"', '"`UNIQ--vote-000009BF-QINU`"' (1) · '"`UNIQ--vote-00000F78-QINU`"', '"`UNIQ--vote-00000F79-QINU`"', '"`UNIQ--vote-00000F7A-QINU`"' (1)
starting dose:
18 mcg DPI once daily (HandiHaler); 2.5 mcg per actuation × 2 inhalations once daily (Respimat) (1) · 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 (1)
preparations:
18 mcg HandiHaler capsules; 2.5 mcg/actuation Respimat solution inhaler (1.25 mcg/actuation for asthma indication) (1) · 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 (1)
fda max:
12 puffs MDI/d typical; nebulized 2000 mcg/d (1) · One dose per day (1)
routes: (Click arrow to add another value)
onset:
Bronchodilation 15-30 minutes (1) · Bronchodilation 30 minutes; steady-state at 1-2 weeks (1)
duration:
24 hours (long receptor dissociation half-life from M3) (1) · 4-6 hours (1)
halflife:
~2 hours (plasma; minimal relevance — local-action drug)'"`UNIQ--ref-00000F7B-QINU`"' (1) · ~25-44 hours plasma; receptor kinetics drive the once-daily duration'"`UNIQ--ref-000009C0-QINU`"' (1)
bioavailability:
Inhaled lung deposition with minimal systemic absorption (the basis of the favorable safety profile vs systemic antimuscarinics)'"`UNIQ--ref-00000F7C-QINU`"' (1) · Inhaled lung deposition ~20%; systemic absorption from lung ~33%; oral component negligible'"`UNIQ--ref-000009C1-QINU`"' (1)
pregnancy:
Limited data; generally considered acceptable when needed.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data; LABA/LAMA strategies in pregnancy generally favor agents with the most reassuring data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
[[USLegal:Prescription only|Rx-only]] in US (2)

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