II. Mechanism

  1. Short-acting Anticholinergic Bronchodilator

III. Preparations: Ipratropium Bromide

  1. Atrovent MDI: 2-3 puffs three to four times daily
  2. Atrovent Nebulization: 1 ampule in nebulization solution every 6 hours prn

IV. Preparations: Combination Ipratropium with Albuterol (Combivent)

  1. Combivent (older CFC version)
    1. Will be phased out in 2013 due to CFC
    2. Dose: 2 puffs up to every 6 hours
    3. Contraindicated in soybean or peanut allergy
  2. Combivent Respimat
    1. Dose: 1 puff every 6 hours
    2. Does not carry the Food Allergy related contraindications of the older Combivent

V. Adverse Effects

  1. Serious adverse effects
    1. Anaphylaxis, Angioedema or other Hypersensitivity Reaction
    2. Paradoxical bronchospasm or Laryngospasm
    3. Exacerbation of Glaucoma
  2. Common adverse effects
    1. Cough
    2. Dry Mouth or oral irritation
    3. Gastrointestinal upset such as Nausea
    4. Urticaria or other rash
    5. Headache
    6. Nervous sensation

Images: Related links to external sites (from Google)

Cost: Medications

IPRATROPIUM NEB (on 2/10/2012 at Target.com)
IPRATROPIUM NEB 0.2 MG/ML* Solution #30 for $4.00 ($0.13/unit)
Ipratropium Bromide (on 2/9/2012 at DrugStore.com)
Ipratropium Bromide 0.03% Solution 30ml Inhaler #1 for $37.99 ($37.99/unit)
Ipratropium Bromide 0.02% Solution 2.5ml Plastic Container #25 for $14.99 ($0.60/unit)
Ipratropium Bromide 0.06% Solution #15 for $34.99 ($2.33/unit)
Ipratropium-Albuterol (on 2/9/2012 at DrugStore.com)
Ipratropium-Albuterol 0.5-2.5 (3)mg/3ml Solution 3ml Plastic Container #30 for $39.99 ($1.33/unit)
Atrovent (on 2/9/2012 at DrugStore.com)
Atrovent 0.03% Solution 30ml Nasal Spray #1 for $100.99 ($100.99/unit)
Atrovent 0.06% Solution 15ml Nasal Spray #1 for $91.99 ($91.99/unit)
Combivent (on 2/9/2012 at DrugStore.com)
Combivent 18-103mcg/act Aerosol 14.7gm Inhaler #1 for $238.33 ($238.33/unit)

Ontology: Ipratropium (C0027235)

Definition (NCI) A synthetic derivative of the alkaloid atropine with anticholinergic properties. Ipratropium antagonizes the actions of acetylcholine at parasympathetic postganglionic effector cell junctions. When inhaled, ipratropium binds competitively to cholinergic receptors in the bronchial smooth muscle thereby blocking the bronchoconstrictor actions of the acetylcholine (Ach) mediated vagal impulses. Inhibition of the vagal tone leads to dilation of the large central airways resulting in bronchodilation.
Definition (MSH) A muscarinic antagonist structurally related to ATROPINE but often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D009241
SnomedCT 349952008, 108624006, 372518007
English Ipratropium, N Isopropylatropine, N-Isopropylatropine, (endo,syn)-(+-)-3-(3-Hydroxy-1-oxo-2-phenylpropoxy)-8-methyl-8-(1-methylethyl)-8-azoniabicyclo(3.2.1)octane, 8-Azoniabicyclo(3.2.1)octane, 3-(3-hydroxy-1-oxo-2-phenylpropoxy)-8-methyl-8-(1-methylethyl)-, (endo,syn)-(+-)-, ISOPROPYLATROPINE N, ipratropium, (3-endo,8-syn)-3-(3-Hydroxy-1-oxo-2-phenylpropoxy)-8-methyl-8-(1-methylethyl)-8-azoniabicyclo(3.2.1)octane, Ipratropium [Chemical/Ingredient], Ipratropium (product), Ipratropium (substance), IPRATROPIUM
Swedish Ipratropium
Czech ipratropium, ipratropiumbromid, N-isopropylatropin
Spanish Ipratropium, ipratropio (producto), ipratropio (sustancia), ipratropio, Ipratropio, N-Isopropilatropina
Finnish Ipratropium
Japanese イプラトロピウム, N-イソプロピルアトロピン, 臭化イプラトロピウム, イソプロピルアトロピン
German ISOPROPYLATROPIN N, Ipratropium, N-Isopropylatropin
French Ipratropium
Polish Ipratropium, N-izopropyloatropina, Bromek ipratropium
Italian Ipratropio
Portuguese Ipratropio, N-Isopropilatropina

Ontology: Atrovent (C0591130)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D009241
English atrovent, Atrovent

Ontology: Combivent (C0591282)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C116388
English Combivent, combivents, combivent