Ipratropium

Brand names of ipratropium

  • Alti-Ipratropium
  • Apo-Atrovent
  • Apo-Ipratropium
  • Atrovent
  • Atrovent Nasal Spray
  • Combivent
  • Dom-Ipratropium
  • Gen-Ipratropium
  • Novo-Ipratropium
  • Nu-Ipratropium
  • PMS-Ipratropium

Ipratropium medication is classified as a bronchodilator as it helps to relax and open air passages in the lungs for easy breathing. Ipratropium is an inhaler used to prevent chest tightness, wheezing, difficult breathing and coughing in people who suffer from COPD or chronic obstructive pulmonary diseases like chronic bronchitis which occurs when air passages to the lungs are blocked because of swelling. Ipratropium is also used to treat emphysema.

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Things you need to tell your physician before taking ipratropium inhalation

Before you begin inhalation with ipratropium your doctor needs to know if you are allergic to ipratropium, atropine or any other medicines that you know of. You must also tell the doctor the names of all the prescribed and non-prescribed medications you are taking presently or plan to take including all vitamins, herbal remedies and any nutritional supplements you are on.

Specially bring to your doctor's notice if you are on antihistamines, drugs for irritable bowel syndrome, motion sickness, Parkinson's disease, urinary problems and ulcers. This information is required by your doctor to change the dosage amounts of medicines you are taking and also to monitor you for any possible side effects.

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In case you are using other inhalers ask your doctor if those inhalers should be used before or after you have used ipratropium inhalation. You should also ask the doctor if the nebulizer you might presently be using could be used for the other medicines in combination with ipratropium.

The following medical conditions need to be reported to your doctor if you have them like glaucoma, any urinary problems and problems of the prostate which is a male reproductive organ. If you are pregnant or plan on getting pregnant or if you are breast feeding, you need to tell your doctor so before you take ipratropium. If while you are using the inhaler you become pregnant tell the doctor immediately.

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If your dentist or surgeon has planned any kind of surgery for you including dental treatment then tell the surgeon and the dentist that you are using ipratropium inhaler presently.

Sometimes, immediately after you have used ipratropium inhalation you could find that you are wheezing and also finding it difficult to breathe. If such a reaction occurs then you should immediately call up the doctor. Till such time as the doctor says its all right to use the inhalation do not use it again.

Usage

The ipratropium inhalation is used to treat certain symptoms that occur from lung diseases like asthma, emphysema and chronic bronchitis.

How to use ipratropium

A nebulizer (a mechanism that mists medication for inhalation) is used to inhale through the mouth ipratropium medication in the form of a solution. Ipratropium is also available as an aerosol and can be used as an inhaler also, through the mouth.

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While the medication is used 3 to 4 times a day with a 6 to 8 hourly interval between each inhalation, the aerosol is used exactly four times a day. Ipratropium should be used exactly as directed and should not be used more times than directed, nor should the medication be used in less or more amounts. It is also advisable to read and understand fully the directions on the label and if you have not understood you could ask your pharmacist or doctor to explain further.

The doctor needs to be consulted if wheezing, chest pain and difficulty in breathing continue. It is quite possible the doctor could advise you to use an inhaler that acts more quickly to reduce these symptoms. Also he could advise you to inhale ipratropium with more frequency along with the new medications. You must understand the doctor's instructions about when to use each of the inhalers. Extra puffs of the ipratropium are not advised unless your doctor has specifically told you to do so. In a day, that is over a 24 hour period the ipratropium aerosol inhalation should not exceed 12 puffs.

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If the symptoms worsen or cannot be controlled despite the medications then you must call your doctor. Also if you had already begun taking the extra dose of ipratropium but you realize you need to use even more doses than advised you must consult the doctor again.

Ipratropium inhalers come in canisters and each canister contains enough medication for 200 puffs. After you have used up the 200 inhalations the canister may no longer have enough medication even if some liquid remains. It is important for you to keep track of the number of inhalations you have used from one canister by counting the number of puffs you take from the inhaler in a day. In this way you will know for how many days one canister of ipratropium will last. Once your count reaches the labelled number of inhalations on the canister, throw it away regardless of whether the spray continues to be released on pressing or liquid remains in it. The canister should not be floated in water to test it to see if there is any liquid in it.

If you are using ipratropium inhaler then you must protect your eyes well. Ipratropium must not enter the eyes and so keep them closed while you are using the medication. With the nebulizer it is advisable to use a mouth piece rather than a facemask. Your doctor could tell you how you can prevent the medication from leaking when you use the facemask.

Narrow angle glaucoma which can lead to loss of vision is an eye condition that could result from ipratropium getting into the eye. In case you already suffer this serious eye condition then the glaucoma could worsen and your pupils could widen more. There would also be accompanying pain, redness in the eye or blurred vision and also changes like seeing halos around lights. The doctor needs to be called if any of these eye problems surface or if ipratropium gets into the eyes.

The ipratropium aerosol inhaler that is supplied along with the canister is designed in such a way that it can only be used with this canister and so it must not be used to inhale any other medicine. Also another inhaler must not be used to puff from the ipratropium canister.

The inhaler may explode if subjected to high temperatures so using it near a source of heat like a flame must be avoided completely.

Read the written instructions very carefully once you have to start using the ipratropium inhaler. Your doctor, pharmacist or your respiratory therapist could demonstrate for you how the inhaler or the nebulizer has to be used. You must practice how to use the inhaler and nebulizer in front of them.

How ipratropium works

Acetylcholine is a chemical in the lungs that constricts the smooth muscles around the air passages. Ipratropium restricts the cough reflex and so blocks the activity of acetylcholine. Whenever ipratropium is inhaled the air passages open up and this is called bronchodilation.

Side effects

Serious
  • lower abdominal pain or bloating
  • tightness in chest
  • swelling of face, lips, or eyelids
  • persistent constipation
  • skin rash
  • wheezing or difficulty breathing
  • hives
  • severe eye pain
Common
Less common

Possible interactions

Herbal medicines like fir or pine oil should be avoided by people suffering from asthma. Ephedra which carries a German Commission E monograph is the only herbal remedy indicated for treating asthma. If you are allergic to the Asteraceae family of plants like aster, chrysanthemum, daisy or ragweed, it is possible for you to be allergic to Echinacea, chamomile, feverfew and St. John's wort as well. Before you add herbal medicines to your treatment ask the doctor for advice.

Though tobacco smoking does not directly interact with the medication it should be totally banned if you suffer from chronic bronchitis or emphysema. Marijuana could result in tachycardia or an increased rate of heart beats.

Do not expose yourself to the cold as breathing in cold air could set off asthmatic wheezing or cough and could cause bronchospasms. Maybe some dose adjustments are required if this should happen.

Also any excessive exercising and physical exertion could induce asthma so avoid it as ipratropium is not particularly effective in controlling asthma induced because of heavy exercising.

Discontinuation

If you need to discontinue ipratropium you need to ask your doctor to help you to get a proper replacement medication.

Storage instructions

Ipratropium should be kept closed tightly in the same container it came and should be in a place children cannot reach. The unused vials of nebulizer solution should be kept inside the foil pouches until they are needed to be used. The medication should not be stored in the bathroom or exposed to excessive heat and moisture. Ipratropium can easily be stored at room temperature.

All outdated medications or those vials and canisters that are no longer required should be disposed off properly after consulting the pharmacist. Aerosol canisters should not be punctured and also the incinerator or fire is not a good place to discard them in.

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