Products
Ipratropium bromide is commercially available as an inhalation solution, metered-dose inhaler, and nasal spray (Atrovent, Rhinovent, generics). Combination preparations with beta2-sympathomimetics are also commercially available (Dospir, Berodual N, generics). Pharmacies also produce inhalation solutions with ipratropium bromide as extemporaneous preparations. The active ingredient has been approved in many countries since 1978.
Structure and properties
Ipratropium bromide (C20H30BrNO3, Mr = 412.4 g/mol) is a racemate and a quaternary ammonium compound. It is a derivative of atropine, a tropane alkaloid found in nightshade plants such as belladonna. Ipratropium bromide exists as a white crystalline powder that is readily soluble in water.
Effects
Ipratropium bromide (ATC R03BB01) has parasympatholytic (anticholinergic) and thereby bronchodilator (bronchospasmolytic) properties. The effect occurs after about 15 minutes and lasts up to 6 hours. The effects are due to antagonism at muscarinic acetylcholine receptors. Other parasympatholytics such as tiotropium bromide, glycopyrronium bromide, and umeclidinium bromide are now available, which have a longer duration of action than ipratropium bromide and require inhalation only once daily.
Indications
- For acute and long-term therapy of bronchospasm in chronic bronchitis, emphysema, and bronchial asthma.
- The nasal spray is approved for symptomatic treatment of rhinorrhea in allergic and non-allergic rhinitis.
Dosage
According to the drug label. The drug is usually inhaled three to four times a day. The nasal spray is administered two to three times daily.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Ipratropium bromide may be co-administered with other bronchodilators.
Adverse effects
The most common possible adverse effects include headache, throat irritation, cough, dry mouth, gastrointestinal symptoms such as constipation, diarrhea, and vomiting, nausea, and dizziness.