Ipratropium Bromide (Atrovent HFA): A Bronchodilator for COPD

Ipratropium bromide is a medication that belongs to the class of anticholinergics. It is used as a bronchodilator to treat chronic obstructive pulmonary disease (COPD), a group of lung diseases that cause breathing difficulties. COPD includes chronic bronchitis and emphysema.

How does ipratropium bromide work?

Ipratropium bromide works by blocking the action of a chemical called acetylcholine, which is released by the nerves that control the muscles around the airways. Acetylcholine causes the muscles to contract, narrowing the airways and making it harder to breathe. By blocking acetylcholine, ipratropium bromide relaxes the muscles and opens up the airways, allowing more air to flow in and out of the lungs.

How is ipratropium bromide used?

Ipratropium bromide is available as an inhaler under the brand name Atrovent HFA. It is used for maintenance treatment of bronchospasm (spasms of the airways) associated with COPD. It is not intended for immediate relief of acute symptoms or exacerbations (flare-ups) of COPD. For that purpose, a short-acting bronchodilator such as albuterol should be used.

The recommended dose of Atrovent HFA is two inhalations (34 mcg) four times a day, with additional inhalations as needed, up to a maximum of 12 inhalations (408 mcg) per day. The inhaler should be primed before the first use and if it has not been used for more than three days. To use the inhaler, shake it well, exhale fully, place the mouthpiece in your mouth, press down on the canister and inhale deeply, then hold your breath for 10 seconds and exhale slowly.

What are the side effects of ipratropium bromide?

The most common side effects of ipratropium bromide are dry mouth, cough, headache, nausea, and dizziness. These are usually mild and temporary. However, some side effects may be serious and require medical attention. These include allergic reactions (such as rash, hives, swelling, or difficulty breathing), eye problems (such as blurred vision, eye pain, or increased pressure in the eye), urinary problems (such as difficulty urinating or painful urination), or worsening of breathing problems.

What are the interactions of ipratropium bromide?

Ipratropium bromide may interact with other medications that have anticholinergic effects, such as some antidepressants, antihistamines, antipsychotics, or muscle relaxants. These medications may increase the risk of side effects such as dry mouth, constipation, or urinary retention. Ipratropium bromide may also interact with glucagon, a hormone used to treat low blood sugar, and macimorelin, a drug used to test for growth hormone deficiency. These drugs may reduce the effectiveness of ipratropium bromide or cause gastrointestinal problems.

What are the alternatives to ipratropium bromide?

There are other bronchodilators that can be used to treat COPD, such as beta-agonists (such as albuterol or salmeterol), methylxanthines (such as theophylline), or phosphodiesterase-4 inhibitors (such as roflumilast). Some of these drugs may have different mechanisms of action, onset of action, duration of action, or side effects than ipratropium bromide. Some of them may also be combined with other drugs such as corticosteroids or antibiotics to provide additional benefits.

The choice of bronchodilator depends on several factors, such as the severity of COPD symptoms, the frequency and severity of exacerbations, the presence of other medical conditions or allergies, and the patient’s preference and response to treatment. A doctor can help determine the best treatment option for each individual case.

Price comparison table

CountryPrice per inhaler (USD)Reference
Canada68.00Canada Drugs Direct
Australia29.00Chemist Warehouse
UAE25.00Life Pharmacy

Top five global brands of ipratropium bromide inhalers

  • Atrovent HFA (Boehringer Ingelheim)
  • Apo-Ipravent (Apotex)
  • Ipratropium Bromide HFA (Teva)
  • Rinatec (3M)
  • Kendral (Sanofi-Aventis)

This blog post is intended for informational purposes only and does not constitute medical advice. Consult your doctor before using any medication or changing your treatment plan.

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