Adult Dosing

COPD maintenance

• MDI: 2 puffs (34 mcg) qid; MAX 12 puffs/day
• NEB: 250-500 mcg q6-8 hrs
• Aerosol/Inhalation: 2 INH qid; Max: 12 INH/day

Bronchiectasis [Non-FDA Approved]

• 40 mcg (2 puffs) q4 hrs PRN OR 500 mcg nebulized every 4 hours PRN

Pediatric Dosing

• Safety and effectiveness in the pediatric population (>12 yrs) have not been established

Bronchospasm adjunct therapy, asthma

Child

• 5-12 yrs (Not-FDA Approved): 125-250 mcg NEB q6-8 hrs
• >12 yrs: 250-500 mcg NEB q6-8 hrs

[Outline]

• Adult Dosing
• Pediatric Dosing

• Maintenance therapy of reversible airway obstruction due to COPD, including chronic bronchitis and emphysema
• May be used alone or in combination with other agents

• Hypersensitivity to ipratropium, atropine, belladonna alkaloids, or bromide

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Ipratropium is not indicated for initial treatment of acute episodes of bronchospasm in which rapid response is required
• Hypersensitivity reactions such as urticaria, angioedema, rash, bronchospasm, anaphylaxis, and oropharyngeal edema have been reported in patients receiving ipratropium. If such a hypersensitivity reaction occurs discontinue the therapy and consider alternative treatment
• Therapy may produce paradoxical bronchospasm, if such reaction occurs discontinue the therapy and consider alternative treatment
• Ipratropium may increase intraocular pressure resulting in precipitation or worsening of narrow-angle glaucoma

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Bladder neck obstruction
• Prostatic hyperplasia
• Angle-closure glaucoma

Pregnancy Category:B

Breastfeeding: No published data. However negligible maternal serum levels following inhalation. The risk to the breastfed infant of maternal ipratropium inhalation is small. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 10 June 2010).

• CNS: Dizziness, headache , nervousness
• EENT: Blurred vision, sore throat, rhinitis, sinusitis
• RESP: Paradoxical bronchospasm, cough, bronchitis, COPD exacerbation, URTIs
• CVS: Hypotension, palpitations
• GI: Oral irritation, dyspepsia, nausea, dry mouth
• DERM: Rash, pruritis, urticaria
• MISC: Hypersensitivity reactions, allergic reactions, anaphylaxis, angioedema

• Anticholinergic agent; antagonizes the action of acetylcholine; produces bronchodilation
• Ipratropium is not readily absorbed into systemic circulation either from the surface of the lung or from the gastrointestinal tract
• Partially metabolized by hydrolysis
• Excreted in feces (primarily) and urine (50% unchanged)
• Half-Life: 2 hrs

US Trade Name(s)

• Atrovent HFA

US Availability

ipratropium (generic)

• INH: 0.02% (500 mcg/2.5 mL neb)

Atrovent HFA

• MDI: 0.021MG/INH

Canadian Trade Name(s)

• Atrovent HFA
• Novo-Ipramide
• Apo-Ipravent

Canadian Availability

ipratropium (generic)

• INH: 0.0125% (125 mcg/mL) [2 mL]
• INH: 0.025% (250 mcg/mL) [1, 2, 20 mL]
• INH: 0.03% (300 mcg/mL)

Novo-Ipramide

• INH: 250 mcg/mL neb

Atrovent HFA

• INH: 125 mcg/mL (2, 20 mL)
• INH: 250 mcg/mL (1, 2, 20 mL)
• MDI: 20 mcg/INH

Apo-Ipravent

• SOLN for INH: 250 mcg/mL

UK Trade Name(s)

• Atrovent
• Respontin

UK Availability

ipratropium (generic)

• INH: 250 mcg/mL neb
• INH: 500 mcg/2 mL neb

Atrovent

• AEROCAPS (DPI): 40 mcg/cap
• MDI: 20 mcg/INH (200 doses)
• INH: 0.025% (250 mcg/mL neb)
• INH: 0.025% (500 mcg/2 mL neb)

Respontin

• INH: 250 mcg/mL neb (1 mL vials)
• INH: 500 mcg/2 mL neb (2 mL vials)

Australian Trade Name(s)

• Areon
• Apoven
• Atrovent
• Ipratrin Uni-dose
• Ipravent

Australian Availability

ipratropium (generic)

• INH: 0.025% (250 mcg/mL neb)
• INH: 0.05% (500 mcg/mL neb)

Areon, Apoven

• INH: 0.025% (250 mcg/mL neb)
• INH: 0.05% (500 mcg/mL neb)

Atrovent

• MDI: 21 mcg/puff (200 puffs)
• INH: 0.025% (250 mcg/mL neb)
• INH: 0.05% (500 mcg/mL neb)

Ipratrin Uni-dose

• INH: 0.025% (250 mcg/mL neb)
• INH: 0.05% (500 mcg/mL neb)

Ipravent

• INH: 250 mcg/mL (1, 20 mL)
• INH: 500 mcg/mL (1 mL)

[Outline]

Pulmonary

Bronchodilators

Anticholinergic Bronchodilators

Allergy & Immunology

Bronchodilators

Anticholinergic Bronchodilators

Pricing data from www.DrugStore.com in U.S.A.

• Ipratropium Bromide 0.02 % SOLN [Plas Cont] (NEPHRON PHARMACEUTICALS CORP.)
  62.5 % = $14.99
  125 % = $19.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.