Side effects of atrovent

Contents

Atrovent HFA

SIDE EFFECTS

The following adverse reactions are described, or described in greater detail, in other sections:

  • Hypersensitivity reactions, including anaphylaxis
  • Paradoxical bronchospasm
  • Ocular effects
  • Urinary retention

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in patients.

Clinical Trials Experience

The adverse reaction information concerning ATROVENT HFA is derived from two 12-week, double-blind, parallel group studies and one 1-year open-label, parallel group study. These studies compared ATROVENT HFA Inhalation Aerosol, ATROVENT CFC Inhalation Aerosol, and placebo (in one study only) in 1010 COPD patients. The following table lists the incidence of adverse reactions that occurred at a rate of greater than or equal to 3% in any ipratropium bromide group and greater than placebo in the 12-week study. The frequency of corresponding reactions in the 1-year open label study is included for comparison.

TABLE 1 : Adverse Reactions (% Patients) in ATROVENT HFA Clinical Trials

Placebo-controlled 12 week Study 244.1405 and Active-controlled 12 week Study 244.1408 Active-controlled 1-year Study 244.2453
Atrovent HFA
(N=243)
%
Atrovent CFC
(N=183)
%
Placebo
(N=128)
%
Atrovent HFA
(N=305)
%
Atrovent CFC
(N=151)
%
BODY AS A WHOLE – GENERAL DISORDERS
Back pain 2 3 2 7 3
Headache 6 9 8 7 5
Influenza-like symptoms 4 2 2 8 5
CENTRAL & PERIPHERAL NERVOUS SYSTEM DISORDERS
Dizziness 3 3 2 3 1
GASTROINTESTINAL SYSTEM DISORDERS
Dyspepsia 1 3 1 5 3
Mouth dry 4 2 2 2 3
Nausea 4 1 2 4 4
RESPIRATORY SYSTEM DISORDERS
Bronchitis 10 11 6 23 19
COPD exacerbation 8 14 13 23 23
Dyspnea 8 8 4 7 4
Sinusitis 1 4 3 11 14
URINARY SYSTEM DISORDERS
Urinary tract infection 2 3 1 10 8

Cough, rhinitis, and upper respiratory infection occurred in greater than or equal to 3% of patients in either ipratropium treatment group but not greater than placebo in the 12-week study.

In the one open label controlled study in 456 COPD patients, the overall incidence of adverse events was also similar between ATROVENT HFA and ATROVENT CFC formulations.

Overall, in the above mentioned studies, 9.3% of the patients taking 42 mcg ATROVENT HFA and 8.7% of the patients taking 42 mcg ATROVENT CFC reported at least one adverse event that was considered by the investigator to be related to the study drug. The most common drug-related adverse events were dry mouth (1.6% of ATROVENT HFA and 0.9% of ATROVENT CFC patients), and taste perversion (bitter taste) (0.9% of ATROVENT HFA and 0.3% of ATROVENT CFC patients).

As an anticholinergic drug, cases of precipitation or worsening of narrow-angle glaucoma, glaucoma, halo vision, conjunctival hyperaemia, corneal edema, mydriasis, acute eye pain, dry throat, hypotension, palpitations, urinary retention, tachycardia, constipation, bronchospasm, including paradoxical bronchospasm have been reported with the use of ATROVENT. Additional adverse reactions identified for ATROVENT seen in clinical trials include throat irritation, stomatitis, mouth edema, and vision blurred.

Allergic-type reactions such as skin rash, pruritus, angioedema including that of tongue, lips and face, urticaria (including giant urticaria), laryngospasm and anaphylactic reactions have been reported .

Post-Marketing Experience

In a 5-year placebo-controlled trial, hospitalizations for supraventricular tachycardia and/or atrial fibrillation occurred with an incidence rate of 0.5% in COPD patients receiving ATROVENT CFC.

In addition to the adverse reactions reported in the controlled clinical trials, adverse reactions have been identified during post approval use of ATROVENT. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Allergic-type reactions such as skin rash, angioedema including that of tongue, lips and face, urticaria (including giant urticaria), laryngospasm and anaphylactic reactions have been reported, with positive rechallenge in some cases.

Additionally, urinary retention, mydriasis, gastrointestinal distress (diarrhea, nausea, vomiting), cough and bronchospasm, including paradoxical bronchospasm, hypersensitivity reactions, intraocular pressure increased, accommodation disorder, heart rate increased, pharyngeal edema, and gastrointestinal motility disorders have been reported during the post-marketing period with use of ATROVENT.

Read the entire FDA prescribing information for Atrovent HFA (Ipratropium Bromide Inhalation Aerosol)

Atrovent Solution

How to use Atrovent Solution

Read the Patient Information Leaflet if available from your pharmacist before you start using ipratropium and each time you get a refill. This medication is used with a special machine called a nebulizer that changes the solution to a fine mist that you inhale. Learn how to prepare the solution and use the nebulizer properly. If a child is using this medication, a parent or other responsible adult should supervise the child. If you have any questions, ask your doctor, pharmacist, or respiratory therapist.

This product should be clear and colorless. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid.

Inhale this medication into your lungs using the nebulizer as directed by your doctor, usually 3 to 4 times a day (6 to 8 hours apart). Avoid getting this medication into your eyes. It may cause eye pain/irritation, temporary blurred vision, and other vision changes. Therefore, it is recommended that you use a mouthpiece rather than a face mask with the nebulizer or that you close your eyes during use. Each treatment usually takes about 5 to 15 minutes. Use this medication only through a nebulizer. Do not swallow or inject the solution. To prevent infections, clean the nebulizer and mouthpiece/face mask according to the manufacturer’s directions.

Rinse your mouth after treatment to prevent dry mouth and throat irritation.

Ipratropium may be mixed with other medications (such as albuterol) or saline if directed by your doctor. Follow your doctor’s instructions carefully. Once a vial is opened, throw away any unused solution.

Dosage is based on your medical condition and response to treatment.

If you are directed to use this medication regularly, it works best if used at evenly spaced intervals. To help you remember, use it at the same times each day. Do not increase your dose, use this medication more often, or stop using it without first consulting your doctor.

Tell your doctor if your symptoms do not improve or if they worsen.

Learn which of your inhalers/medications you should use every day and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, waking up at night with trouble breathing, if you use your quick-relief inhaler more often, or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away.

What is Atrovent used for?

Atrovent is a medicine used on a regular basis to open up the airways and make breathing easier in people with:

  • Asthma.
  • Chronic obstructive pulmonary disease (COPD).

Atrovent inhaler is taken regularly every day to help keep the airways open all the time. It doesn’t open the airways as quickly as short-acting beta 2 agonists (reliever inhalers) such as salbutamol or terbutaline. Its maximum effect on the airways occurs 30 to 60 minutes after breathing in the medicine and this effect lasts for three to six hours.

Atrovent UDVs (unit dose vials) are used in a nebuliser. A nebuliser is a machine that converts the liquid medicine inside the nebules into particles that can be inhaled. It is used to deliver higher doses of the medicine than a standard inhaler. Nebuliser solutions of ipratropium are used in the emergency treatment of asthma attacks and acute breathing difficulties.

People with COPD who have been shown to benefit from regular use of high doses of ipratropium are also sometimes prescribed nebules to be used on a regular basis in a nebuliser at home.

How does Atrovent work?

Atrovent inhaler and Atrovent UDVs both contain the active ingredient ipratropium bromide, which is a type of medicine called an antimuscarinic (or anticholinergic) bronchodilator. It works by opening the airways, making it easier to breathe.

In asthma or chronic obstructive pulmonary disease (COPD, eg emphysema and chronic bronchitis), the airways become narrowed, making it difficult for air to get in and out of the lungs.

Ipratropium works by blocking muscarinic receptors that are found on the muscle surrounding the airways. This allows the muscle around the airways to relax and the airways to open.

How do I use Atrovent inhaler?

  • Atrovent inhaler should be used regularly every day, usually three times a day, but always follow the instructions given by your doctor regarding how often to use your Atrovent inhaler and how many puffs you should take each time. Don’t exceed the prescribed dose.
  • Adults usually need to use one or two puffs three to four times a day.
  • Children aged 6 to 12 years usually need to use one or two puffs three times a day, and children under six years usually need one puff three times a day.
  • It’s very important to learn how to use your inhaler correctly, as otherwise you won’t be breathing the right dose of medicine into your lungs. Instructions will be provided with your inhaler. However, your doctor, nurse or pharmacist can also show you how to use your inhaler and can check that you are using it correctly.
  • If you find it difficult to use the Atrovent inhaler because you have problems pressing down the canister at the same time as breathing in, the AeroChamber Plus spacer device can be used with this inhaler to make it easier. Ask your pharmacist for more information and advice.
  • If you forget to take a dose take it as soon as you remember, unless it’s nearly time for your next dose. If this is the case, leave out the forgotten dose and just take your next dose as usual. Do not take a double dose to make up for a missed dose.

What should I know about using Atrovent?

  • Atrovent might make you feel dizzy or have blurred vision. If affected you should avoid driving or operating machinery.
  • Atrovent won’t open your airways as quickly as fast-acting reliever inhalers such as salbutamol or terbutaline. It’s important to keep your reliever inhaler with you at all times in case you need to quickly relieve wheezing or breathing difficulties.
  • If your Atrovent inhaler or nebuliser doesn’t seem to work as well or for as long as usual, or if you find you need to use your reliever inhaler (salbutamol or terbutaline) more often than normal, you should see your doctor as soon as possible because you may be having a flare-up of your asthma or COPD, or it may be getting worse. Don’t exceed the dose of Atrovent that your doctor has prescribed.
  • Inhalers may cause an unexpected increase in wheezing (paradoxical bronchospasm) straight after using them. If this happens, stop using the inhaler immediately and consult your doctor. The medicine should be stopped and an alternative treatment found.
  • Take care to avoid accidentally getting this medicine into your eyes, particularly if you are using a nebuliser. It’s recommended that you use a mouthpiece with a nebuliser, or if this is not available, then a properly fitting nebuliser mask to avoid the mist getting in your eyes. Seek medical advice if the medicine gets into your eyes. This is especially important if you have, or are susceptible to, glaucoma.
  • Ipratropium can cause a dry mouth, which may increase the risk of tooth decay with long-term use of the medicine. It’s important to practice good oral hygiene and visit your dentist regularly for check-ups.

Who might need extra monitoring while using Atrovent?

  • People who have difficulty passing urine, for example men with an enlarged prostate gland (prostatic hypertrophy) or people with an obstruction of the bladder.
  • People with raised pressure in the eye or glaucoma.
  • People with cystic fibrosis.

Who shouldn’t use Atrovent?

  • People who are allergic to ipratropium bromide or related medicines, eg atropine.
  • People allergic to any other ingredient of the medicine.

Can I use Atrovent while pregnant or breastfeeding?

  • Make sure that your doctor knows if you are pregnant or breastfeeding before you start using Atrovent.
  • Atrovent should only be used during pregnancy if the expected benefit to the mother is greater than any possible risk to the developing baby. Your doctor or pharmacist can give you more information and advice.
  • It’s not known if ipratropium passes into breast milk. Atrovent should only be used in mothers who are breastfeeding if the benefits to the mother outweigh any risks to the nursing infant. Ask your doctor or pharmacist for more information and advice.

What are the possible side effects of Atrovent?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with ipratropium bromide. Just because a side effect is stated here doesn’t mean that all people using Atrovent will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

  • Headache.
  • Dizziness.
  • Dry mouth.
  • Cough.
  • Throat irritation.
  • Feeling sick.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Blurred vision. Don’t drive if affected.
  • Dilated pupils.
  • Red eyes.
  • Raised pressure in the eye or glaucoma. Consult your doctor immediately if you get a red and painful eye, possibly with headache, loss of vision or blurred vision, or seeing haloes around lights while using Atrovent.
  • Heart palpitations.
  • Dry or swollen throat.
  • Sore mouth.
  • Constipation or diarrhoea.
  • Vomiting.
  • Rash or itching.
  • Difficulty passing urine (urinary retention).
  • Allergic reaction, such as swelling of the face, lips and tongue (angioedema).

Rare (affect between 1 in 1000 and 1 in 10,000 people)

  • Difficulty focusing.
  • Fast or irregular heartbeat.
  • Nettle-type rash (hives or urticaria).

If you want any more information about the possible side effects of Atrovent you should read the leaflet that comes with your inhaler or talk to your doctor or pharmacist. If you think you have experienced a side effect, did you know you can report this using the yellow card website?

Can I use other medicines with Atrovent?

It’s important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start using Atrovent. Similarly, check with your doctor or pharmacist before taking any new medicines while using Atrovent, to make sure that the combination is safe. Remember that some medicines might not be suitable for you because you have asthma or COPD, rather than because you are using Atrovent to treat it.

You’re more likely to get side effects like blurred vision, dry mouth, difficulty passing urine or constipation if you use other medicines that have antimuscarinic effects in combination with Atrovent. These include the following:

  • aclidinium, glycopyrronium, oxitropium and tiotropium for COPD or asthma
  • antihistamines that cause drowsiness such as chlorphenamine, hydroxyzine or promethazine
  • antimuscarinic medicines for Parkinson’s symptoms, eg procyclidine, orphenadrine, trihexiphenidyl
  • antimuscarinic medicines for urinary incontinence, eg oxybutynin, flavoxate, tolterodine, propiverine, trospium
  • some antipsychotics, eg chlorpromazine, clozapine
  • antispasmodics, eg hyoscine, atropine
  • tricyclic antidepressants, eg amitriptyline, imipramine.

If you experience a dry mouth while using Atrovent you may find that medicines that are designed to dissolve and be absorbed from under the tongue, eg sublingual glyceryl trinitrate (GTN) tablets for angina, become less effective. This is because the tablets do not dissolve properly in a dry mouth. To resolve this, drink a mouthful of water before taking sublingual tablets.

What other medicines contain ipratropium bromide?

  • Inhalvent inhaler.
  • Ipratropium steri-neb.
  • Respontin nebules.
  • Rinatec nasal spray (used for hayfever).

Ipratropium unit dose vials for use in a nebuliser are also available without a brand name, ie as the generic medicine.

Combivent UDVs contain ipratropium in combination with salbutamol.

Last updated 26.03.2018

Helen Marshall, BPharm, MRPharmS Helen Marshall, BPharm, MRPharmS A UK registered pharmacist with a background in hospital pharmacy.

Atrovent Nasal Spray

How does this medication work? What will it do for me?

Ipratropium belongs to the family of medications called anticholinergics. Ipratropium nasal spray comes in two strengths that are used for different purposes. The 0.03% strength is used to relieve a runny nose caused by seasonal or perennial (year-round) allergies. The 0.06% strength is used to treat a runny nose caused by the common cold.

The medication works by stopping mucus glands in the nose from overproducing the watery mucus that leads to a runny nose. Ipratropium nasal spray begins to work within 15 minutes.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

0.03%
Each spray is designed to deliver 0.07 mL, which contains ipratropium bromide 21 µg. Nonmedicinal ingredients: benzalkonium chloride, edetate disodium, hydrochloric acid, sodium chloride, sodium hydroxide, and purified water.

0.06%
Each spray is designed to deliver 0.07 mL, which contains ipratropium bromide 42 µg. Nonmedicinal ingredients: benzalkonium chloride, edetate disodium, hydrochloric acid, sodium chloride, sodium hydroxide, and purified water.

How should I use this medication?

The recommended dose of ipratropium nasal spray for runny nose due to allergies is 2 sprays (0.03% strength) in each nostril 2 or 3 times per day.

The recommended dose for runny nose due to the common cold is 2 sprays (0.06% strength) in each nostril 3 or 4 times per day as needed. This medication has only been studied for up to 4 days of use for the common cold. Efficacy and safety of treatment beyond 4 days have not been established.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Before using this medication for the first time, the pump must be primed. To do this, remove the cap and safety clip. Then, hold the bottle with your thumb at the base and your index and middle fingers on the shoulder area of the pump. Point the bottle upright and away from your eyes. Press your thumb firmly and quickly against the bottle 7 times. You will need to reprime the pump with 1 or 2 sprays if you have not used it for 24 hours.

To use this medication:

  1. Blow your nose gently to clear your nostrils if needed.
  2. Remove the cap and safety clip.
  3. Close one nostril by gently placing your finger against the side of your nose, tilt your head slightly forward, and keeping the bottle the upright, insert the nasal tip into the other nostril. Point the tip toward the back and outer side of the nose.
  4. Press firmly and quickly upwards with the thumb at the base while holding the shoulder portion of the pump between your index and middle fingers. Following each spray, sniff deeply and breathe out through your mouth.
  5. After spraying the nostril and removing the pump, tilt your head backwards for a few seconds to let the spray spread over the back of the nose.
  6. Repeat steps 3 through 5 in the other nostril.
  7. Replace the cap and safety clip.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double a dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from excessive heat and freezing, and keep it out of the reach of children.

This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under “What form(s) does this medication come in?”

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Ipratropium nasal spray should not be used by anyone who:

  • is allergic to ipratropium or to any of the ingredients of the medication
  • is allergic to atropine or medications related to atropine

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dry mouth
  • dry nose
  • dry throat
  • headache
  • nasal congestion
  • nasal irritation
  • nausea
  • nosebleed
  • sore throat

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • difficult or painful urination
  • eye pain
  • fast or irregular heartbeat
  • increased wheezing or tightness in the chest
  • skin rash
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • symptoms of an allergic reaction (e.g., hives; difficulty breathing; swelling of lips, face, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Eyes: Avoid spraying ipratropium nasal spray in or around the eyes. If this happens, immediately flush your eyes with cool tap water for several minutes. If you get this medication in your eyes, you may experience blurred vision and increased sensitivity to light, which may last for a few hours. If these eye symptoms persist for more than a few hours or if you experience other eye symptoms (e.g., seeing halos, eye pain), contact your doctor.

Medical conditions: People with cystic fibrosis, glaucoma, enlarged prostate, or problems with urination should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if ipratropium nasal spray passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 12 years of age.

What other drugs could interact with this medication?

There may be an interaction between ipratropium nasal spray and any of the following:

  • ipratropium inhaled orally
  • other anticholinergic medications (e.g., benztropine, tolterodine, and oxybutynin)
  • other nasal sprays, especially those containing corticosteroids (e.g., beclomethasone, budesonide, fluticasone)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Atrovent-Nasal-Spray

Generic Name: ipratropium inhalation (IP ra TRO pee um)
Brand Names: Atrovent HFA, Atrovent

Medically reviewed by Kaci Durbin, MD Last updated on Apr 30, 2019.

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What is Atrovent HFA?

Atrovent (ipratropium) is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs.

Atrovent is used to to prevent bronchospasm, or narrowing airways in the lungs, in people with COPD (chronic obstructive pulmonary disease), including chronic bronchitis and emphysema.

Atrovent HFA may also be used for purposes not listed in this medication guide.

Important Information

Do not get Atrovent HFA in your eyes, especially if you have glaucoma.

Atrovent HFA will not work fast enough to treat an bronchospasm attack that has already begun. It is used for prevention of an attack only. Use only a fast acting inhalation medicine to treat an bronchospasm attack.

Seek medical attention if your breathing problems get worse quickly, or if you think your medications are not working as well.

Before taking this medicine

You should not use Atrovent HFA if you are allergic to ipratropium or atropine.

To make sure Atrovent HFA is safe for you, tell your doctor if you have ever had:

  • glaucoma;

  • an enlarged prostate; or

  • bladder obstruction or other urination problems.

Tell your doctor if you are pregnant or breastfeeding.

Atrovent HFA should not be used by anyone younger than 12 years old. Atrovent HFA is not approved for use by anyone younger than 18 years old.

How should I use Atrovent HFA?

Use Atrovent HFA exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Do not use more than 12 Atrovent HFA inhalations in a 24-hour period.

If you are using this medicine with a nebulizer, space your doses 6 to 8 hours apart.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Before your first use of Atrovent HFA, prime the inhaler with 2 test sprays into the air, away from your face. Prime again whenever the inhaler has not been used in longer than 3 days. You do not need to shake this medicine before each use.

Atrovent HFA is not a rescue medicine for bronchospasm attacks. Use only fast-acting inhalation medicine for an attack. Seek medical attention if your breathing problems get worse quickly, or if you think your medications are not working as well.

Store at room temperature. Keep the cover on your inhaler when not in use. Keep away from open flame or high heat. The canister may explode if it gets too hot. Do not puncture or burn an empty inhaler canister.

Throw away the inhaler canister when the dose indicator reaches 0, even if it feels like there is still medicine inside.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

Do not use more than 12 inhalations in a 24-hour period.

What happens if I overdose?

Overdose is unlikely with Atrovent. If you do overdose, seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Atrovent HFA?

Avoid getting this medication in your eyes. If this happens, rinse with water. Atrovent in the eye can lead to worsening of existing glaucoma, eye pain, blurred vision, and eye redness. If these symptoms develop, call your doctor immediately.

This medicine may cause blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you.

Atrovent HFA side effects

Get emergency medical help if you have signs of an allergic reaction to Atrovent HFA: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

You may need to use a different bronchodilator medication if you have an allergic reaction to ipratropium.

Call your doctor at once if you have:

  • wheezing, choking, or other breathing problems after using this medicine;

  • little or no urination;

  • blurred vision, tunnel vision, eye pain, or seeing halos around lights; or

  • worsened breathing problems.

Common Atrovent HFA side effects may include:

  • dry mouth;

  • bitter taste;

  • headache, dizziness;

  • stuffy nose, sinus pain;

  • cough, hoarseness;

  • nausea, upset stomach, constipation

  • back pain; or

  • fever, chills, body aches, flu symptoms

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Atrovent HFA?

Tell your doctor about all your other medicines, especially:

  • medicine to treat depression, anxiety, mood disorders, or mental illness;

  • cold or allergy medicine (Benadryl and others);

  • medicine to treat Parkinson’s disease;

  • medicine to treat stomach problems, motion sickness, or irritable bowel syndrome;

  • medicine to treat overactive bladder; or

  • another bronchodilator medication.

This list is not complete. Other drugs may interact with ipratropium, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Atrovent HFA only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 11.01.

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More about Atrovent HFA (ipratropium)

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  • Drug class: anticholinergic bronchodilators

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  • Atrovent HFA

Other brands: Ipratropium Inhalation Solution, Ipratropium Inhalation Aerosol

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  • Atrovent HFA (FDA)
  • … +1 more

Other Formulations

  • Atrovent Inhalation, oral/nebulization
  • Atrovent Nasal

Related treatment guides

  • Asthma
  • COPD, Maintenance

Atrovent HFA (ipratropium bromide HFA)

Atrovent HFA (ipratropium bromide HFA) Inhalation Aerosol is an oral inhalation medicine used to treat chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

Atrovent is part of a class of drugs for COPD called anticholinergic bronchodilators. There are long-acting and short-acting anticholinergics bronchodilators; Atrovent HFA is the short-acting type. Atrovent HFA is usually used to treat COPD patients who have breathing symptoms sometimes, but not all of the time.

Atrovent HFA is a maintenance therapy for COPD and is not used for treating COPD flare-ups that have already started. Rescue inhalers should be used for symptoms that are very severe and need relief very quickly.

What are the ingredients in Atrovent HFA?

The active ingredient in ATROVENT HFA is ipratropium bromide (as the monohydrate).

How does Atrovent HFA work?

As an anticholinergic drug, Atrovent HFA helps to treat COPD symptoms by helping the muscles that surround the airways to stay relaxed. COPD can cause irritation in the lungs that makes those muscles tighten up, which can make COPD breathing symptoms worse.

Ipratropium bromide is the active ingredient in Atrovent HFA. It is delivered in a canister that is placed into a metered-dose inhaler. The usual dosage for COPD patients is 2 inhalations per dose, four times a day.

For most COPD patients, the medicine in Atrovent HFA starts improving lung function within about 15 minutes. Atrovent HFA takes about three times longer than albuterol to start working. For this reason, it is not recommended for use as a rescue inhaler.

What are the possible side effects of Atrovent HFA?

In the 12-week placebo-controlled clinical trials of Atrovent HFA, the most common adverse reactions were bronchitis, COPD exacerbation, dyspnea (difficulty or labored breathing), and headache. This is not an exhaustive list of all potential side effects of Atrovent HFA. Talk to your healthcare provider or pharmacist for further information. If you experience extreme breathlessness right after taking Atrovent HFA, stop taking it and seek medical help immediately. A small number of people have difficulty urinating while taking Atrovent HFA, especially men with enlarged prostates.

Things to know about Atrovent HFA

Anticholinergics like Atrovent HFA may interact additively with concomitantly used anticholinergic medications. It’s important to avoid administration of Atrovent HFA with other anticholinergic-containing drugs.

If Atrovent HFA is accidentally sprayed in the eyes, it can cause a serious eye condition called narrow-angle glaucoma. For people who already have narrow-angle glaucoma, it can cause this condition to get worse. Spraying Atrovent HFA in the eyes can also cause symptoms such as, eye pain and discomfort, blurry vision and dilated pupils.

It’s important to consult your health care provider immediately if any of the medicine gets into your eyes.

Dosing information

The typical starting dose of Atrovent HFA is two inhalations four times per day. Healthcare providers may advise some patients that they can take more inhalations during the day if needed to relieve symptoms. However, you should never take more than 12 inhalations in a 24-hour period. Atrovent HFA does not require shaking prior to administration. Before using Atrovent HFA for the first time, the inhaler should be primed (or actuated) by releasing 2 test sprays into the air, away from the face. In cases where the inhaler has not been used for more than 3 days, prime the inhaler again by releasing 2 test sprays into the air, away from the face.
For more information, read the full prescribing information of Atrovent HFA.

How to use your new inhaler

Important Safety Information

Do not use ATROVENT HFA (ipratropium bromide HFA) if you are allergic to ipratropium or any of the ingredients in ATROVENT HFA or to atropine or similar drugs.

ATROVENT HFA is not a rescue medicine and should not be used for treating sudden breathing problems. Your doctor may give you other medicine to use for sudden breathing problems.

Allergic reactions may occur, including itching, swelling of the face, lips, tongue, or throat (involving difficulty in breathing or swallowing), rash, hives, bronchospasm (airway narrowing), or anaphylaxis. Some of these may be serious. If you experience any of these symptoms, stop taking ATROVENT HFA at once and call your doctor or get emergency help.

ATROVENT HFA can cause the narrowing of the airways to get worse (paradoxical bronchospasm) which may be life threatening. If this happens, stop taking ATROVENT HFA at once and call your doctor or get emergency help.

ATROVENT HFA may increase eye pressure which may cause or worsen some types of glaucoma.

Do not get the spray into your eyes. The spray may cause eye pain or discomfort, blurred vision, enlarged pupils, seeing halos or colored images along with red eyes. If you have any of these symptoms, stop taking ATROVENT HFA and call your doctor right away.

Dizziness and blurred vision may occur with ATROVENT HFA. Should you experience these symptoms, use caution when engaging in activities such as driving a car or operating appliances or machinery.

ATROVENT HFA may cause difficulty with urination. Symptoms may include difficulty passing urine and/or painful urination. If you have any of these symptoms, stop taking ATROVENT HFA and call your doctor right away.

The most common side effects reported with use of ATROVENT HFA were bronchitis, COPD flare‑up (exacerbation), shortness of breath and headache.

Tell your doctor about all medicines you are taking, including eye drops. Ask your doctor if you are taking any anticholinergic medicines because taking them together with ATROVENT HFA can increase side effects.

INDICATION FOR USE

ATROVENT HFA (ipratropium bromide HFA) Inhalation Aerosol is a prescription maintenance treatment for bronchospasm (airway narrowing) in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1‑800‑FDA‑1088.

Please see full Prescribing Information including Instructions for Use.

The information provided on this site is for general information and educational purposes only. You should always consult a doctor for diagnosing and treating a health or fitness problem, and before using any drug product discussed on this site.

This medicine usually comes with patient instructions. Read them carefully before using the medicine. If you do not understand the directions or you are not sure how to use the inhaler, ask your doctor to show you how to use it.

Use this medicine only as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. Also, do not stop using this medicine without telling your doctor. To do so may cause your lung condition to become worse.

Keep the spray or solution away from the eyes. This medicine may cause eye pain or discomfort, irritation, blurred vision, or start seeing halos or odd colors when you look at things. Closing your eyes while you are inhaling ipratropium may keep the medicine from getting into your eyes. If it does come into contact with your eyes, check with your doctor right away.

If you are taking this medicine every day to help control your symptoms, it must be taken at regularly spaced times as ordered by your doctor.

For patients using ipratropium inhalation aerosol:

  • If you do not understand the directions or you are not sure how to use the inhaler, ask your doctor to show you how to use it. Also, ask your doctor to check regularly how you use the inhaler to make sure you are using it properly.
  • There are two formulas of the inhaled aerosol. One contains chlorofluorocarbons and the other contains HFA as the propellant. The taste and inhalation of these may seem different, but the safety and effectiveness of both formulas are similar.
  • The ipratropium aerosol canister provides about 200 inhalations, depending on the size of the canister your doctor ordered. You should try to keep a record of the number of inhalations you use so you will know when the canister is almost empty. This canister, unlike some other aerosol canisters, cannot be floated in water to test its fullness.
  • When you use the inhaler for the first time, or if you have not used it for a while, the inhaler may not give the right amount of medicine with the first puff. Therefore, before using the inhaler, test or prime it.
  • To test or prime the inhaler:
    • Insert the canister firmly into the clean mouthpiece according to the manufacturer’s instructions. Check to make sure it is placed properly into the mouthpiece.
    • Take the cap off the mouthpiece and shake the inhaler three or four times.
    • Hold the inhaler away from you at arm’s length and press the top of the canister, spraying the medicine two times into the air. The inhaler will now be ready to give the right amount of medicine when you use it.
    • If the inhaler is not used for more than 3 days, prime the inhaler two times to prepare it for use.
  • To use the inhaler:
    • Using your thumb and one or two fingers, hold the inhaler upright, with the mouthpiece end down and pointing toward you.
    • Take the cap off the mouthpiece. Check the mouthpiece to make sure it is clear. Then, gently shake the inhaler three or four times.
    • Breathe out slowly to the end of a normal breath.
    • Use the inhalation method recommended by your doctor:
      • Open-mouth method—Place the mouthpiece about 1 or 2 inches (2 finger-widths) in front of your widely opened mouth. Make sure the inhaler is aimed into your mouth so the spray does not hit the roof of your mouth or your tongue.
      • Closed-mouth method—Place the mouthpiece in your mouth between your teeth and over your tongue with your lips closed tightly around it. Make sure your tongue or teeth are not blocking the opening.
    • Start to breathe in slowly and deeply through your mouth. At the same time, press the top of the canister once to get one puff of medicine. Continue to breathe in slowly for 5 to 10 seconds. Count the seconds while breathing in. It is important to press the canister and breathe in slowly at the same time so the medicine gets into your lungs. This step may be difficult at first. If you are using the closed-mouth method and you see a fine mist coming from your mouth or nose, the inhaler is not being used correctly.
    • Hold your breath as long as you can up to 10 seconds. This gives the medicine time to settle into your airways and lungs.
    • Take the mouthpiece away from your mouth and breathe out slowly.
    • If your doctor has told you to inhale more than one puff of medicine at each dose, gently shake the inhaler again, and take the second puff following exactly the same steps you used for the first puff. Press the canister one time for each puff of medicine.
    • When you are finished, wipe off the mouthpiece and replace the cap.
  • Your doctor may want you to use a spacer device or holding chamber with the inhaler. A spacer helps get the medicine into the lungs and reduces the amount of medicine that stays in your mouth and throat.
    • To use a spacer device with the inhaler:
      • Attach the spacer to the inhaler according to the manufacturer’s directions. There are different types of spacers available, but the method of breathing remains the same with most spacers.
      • Gently shake the inhaler and spacer three or four times.
      • Hold the mouthpiece of the spacer away from your mouth and breathe out slowly to the end of a normal breath.
      • Place the mouthpiece into your mouth between your teeth and over your tongue with your lips closed around it.
      • Press the top of the canister once to release one puff of medicine into the spacer. Within 1 or 2 seconds, start to breathe in slowly and deeply through your mouth for 5 to 10 seconds. Count the seconds while inhaling. Do not breathe in through your nose.
      • Hold your breath as long as you can up to 10 seconds.
      • Take the mouthpiece away from your mouth and breathe out slowly.
      • If your doctor has told you to take more than one puff of medicine at each dose, gently shake the inhaler and spacer again and take the next puff, following exactly the same steps you used for the first puff. Do not put more than one puff of medicine into the spacer at a time.
      • When you are finished, remove the spacer device from the inhaler and replace the cap.
  • The mouthpiece has a dose indicator window that shows how much medicine is left. When the dose indicator window displays “40” or changes from green to red color background, this means that you need to refill your prescription or ask your doctor if you need another prescription of this medicine.
  • Clean the inhaler, mouthpiece, and spacer at least once a week.
    • To clean the inhaler:
      • Remove the canister from the inhaler and set aside.
      • Wash the mouthpiece, cap, and the spacer with warm, soapy water. Then, rinse well with warm, running water.
      • Shake off the excess water and let the inhaler parts air dry completely before putting the inhaler back together.

For patients using the inhalation solution:

  • Use this medicine only in a power-operated nebulizer with an adequate flow rate and equipped with a face mask or mouthpiece. Your doctor will tell you which nebulizer to use. Make sure you understand exactly how to use it. If you have any questions about this, check with your doctor.
  • To prepare the medicine for use in the nebulizer:
    • If you are using the single-dose vial of ipratropium:
      • Break away one vial by pulling it firmly from the strip.
      • Twist off the top to open the vial. Use the contents of the vial as soon as possible after opening it.
      • Squeeze the contents of the vial into the cup of the nebulizer. If your doctor has told you to use less than a full vial of solution, use a syringe to withdraw the correct amount of solution from the vial and add it to the nebulizer cup. Be sure to throw away the syringe after one use.
    • If you are using the multiple-dose bottle of ipratropium:
      • Use a syringe to withdraw the correct amount of solution from the bottle and add it to the nebulizer cup. Do not use the same syringe more than once.
  • If you have been told to dilute the ipratropium inhalation solution in the nebulizer cup with the sodium chloride solution provided, use a new syringe to add the sodium chloride solution to the cup as directed by your doctor.
  • If your doctor told you to use another inhalation solution with the ipratropium inhalation solution, add that solution also to the nebulizer cup.
  • To use the nebulizer:
    • Gently shake the nebulizer cup to mix the solutions well.
    • Connect the nebulizer tube to the air or oxygen pump and begin the treatment. Adjust the mask, if you are using one, to prevent mist from getting into your eyes.
    • Use the method of breathing your doctor told you to use to take the treatment. One way is to breathe slowly and deeply through the mask or mouthpiece. Another way is to breathe in and out normally with the mouthpiece in your mouth, taking a deep breath every 1 or 2 minutes. Continue to breathe in the medicine as instructed until no more mist is formed in the nebulizer cup or until you hear a sputtering (spitting or popping) sound.
    • When you have finished, replace the caps on the solutions. Store the bottles of solution in the refrigerator until the next treatment.
    • Clean the nebulizer according to the manufacturer’s directions.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Atrovent Inhalation Solution

Generic Name: Atrovent Inhalation Solution
Product Name: ipratropium bromide

Indication: What Atrovent Inhalation Solution is used for

Atrovent Inhalation Solution is used to treat:

  • Asthma;
  • Chronic obstructive bronchitis;
  • People who have difficulty breathing during or after surgery using assisted ventilation.

Ask your doctor if you have any questions about why Atrovent Inhalation Solution has been prescribed for you. Your doctor may have prescribed Atrovent Inhalation Solution for another reason.

There is no evidence that Atrovent Inhalation Solution is addictive.

Atrovent Inhalation Solution is available only with a doctor’s prescription.

Action: How Atrovent Inhalation Solution works

Atrovent Inhalation Solution contains the active ingredient ipratropium bromide. It belongs to a group of medicines called anticholinergic bronchodilators.

Atrovent Inhalation Solution opens up the air passages in people suffering from asthma, chronic bronchitis and difficulty breathing during or after surgery. It begins to act quickly after use but may take up to 2 hours to give maximum benefit.

It appears to inhibit vagally mediated reflexes by antagonising the action of acetylcholine, the transmitter agent released from the vagal nerve. Anticholinergics prevent the increase in intracellular calcium concentration caused by the interaction of acetylcholine with the muscarinic receptor on bronchial smooth muscle. It has no deleterious effect on airway mucous secretion or mucociliary clearance.

Each mL of Atrovent Inhalation Solution contains 261 micrograms of ipratropium bromide (equivalent to 250 micrograms of ipratropium bromide anhydrous) as the active ingredient.

It also contains sodium chloride, benzalkonium chloride, disodium edetate, hydrochloric acid, and purified water.

Atrovent Inhalation Solution does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.

Dose advice: How to use Atrovent Inhalation Solution

Before you use Atrovent Inhalation Solution

When you must not use it

Do not use Atrovent Inhalation Solution if you have an allergy to:

  • Ipratropium bromide;
  • Similar medicines which contain atropine or medicines like atropine;
  • Any of the ingredients listed here;
  • Any other anticholinergic medicines.

Some of the symptoms of an allergic reaction may include:

  • Shortness of breath, wheezing or troubled breathing;
  • Swelling of the face, lips, tongue or other parts of the body;
  • Rash, itching or hives on the skin.

Do not use Atrovent Inhalation Solution after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start using Atrovent Inhalation Solution, contact your doctor or pharmacist.

Before you start to use it

Tell your doctor or pharmacist if you have allergies to any other medicines, foods, preservatives or dyes.

Tell your doctor or pharmacist if you are pregnant or intend to become pregnant. Your doctor or pharmacist will discuss the possible risks and benefits of using Atrovent Inhalation Solution during pregnancy.

Tell your doctor or pharmacist if you are breastfeeding or plan to breastfeed. Your doctor or pharmacist will discuss the possible risks and benefits of using Atrovent Inhalation Solution during breastfeeding.

Tell your doctor or pharmacist if you have or have had any of the following medical conditions:

  • Glaucoma (high pressure in the eye);
  • Difficulty or pain when passing urine;
  • Constipation;
  • Cystic fibrosis;
  • Hyper-reactive airways.

If you have not told your doctor or pharmacist about any of the above, tell them before you start using Atrovent Inhalation Solution.

Using other medicines

Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and Atrovent Inhalation Solution may interfere with each other. These include:

  • Medicines used to treat heart problems such as adrenaline;
  • Medicines used to treat asthma or a lung condition called chronic obstructive pulmonary diseases (COPD) such as theophylline, salbutamol or tiotropium;
  • Other nebuliser solutions such as disodium cromoglycate that contain the preservative benzalkonium chloride.

This is because some nebuliser solutions may not mix well with Atrovent Inhalation Solution and may need to be nebulised separately.

These medicines may be affected by Atrovent Inhalation Solution or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.

Your doctor may prescribe Atrovent Inhalation Solution with other medicines that relax the air passages for additional symptom relief.

Check with your doctor or pharmacist before mixing other nebuliser solutions with Atrovent Inhalation Solution. Some nebulised medicines may not mix well with Atrovent Inhalation Solution and may need to be nebulised separately.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while using Atrovent Inhalation Solution.

How to use Atrovent Inhalation Solution

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained here.

Atrovent Inhalation Solution is intended for inhalation with suitable nebulising equipment and must not be swallowed.

Diluted solutions should be freshly prepared before use.

At the end of inhalation, the leftover solution from the nebuliser bowl should be discarded.

Atrovent Inhalation Solution should not be used if the bottle has been opened for more than 28 days. After this period, a new Atrovent Inhalation Solution bottle should be used.

Take the following steps in using Atrovent Inhalation Solution and if you have any problems, ask your doctor or pharmacist for assistance.

  • Get your nebuliser ready by following the manufacturer’s instructions and the advice of your doctor;
  • Place the prescribed number of drops into the nebuliser bowl. The dropper insert on top of the bottle delivers 1 mL of Atrovent Inhalation Solution per 20 drops. Each 1 mL of Atrovent Inhalation Solution contains 261 micrograms of ipratropium bromide . To make the dropper function, tap lightly on the bottom of the bottle;
  • If dilution is necessary this should be carried out using normal saline and as instructed by your doctor;
  • Assemble the nebuliser and use it as directed by your doctor;
  • After nebulisation follow the manufacturer’s instructions about cleaning your nebuliser.

If you are not sure how to use a nebuliser mask, or do not understand the instructions on the box, ask your doctor or pharmacist for help.

Children should only use Atrovent Inhalation Solution on medical advice and with the help of an adult. Fit the nebuliser mask to your or your child’s nose and mouth before nebulising and inhaling Atrovent Inhalation Solution to prevent the mist from contacting the eyes. Should the mist contact the eyes, immediately flush your eyes with cold tap water for several minutes.

If you find it difficult to breathe in and use your nebulising mask at the same time, talk to your doctor or pharmacist. They may be able to recommend another method.

How much to use

The usual doses for adults and children are stated below.

Adults

1 to 2 mL diluted to 2-3 mL with normal saline and nebulised until the entire volume of solution is inhaled, 4 times daily.

Children

1 mL diluted to 2-3 mL with normal saline and nebulised until the entire volume of solution is inhaled, 4 times daily.

Depending on your condition and specific needs, your doctor may advise you to take a different dose.

When to use it

If your doctor has advised you to use Atrovent Inhalation Solution regularly, then use your medicine at about the same time each day. Using it at the same time each day will have the best effect. It will also help you remember when to use it.

If you forget to use it

If it is almost time for your next dose, skip the dose you missed and have your next dose when you are meant to. Otherwise, use it as soon as you remember, and then go back to using your medicine as you would normally.

Do not use a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.

If you are not sure what to do, ask your doctor or pharmacist. If you have trouble remembering to use your medicine, ask your pharmacist for some hints.

How long to use it

Continue using Atrovent Inhalation Solution for as long as your doctor tells you. Atrovent Inhalation Solution helps control your condition but does not cure it. It is important to keep using it even if you feel well.

If you take too much (overdose)

Immediately telephone your doctor or pharmacist or the Poisons Information Centre (telephone 13 11 26) for advice or go to Emergency at the nearest hospital, if you think that you or anyone else may have used too much Atrovent Inhalation Solution. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

Symptoms of an overdose may include:

  • Fast or irregular heartbeat;
  • Dry mouth;
  • Blurred vision.

While you are using Atrovent Inhalation Solution

Things you must do

Stop using Atrovent Inhalation Solution and tell your doctor immediately if you get sudden tightness of the chest, coughing, wheezing or breathlessness immediately after using Atrovent Inhalation Solution. These may be signs of a condition called bronchospasm.

If you have an Asthma Action Plan that you have agreed with your doctor, follow it closely at all times.

If you find that the usual dose of Atrovent Inhalation Solution is not giving as much relief as before, or you need to use it more often, contact your doctor so that your condition can be checked. This is important to ensure your breathing problem is controlled properly.

Continue using Atrovent Inhalation Solution for as long as your doctor or pharmacist tells you.

Keep all your doctor’s appointments so that your progress can be checked.

Contact your doctor immediately if your breathing suddenly becomes more difficult after using Atrovent Inhalation Solution. This may be a sign of an allergic reaction.

Contact your doctor immediately if you experience irritation or a feeling of having something in the eye, or any disturbances with your sight (blurred vision, visual halos or coloured images) together with red eyes, during or after using Atrovent Inhalation Solution. This may mean that you have developed a serious eye condition called narrow-angle glaucoma. This can happen if the solution gets in your eyes.

Tell any other doctors, dentists, and pharmacists who are treating you that you are using Atrovent Inhalation Solution.

If you are about to start any new medicine, tell your doctor or pharmacist that you are using Atrovent Inhalation Solution.

If you plan to have surgery, tell the surgeon or anaesthetist that you are using Atrovent Inhalation Solution. It may affect other medicines during surgery.

If you become pregnant while using Atrovent Inhalation Solution tell your doctor or pharmacist immediately.

Things you must not do

Do not take any other medicines for your breathing problems without checking with your doctor.

Do not give Atrovent Inhalation Solution to anyone else, even if they have the same condition as you.

Do not use Atrovent Inhalation Solution to treat any other complaints unless your doctor or pharmacist tells you to.

Do not stop using Atrovent Inhalation Solution or lower the dosage, without checking with your doctor or pharmacist.

Do not allow the Atrovent Inhalation Solution to enter the eyes.

Things to be careful of

Be careful driving or operating machinery until you know how Atrovent Inhalation Solution affects you. Atrovent Inhalation Solution may cause dizziness and blurred vision in some people. If you have any of these symptoms, do not drive, operate machinery or do anything else that could be dangerous. Children should be careful when performing physical activities.

After using Atrovent Inhalation Solution

Storage

Keep your Atrovent Inhalation Solution in a cool, dry place where the temperature stays below 30°C. Discard unused contents 28 days after opening.

Do not store Atrovent Inhalation Solution or any other medicine in the bathroom or near a sink. Do not leave it in the car on hot days or on window sills. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop using Atrovent Inhalation Solution or it has passed its expiry date, ask your pharmacist what to do with any medicine that is left over.

Schedule of Atrovent Inhalation Solution

Atrovent Inhalation Solution is an S4 – prescription only medicine.

Side effects of Atrovent Inhalation Solution

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using Atrovent Inhalation Solution. This medicine helps most people with asthma or chronic obstructive bronchitis, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Do not be alarmed by the following list of possible side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

If you get any side effects, do not stop using the Atrovent Inhalation Solution without first talking to your doctor or pharmacist.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

These are the more common side effects of Atrovent Inhalation Solution. Usually, they are mild and short-lived.

Tell your doctor as soon as possible if you experience difficulty passing urine. This is a serious side effect that may require medical attention.

If any of the following happen, tell your doctor immediately or go to Emergency at the nearest hospital:

  • Difficulty breathing or worsening of your breathing problems;
  • Swelling of the throat;
  • Fast or irregular heartbeat, also called palpitations;
  • Pounding heartbeat;
  • Allergic reaction (shortness of breath, wheezing or troubled breathing; swelling of the face, lips, tongue or other parts of the body, rash, itching or hives on the skin);
  • Irritation or a feeling of having something in the eye, red eyes, dilated pupils, blurred vision, visual halos or coloured images.

The above list includes very serious side effects. You may need urgent medical attention or hospitalisation.

Tell your doctor or pharmacist if you notice anything else that is making you feel unwell. Other side effects not listed above may occur in some people.

For further information talk to your doctor.

  1. Atrovent Inhalation Solution Consumer Medicine Information (CMI). St Leonards, NSW: Boehringer Ingelheim Pty Limited. November 2015.
  2. Atrovent Inhalation Solution Product Information (PI). St Leonards, NSW: Boehringer Ingelheim Pty Limited. October 2015.

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