Anticholinergic bronchodilator

⚠️ PCP: Requires BCEHS-specific education

Severe bronchospasm in asthma and chronic obstructive pulmonary disease

• Known hypersensitivity to ipratropium or any formulation components

Inhaled:

• Onset: 3-15 minutes
• Peak: 1.5-2 hours
• Duration: 6 hours

• Adverse effects are similar to other anticholinergics and can include atrial arrhythmias and blurred vision
• Coughing is common
• Although not common, be aware that paradoxical bronchospasm can occur during the use of inhaled bronchodilators (this is not the same thing as an inadequate response to treatment). It typically occurs upon the initial use of the medication.

Very high doses of ipratropium (up to 1.2 mg) have been given to volunteers without the development of serious systemic side effects.

• Ipratropium is intended to act synergistically with salbutamol as part of a management plan for bronchospasm. It is not indicated for episodes of acute bronchospasm as monotherapy.
• Use with caution in patients with narrow- angle glaucoma, as it may increase intraocular pressure
• Use with caution in patients with prostatic hyperplasia or bladder neck obstruction as it may cause urinary retention