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Last updated: June 2023
Prescription under medical supervision
- Bronchodilator, anticholinergic drug
- Severe asthma attack, in combination with salbutamol
Forms and strengths
- Solution for inhalation in pressurised metered dose inhaler, delivering 20 micrograms of ipratropium/puff
Dosage and duration
- Child and adult: 4 to 8 puffs (80 to 160 micrograms) every 20 minutes for the first hour
- Shake the inhaler. Remove the mouthpiece cover.
- Inhale and breathe out as completely as possible. Place the lips tightly around the mouthpiece. Inhale deeply while activating the inhaler. Hold breath 10 seconds before exhaling.
- Hand-breath co-ordination is very difficult in children under 6 years, older patients and patients with severe dyspnoea. Use a spacer to facilitate administration and improve the efficacy of treatment.
Contra-indications, adverse effects, precautions
- May cause:
- throat irritation, headache, cough, vomiting;
- anticholinergic effects: dryness of the mouth, constipation, dilation of the pupils, blurred vision, urinary retention, tachycardia.
- Administer with caution to older patients and patients with closed-angle glaucoma, urethroprostatic disorders, urinary retention.
- Avoid or monitor combination with drugs known to have anticholinergic effects: tricyclic antidepressants (e.g. amitriptyline), first generation H-1 antihistamines (e.g. hydroxyzine, promethazine), biperiden, antispasmodics (e.g. atropine, hyoscine butylbromide), antipsychotics (e.g. chlorpromazine, haloperidol), etc. (increased risk of adverse effects).
- Pregnancy: no contra-indication
- Breast-feeding: no contra-indication
- In severe asthma attack, preferably administer the treatment by nebulisation.
- Clean the mouthpiece before and after each use.
- Do not pierce or incinerate used aerosol containers (risk of explosion).
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