IPRATROPIUM bromide metered dose inhaler

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    Last updated: June 2023


    Prescription under medical supervision


    Therapeutic action

    • 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

    Administration technique

    • 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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